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Section 1: The Emotional Reality & Your Motivation
When you think about the possibility of needing long-term care (in-home care, assisted living, or a nursing home), what is your greatest fear?
Becoming a burden on my children or family
Losing my independence and being forced into a facility I did not choose
Having my life savings wiped out to pay for care
Leaving my spouse impoverished and unable to afford their own life
I have not really thought about it
What is your primary motivation for completing this assessment today? (Select all that apply)
I want to make sure my spouse is financially protected if I get sick
I want to protect the assets I have built so I can leave an inheritance to my children
I recently saw a friend or family member go through this and want to be prepared
I or my spouse recently received a diagnosis and we need a plan now
I just want peace of mind knowing we have a plan in place
CHECKPOINT: How confident are you that you understand the difference between what Medicare covers and what Medicaid covers?
1 - Not confident at all
2
3
4
5 - Extremely confident
Section 2: Baseline Data & The Crisis vs. Planning Timeline
What's your birthday?
What is your marital status?
What's your spouse's birthday?
What state do you currently live in? Medicaid is a joint federal-state program. While the federal government sets the baseline rules, each state administers its own program with specific asset limits, income caps, and home equity exemptions.
Which best describes your current timeline for needing long-term care?
Proactive Planning - We are healthy and just planning for the future - 5+ years out
Early Warning - We have some health concerns but no immediate need for daily care - 1-4 years out
Pending Need - We will likely need in-home care or assisted living within the next 12 months
Crisis Mode - I or my spouse need nursing home care right now
Section 3: The Financial Picture (Countable vs. Exempt Assets)
Do you have a family history of conditions that commonly require long-term care (Alzheimer's, dementia, Parkinson's, stroke, ALS)?
Yes - one or both parents needed long-term care
Yes - other close relatives such as siblings or grandparents
No significant family history
Not sure
How long do you expect to need care if it becomes necessary? The average nursing home stay is 2.5 years, but patients with dementia or Alzheimer's average 4–8 years. At $10,000/month, the difference between a 2-year stay ($240,000) and a 6-year stay ($720,000) is the difference between manageable and catastrophic.
Less than 1 year - short-term recovery
1-3 years
3-5 years
5+ years - e.g. progressive cognitive decline
I have no idea
If you needed daily assistance, what would be your preferred care setting?
Stay in my own home with in-home caregivers
Move to an Assisted Living community
I would accept a Nursing Home or Skilled Nursing Facility if needed
I would want to live with a family member
I have not thought about it
Are you aware that Medicaid primarily covers nursing home care, and that coverage for in-home care or assisted living is limited and varies significantly by state?
Yes - I understand the limitations
No - I assumed Medicaid would cover whatever type of care I needed
Do you believe Medicare will cover long-term nursing home care if you need it? This is the single most common misconception in retirement planning. Medicare does NOT cover long-term custodial care — it only covers short-term rehabilitation (up to 100 days) after a qualifying hospital stay. Once that runs out, you are paying out of pocket unless you qualify for Medicaid.
Yes - I thought Medicare covers nursing homes
I know Medicare only covers short-term rehab stays - up to 100 days - not long-term custodial care
Not sure what the difference is
Section 4: The Financial Picture (Countable vs. Exempt Assets)
Medicaid divides your assets into two categories: "Exempt" (things they generally don't count, like your primary home and one car) and "Countable" (things they expect you to spend down to $2,000 before they will pay for care).
Do you own your primary residence?
Yes - owned free and clear
Yes - but with a mortgage
No - I rent or live with family
What is the approximate equity (current value minus mortgage balance) in your primary residence? Federal Medicaid rules protect your primary home up to a specific equity limit, which varies by state between $713,000 and $1,071,000. Equity above that limit is considered a countable asset.
Less than $713,000
Between $713,000 and $1,071,000
More than $1,071,000
Not applicable - I do not own a home
Excluding your primary home and one vehicle, what is the approximate total value of your "Countable Assets"? This includes checking/savings, brokerage accounts, CDs, mutual funds, second homes, and in most states, your IRAs and 401ks.
What is your approximate MONTHLY household income from guaranteed sources (Social Security, pensions, annuities)? Many states have a strict "Income Cap" — currently around $2,829/month for an individual. If your income exceeds this amount, you cannot qualify for Medicaid unless you establish a specific legal tool called a Qualified Income Trust (or Miller Trust).
Less than $2,829 per month
$2,829 - $5,000 per month
$5,000 - $8,000 per month
More than $8,000 per month
Does the healthy spouse have their own separate income (Social Security, pension, or employment income)? If the healthy spouse has no independent income and the sick spouse enters a facility, the Minimum Monthly Maintenance Needs Allowance (MMMNA) rules determine how much of the sick spouse's income the healthy spouse can keep. If the healthy spouse has zero income of their own, this becomes a critical planning issue.
Yes - my spouse has their own income sources
No - my spouse depends entirely on my income
Not applicable - Not married
Section 5: The 5-Year Look-Back & Penalty Risks
Have you gifted, transferred, or sold any assets for less than fair market value to anyone (including children or a trust) within the last 5 years? Why we ask: Medicaid will review every financial transaction you've made for the 5 years prior to your application. Any gifts or transfers — even innocent ones — will trigger a "Penalty Period" during which Medicaid will refuse to pay for your care.
Yes - significant amounts - e.g. deeded a house or transferred large cash sums
Yes - smaller amounts - e.g. helping with grandchildren tuition or holiday gifts
No - I have not made any transfers
Not sure
Are you currently paying a family member to provide care for you or your spouse? Why we ask: Paying a family member informally is viewed by Medicaid as a "gift" and will trigger a penalty period. A formal Personal Care Agreement makes it a legitimate, Medicaid-compliant expense.
Yes - under a formal written Personal Care Agreement drafted by an attorney
Yes - but informally - we just write them a check or give them cash
No
Checkpoint: How concerned are you about the 5-year look-back period affecting your ability to qualify for care?
1 - Not concerned at all
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3
4
5 - Extremely concerned
Section 6: Spousal Protections & Estate Recovery
Are you aware of the "Spousal Impoverishment Rules" that allow the healthy spouse (the "Community Spouse") to keep a portion of the couple's assets and income while Medicaid pays for the sick spouse?
Yes - I know exactly how much my spouse would be allowed to keep
I have heard of it but do not know the limits
No - I thought we had to spend down everything before Medicaid would help
Not applicable - Not married
If one of you needed nursing home care tomorrow at $10,000/month, how would it impact the healthy spouse's standard of living?
We have long-term care insurance to cover it
We have enough assets to pay out of pocket without changing the healthy spouses lifestyle
It would severely reduce the healthy spouses standard of living
It would completely bankrupt the healthy spouse
Not applicable - Not married
Are you aware of "Medicaid Estate Recovery"?
Yes - I know that after I die the state can force the sale of my home to recover what they spent on my care
No - I thought my home was completely protected and would pass to my children
Section 7: Current Legal & Planning Defenses
Do you currently have a Long-Term Care Insurance policy?
Yes - a traditional policy
Yes - a hybrid life insurance and LTC policy
No - I applied but was denied
No - it was too expensive
No - I never looked into it
Do you currently have an Irrevocable Medicaid Asset Protection Trust?
Yes - and it was funded more than 5 years ago
Yes - but it was funded less than 5 years ago
I have a Revocable Living Trust which does not protect assets from Medicaid
I only have a Will or no estate planning documents
Not sure what kind of trust I have
Do you have a Durable Financial Power of Attorney that specifically includes "Medicaid Planning Powers" (the legal authority for your agent to create trusts or transfer assets on your behalf if you are incapacitated)?
Yes - my attorney specifically included those powers
I have a POA but I do not know if it includes those specific powers
No - I do not have a POA
Are you (or your spouse) a wartime Veteran? Wartime veterans and their surviving spouses may be eligible for the VA Aid & Attendance pension, which provides tax-free monthly income to help pay for care, completely separate from Medicaid.
Yes
No
CHECKPOINT: How confident are you that your current legal and financial plan will protect your assets from long-term care costs?
1 - Not confident at all
2
3
4
5 - Extremely confident
Section 8: What Have You Tried?
Have you consulted with an attorney who specializes in Medicaid or Elder Law planning?
Yes - and we have a plan in place
Yes - but we have not acted on their recommendations yet
No - but I plan to
No - I did not know this was a specialty
Have you explored the VA Aid & Attendance benefit?
Yes - I am receiving it or have applied
Yes - I looked into it but did not qualify
No - I did not know about it
Not applicable - Not a veteran or veterans spouse
Have you had a conversation with your financial advisor specifically about long-term care risk and Medicaid planning?
Yes - and they helped me build a plan
Yes - but they did not offer specific Medicaid strategies
No - we have never discussed it
Section 9: Integration with Your Broader Plan
Does your current estate plan (Will, Trust, POA) include specific provisions for what happens if you or your spouse need long-term care?
Yes - our estate plan was designed with Medicaid in mind
Not sure - I would have to check with my attorney
No - our estate plan only addresses what happens when we die not if we get sick
Have you discussed with your family how long-term care decisions would be made and paid for?
Yes - we have had an open conversation and everyone knows the plan
Somewhat - we have mentioned it but do not have a clear plan
No - we have never discussed it
Your Next Step
Would you like our team to prepare a personalized Medicaid Eligibility & Asset Protection Analysis based on your specific financial numbers? If yes, we'll send a brief secure intake form to collect the exact figures needed to determine your eligibility timeline and protection options.
Yes - I would like a personalized protection analysis
No - the educational report is enough for now
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This assessment is designed to provide educational information. It is intended to serve as a framework for discussion with a qualified professional and is not a substitute for professional advice.
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Any projections, estimates, formulas, statistics, or calculations shown are hypothetical in nature and are based on the information you provided, along with standardized assumptions. Actual results will vary. Past performance of investments is not indicative of future results. This assessment is based on national averages and may not reflect your particular situation, therefore it does not recommend any specific insurance product, financial institution or product, plan, or provider.
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The information contained in this assessment does not constitute financial, investment, tax, or legal advice. Scores, calculations, and findings are educational approximations based on the information you provided. Your actual situation may differ materially from any estimates shown. You should consult with a licensed professional before making any decisions.
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Content in this assessment may have been generated in whole or in part by artificial intelligence (AI) systems. While AI can provide valuable educational insights, these systems can make mistakes or produce inaccurate information. The information presented should be used as a starting point for your planning discussions, not as definitive advice. Before taking any actions, consult with qualified professionals who can evaluate your specific situation.
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The Retirement Institute has not acted as your legal, financial, or fiduciary advisor in the preparation of this report.
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