If your family is starting to ask questions like, “How would we pay for assisted living?” or “What happens if one spouse needs a nursing home?”, you’re not alone.

Long-term care has become one of the biggest financial pressures facing older adults and their families. The hard part is that most people don’t plan for it until they’re already in a crisis… and by then, your options may be limited.

Here’s what the latest data shows, and the most important planning moves Indiana families can make to protect their loved ones and preserve what they’ve built.

The real cost of care in Indiana

According to Genworth & CareScout’s 2024 Cost of Care Survey (released March 2025), long-term care costs remain high, and continue trending upward.

Indiana annual median costs (2024)

• Assisted living: $64,380/year (Indiana)
  
• Nursing home (semi-private room): $101,835/year (Indiana)
  
• Nursing home (private room): $124,283/year (Indiana)
  
• Homemaker services (in-home help): $73,216/year (Indiana)
  
• Home health aide: $75,504/year (Indiana)
  

National context (why families feel squeezed)

National median costs in the same survey included:

• Assisted living: $70,800/year (up 10% YoY)
  
• Nursing home (private room): $127,750/year (up 9% YoY)
  

Takeaway: Even a “short” stay can create life-changing financial decisions, selling a home, draining retirement accounts, or scrambling to qualify for help.

Why this is an estate planning issue (not just a healthcare issue)

Many families think “estate planning” only matters after someone passes away.

But long-term care planning is just as much about protecting the living, especially:

• The spouse who remains at home
  
• Adult children trying to help without going broke themselves
  
• The legacy you want to leave (instead of spending everything down)
  

And the need is common:

• AARP-backed analysis estimates 56% of people turning 65 (2021–2025 cohort) will need long-term services and supports (LTSS) in their lifetime, and 45% will need paid LTSS.
  
• An Urban Institute brief found 70% of adults who reach 65 develop severe LTSS needs before they die, and 48% receive some paid care.
  

Long-term care risk is also closely tied to cognitive decline:

• The Alzheimer’s Association estimates 7.2 million Americans age 65+ are living with Alzheimer’s in 2025, and about 1 in 9 people 65+ has Alzheimer’s.
  
• Dementia-related health and long-term care costs are projected to reach $384 billion in 2025.
  

7 Medicaid planning moves Indiana families should know (before it’s urgent)

1) Know the “5-year lookback” rule (and why timing matters)

Medicaid eligibility isn’t just about what you own today, it can involve reviewing transfers going back 60 months (5 years).

That means gifts, below-market transfers, or certain trust moves made too late can trigger penalties and delays.

Planning insight: The earlier you plan, the more options you typically have.

2) Understand what Medicaid allows your spouse to keep (Indiana-specific)

Indiana recognizes spousal impoverishment protections so the “community spouse” (the spouse still living at home) isn’t left financially devastated.

For 2026, Indiana’s published spousal impoverishment guidance includes:

• Community spouse may keep up to $162,660 in protected resources (with a minimum also specified)
  
• The nursing home spouse is generally limited to $2,000 in non-exempt assets
  

Medicaid.gov also explains the federal spousal impoverishment framework and annual min/max protected amounts.

Planning insight: Married couples often have different planning pathways than single individuals, and mistakes can be expensive.

3) Don’t assume a will avoids probate (or prevents delays)

A will is essential, but probate can still take time, add costs, and create public court filings.

If your goal is to reduce friction for your family, the conversation often includes whether certain assets should pass outside probate (depending on your situation and goals). Learn more about our services including Estate Planning and Probate.

4) Plan for incapacity (this is where many families get blindsided)

Long-term care planning isn’t only about money, it’s also about control.

If you become incapacitated, your family may need the right legal tools to:

• manage finances,
  
• handle benefits,
  
• coordinate care decisions.
  

This is where a complete estate plan typically includes more than just a will.

5) If you’re considering a trust, make sure it matches the goal

Trusts can serve different purposes:

• probate avoidance,
  
• beneficiary protection,
  
• long-term care/Medicaid strategy (in the right circumstances).
  

But not all trusts do the same thing, and “DIY” trust language can create unintended results when benefits eligibility or tax issues come into play. Learn more about Medicaid Asset Protection Trust.

6) Factor in the caregiving reality (most care is still unpaid)

Most families rely heavily on unpaid caregiving, even before paid care becomes necessary.

AARP estimates the economic value of family caregiving was about $600 billion in 2021.

Planning insight: A plan that ignores caregiver burnout and family logistics often collapses under real-world pressure.

7) Get a plan in writing before a health event forces decisions

The biggest planning mistakes tend to happen in the same moment:

• a hospitalization,
  
• a fall,
  
• a dementia diagnosis,
  
• a sudden need for assisted living or a nursing facility.
  

When time is short, families often make irreversible moves.

A better path: start with a conversation and a written plan while you can still choose calmly.

FAQs

How much does a nursing home cost in Indiana?
Median annual costs reported by Genworth/CareScout for 2024 were $101,835 for a semi-private room and $124,283 for a private room in Indiana.

Does Medicaid take your house in Indiana?
Medicaid rules are fact-specific and depend on who lives in the home, what benefits are received, and recovery rules. An elder law attorney can explain how Indiana applies these rules to your situation.

Is Medicaid planning only for the wealthy?
No. The data shows long-term care costs can overwhelm many middle-income families, which is why planning is often most important for “in-between” households.

What’s the Medicaid lookback period?
Federal guidance explains that the lookback period for certain asset transfers was lengthened to 60 months (five years).

Talk with a Northwest Indiana elder law & estate planning attorney

Politakis Law focuses on helping individuals and families in Northwest Indiana with estate planning, probate, and elder law planning. If you want to understand your options before decisions get forced on you, scheduling a conversation now can protect your future.

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Disclaimer: This article is for general educational purposes and does not constitute legal advice. Every situation is different; talk with a qualified attorney about your specific circumstances.