The costs most families do not see coming
Long-term care in New Jersey is expensive, and the cost is not hiding — it is just not talked about. Assisted living in Bergen County runs somewhere north of $6,000 a month. A private room in a skilled nursing facility can exceed $14,000. Memory care — the level of service most dementia patients eventually need — runs between the two. These numbers climb every year, and they are not covered by the insurance most people think they have.
Medicare does not pay for long-term custodial care. It covers limited skilled nursing after a qualifying hospital stay, and that coverage runs out in weeks, not years. Medicaid covers long-term care, but only after the applicant has spent down most of their assets. The space between those two programs — the years of care that a parent needs but cannot afford to pay for and is not yet broke enough to qualify for — is where families get stuck.
The planning question is not just whether the parent has enough money. It is whether the family has a plan for the gap, and whether that plan protects the adult child's own retirement at the same time.
Elder care planning is one of the hardest conversations in the broader personal financial planning work we do with families across Northern New Jersey. It touches two generations and two balance sheets at the same time.
Planning for two generations at once
The hardest part of elder care planning is that it touches two financial plans at the same time. The parent's resources have to be inventoried — Social Security, pension, savings, home equity, existing insurance. The adult child's situation has to be honest — can you contribute financially, and for how long, without derailing your own retirement?
Most families skip this conversation because it feels like an accusation. It is not. It is a planning exercise. A parent with a pension, a paid-off house, and $200,000 in savings is in a very different position than a parent with Social Security alone. An adult child with a solid retirement fund and a working spouse has more capacity than a single earner with two kids in college.
We bring both pictures into the same room and build a plan that works for the family, not just the parent. Sometimes that plan includes selling the house, applying for Medicaid, or purchasing a short-term care policy. Sometimes it includes the adult child adjusting their own savings rate for a few years. The honest answer is almost always a combination.
Medicaid, spend-down, and the planning window
Medicaid planning is legitimate, legal, and time-sensitive. New Jersey has a five-year look-back period for asset transfers, which means gifts or transfers made within five years of a Medicaid application can trigger a penalty period during which Medicaid will not pay for care. That five-year clock is the planning window.
For families who start early, there are legal strategies to protect some assets — certain trusts, spousal protections, exempt assets like a primary residence up to a value threshold. For families who start late, the options narrow. We coordinate with elder law attorneys on the legal side and handle the financial modeling — how long the parent's money lasts, when Medicaid becomes necessary, and what the family needs to do before that date arrives.
We are not elder law attorneys. We do not draft Medicaid applications or trust documents. What we do is build the financial timeline that tells you when to call the attorney and what to bring to the meeting.
The insurance side of this conversation — long-term care policies, what they cover, what they cost — connects to the independent insurance guidance we provide without selling any coverage.
“The conversation about a parent's care is never easy. Having the numbers in front of you does not make it easier — but it makes the decisions clearer.”
What working with us looks like
First meeting — both pictures on the table
We sit down with you — and with your parent, when appropriate. We inventory the parent's resources, estimate the monthly care cost range, and look at how long the money lasts under different scenarios. We also review your own plan to understand how much capacity exists. Bring Social Security statements, pension documents, account balances, and any existing long-term care or life insurance policies.
Written elder care plan with a family timeline
You leave with a document that maps the parent's resources against projected care costs, names the Medicaid planning window, identifies the legal steps that need to happen and when, and shows how the plan affects your own retirement. We coordinate with an elder law attorney on the legal side and revisit the plan annually.
A note on fit
When this might not be right for you
Elder care planning is not the right fit for every family:
- Anyone looking for an elder law attorney to draft Medicaid applications or trusts. We coordinate with attorneys but do not practice law.
- Anyone whose parent is already on Medicaid and receiving care. The planning window has closed — the ongoing work belongs with the attorney and the care facility.
- Anyone who wants to hide assets from Medicaid illegally. We plan inside the rules and coordinate with counsel who does the same.
If any of those describe your situation, we will say so on the first call and point you to the right resource.
Frequently asked questions
How much does long-term care cost in New Jersey?
Assisted living in Northern NJ typically runs $6,000 to $8,000 a month. A private room in a skilled nursing facility can exceed $14,000. Memory care falls between the two. These costs rise every year, and most families underestimate them significantly.
Does Medicare pay for long-term care?
Almost never. Medicare covers limited skilled nursing after a qualifying hospital stay — typically up to 100 days, with copays after day 20. It does not cover custodial care, assisted living, or memory care. Most long-term care falls outside Medicare entirely.
What is the Medicaid look-back period in NJ?
New Jersey has a five-year look-back period. Asset transfers made within five years of a Medicaid application can trigger a penalty period during which Medicaid will not pay for care. Planning should start well before that window to preserve options.
Should I buy long-term care insurance for my parent?
It depends on the parent's age, health, and financial picture. Long-term care insurance is most affordable and most available for healthy applicants in their fifties and sixties. For a parent already in their late seventies or eighties, the premiums may be prohibitive or the application may be declined. We model the cost against self-funding before recommending a policy.
How do I plan for my parent's care without wrecking my own retirement?
By putting both financial pictures on the table at the same time. We model the parent's resources against projected care costs and then look at your own plan to see how much capacity exists. The answer is usually a combination of the parent's assets, family support, and public programs — sized so neither generation is ruined.
Do you work with elder law attorneys?
Yes. We handle the financial planning — projections, cash flow, and timeline. Elder law attorneys handle the legal work — Medicaid applications, trust drafting, and asset protection strategies. We coordinate closely and share information with your permission.