Medicaid Planning Questionnaire

Am I willing to risk all that I have accumulated through a lifetime of hard work and disciplined saving, including my home, my car and all of my liquid assets, rather than take the time to plan for the future?

Yes
No

Do I understand that the cost of planning is insignificant when compared to the cost of paying for long-term care?

Yes
No

Do I understand that the risk of my needing some form of long-term care (e.g., home care, assisted living, nursing home care) is roughly 70%?

Yes
No

Do I know what that will cost?

Yes
No

Do I know how I will pay for that care if I need it?

Yes
No

Do I know what the impact will be on my spouse and children if I spend $100,000 ± a year on long-term care?

Yes
No

Should I explore the possibility of buying long-term-care insurance?

Yes
No

Should I hope this problem never arises and ignore it?

Yes
No

Or should I take steps to try to protect my life savings now?

Yes
No

Do I understand that if I become sick, it may be impossible for my spouse or children to care for me, regardless of how much they are committed to doing so?

Yes
No

Are my wills, trusts, living wills, powers of attorney and other legal documents up to date?

Yes
No

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