Long-term care planning isn’t something most families think about—until they have to. A sudden fall. A dementia diagnosis. A hospital discharge with nowhere safe to go.
In Oakland County, thousands of families face these moments every year. The questions come fast: How much will care cost? Will Medicare help? What about our savings?
Here’s what many Michigan families don’t realize: the time to plan for long-term care is before the crisis hits. Waiting until care is needed means fewer options, higher costs, and decisions made under pressure.
This guide breaks down what Oakland County families need to know about long-term care—the real costs, funding strategies, Medicaid rules, and planning tools that can protect your family’s future.
What Long-Term Care Actually Costs in Oakland County
Let’s start with the numbers. They’re significant, and families deserve transparency.
In-Home Care
Many seniors prefer aging at home. In Metro Detroit, non-medical home care costs approximately $25 to $35 per hour. For someone needing 40 hours of weekly assistance, that’s $4,000 to $5,600 per month—and it adds up quickly.
Assisted Living
Oakland County assisted living facilities average around $4,224 per month as of 2025. Costs vary based on location, care level, and amenities. Some communities charge significantly more for memory care services.
Nursing Home Care
This is where costs become substantial:
- Private room: ~$423/day ($154,556 annually)
- Semi-private room: ~$381/day ($138,904 annually)
These figures represent 2025-2026 estimates for the Detroit metro area. At $10,000 to $12,000+ per month, a multi-year nursing home stay can deplete even substantial savings.
The Medicare Misconception
Many families assume Medicare covers long-term care. It doesn’t.
Medicare may cover up to 100 days of skilled nursing following a qualifying hospital stay (typically only up to 21 days), with copays of approximately $217/day starting on day 21 (2026 figures). But Medicare does not pay for ongoing custodial care—the daily help with bathing, dressing, and meals that most seniors eventually need.
This gap catches families off guard. Planning ahead prevents that surprise.
Paying for Care: Your Options
With nursing home costs exceeding $10,000 monthly, funding strategy matters.
Self-Funding
Many Oakland County families start by paying out-of-pocket. This works—until it doesn’t. Without planning, a three-year nursing home stay could consume $360,000 or more in savings.
Long-Term Care Insurance
Traditional policies pay daily or monthly benefits toward care costs. Key considerations:
- Premiums depend on age, health, and benefit design
- Policies require elimination periods before benefits begin
- Coverage may not keep pace with rising costs
Hybrid Life/LTC Policies
These combine life insurance with long-term care benefits. If care is never needed, the policy provides a death benefit. This flexibility appeals to families uncertain about future needs.
Medicaid
For families without unlimited resources, Medicaid often becomes the primary nursing home payer. But qualifying requires meeting strict financial limits—and that’s where planning becomes essential.
Michigan Medicaid: What Oakland County Families Must Know
Understanding Medicaid eligibility is crucial for effective long-term care planning.
The Basics
Medicaid covers nursing home care for individuals meeting financial and medical requirements. Michigan also offers home-based alternatives through MI Choice and PACE programs for qualifying seniors.
2026 Financial Eligibility Limits
Michigan’s asset limits for Medicaid long-term care (as of 2026):
- Single applicant: $9,950 in countable assets
- Married couple (both applying): $14,950 in countable assets
What Counts—And What Doesn’t
Exempt assets typically include:
- Primary residence (unlimited equity limits, if spouse is alive and resides there)
- One vehicle
- Personal belongings
- Prepaid burial arrangements
Countable assets include financial accounts, investments, and non-homestead real estate. These must be reduced to qualify.
Spousal Protections
Michigan law protects the at-home spouse from impoverishment. Under community spouse resource allowance (CSRA) rules, the spouse remaining home keeps a portion of the couple’s assets while the applicant spouse qualifies for Medicaid.
Asset Protection Strategies That Work
“Many Oakland County families believe they must spend down everything before qualifying for Medicaid. That’s not true—legal strategies exist to protect assets while meeting eligibility requirements.”
Legitimate planning options include:
- Medicaid-compliant annuities converting countable assets to income streams
- Spousal transfers maximizing the community spouse’s protected resources
- Irrevocable trusts (most effective when established 5+ years before care)
- Strategic spend-downs on allowable expenses
The Problem-Solution Reality
Problem: A married couple has $200,000 in savings. One spouse needs nursing home care. Without planning, they face spending down to $9,950 before Medicaid helps.
Why it matters: The healthy spouse could be left with inadequate resources for their own future needs.
Michigan law context: Spousal impoverishment protections under federal and state Medicaid rules allow the community spouse to retain significant assets—but maximizing these protections requires proper planning.
Solution: Working with an elder law attorney, the couple can legally reposition assets, utilize spousal protections, and potentially qualify for Medicaid while preserving resources for the healthy spouse.
Next step: Consult with an elder law attorney before a crisis forces rushed decisions.
Crisis vs. Proactive Planning Costs
Planning ahead typically costs between $6,500 and $9,500 for comprehensive elder law services. Crisis planning—when care is needed immediately—often runs $12,000 to $20,000 because options narrow and urgency increases.
The math is clear: proactive planning saves money and preserves choices.
Essential Legal Documents Every Family Needs
“In our experience serving Oakland County families, the most common mistake is waiting until a health crisis to get legal documents in place. By then, options may be limited.”
Before long-term care becomes necessary, ensure these documents are current:
Durable Financial Power of Attorney
Allows a trusted person to manage finances if you become incapacitated. Under Michigan’s Uniform Power of Attorney Act (MCL 556.201 et seq.), specific requirements must be met for validity.
Patient Advocate Designation
Authorizes someone to make medical decisions on your behalf. Governed by MCL 700.5506-700.5515.
Revocable Living Trust
Streamlines asset management and transition when long-term care becomes necessary—or after death.
Michigan polling shows only about 25% of adults have designated a power of attorney. Don’t be part of that unprepared majority.
Frequently Asked Questions About Long-Term Care in Oakland County
How much does nursing home care cost in Oakland County?
Nursing home costs in Oakland County range from approximately $9,000 to $12,000+ per month, depending on room type and facility. Private rooms average around $423/day ($154,556 annually). Always request current pricing from specific providers.
Does Medicare pay for long-term care in Michigan?
No. Medicare covers limited skilled nursing care—up to 100 days following a qualifying hospital stay—but does not pay for ongoing custodial care. Families must plan for alternative funding through insurance, savings, or Medicaid.
When should we start Medicaid planning?
Ideally, several years before care is needed. Early planning allows more options, including irrevocable trusts and strategic asset repositioning. Crisis planning is possible but more limited and expensive. For most individuals, beginning to plan in their 60s is generally recommended.
Can we protect our home if a spouse needs nursing home care?
Often, yes. Medicaid rules typically treat the home as exempt if a spouse still lives there. Additional tools like Lady Bird deeds and trusts can provide further protection under Michigan law.
How much does elder law planning cost in Michigan?
Proactive elder law planning typically costs $6,500 to $9,500. Crisis planning when care is immediately needed often runs $12,000 to $20,000 due to increased complexity and urgency.
Take Action Before the Crisis
Long-term care planning isn’t about expecting the worst. It’s about protecting your family’s choices, resources, and peace of mind.
At Boroja, Bernier & Associates, we help Oakland County and Metro Detroit families navigate Medicaid planning, asset protection, and long-term care decisions. Our elder law attorneys understand Michigan’s specific rules and create personalized strategies that protect what matters most.
With our main office in Shelby Township and satellite offices in Troy, Ann Arbor, and Lansing, we serve families throughout Macomb County, Oakland County, Wayne County, Southeast Michigan, and Mid-Michigan.
To schedule a consultation with the Michigan elder law attorneys at Boroja, Bernier & Associates, call our law offices at (586) 991-7611. The sooner you plan, the more options you’ll have.
