Long-Term Care Planning

Long-Term Care Planning in Harrisburg

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Long-term care planning is estate planning

Written by Christian Joseph Marrazzo, Life and Health Insurance Agent 717-564-6400

PAC Financial is a third-generation, family-owned financial advisory and insurance firm in Harrisburg, and here is the sentence this entire page unpacks: an estate plan decides where your assets go; a care plan decides whether they are still there. In the Harrisburg area, a private nursing home room now runs $15,056 a month, and roughly 70% of people over 65 will need some form of long-term care in their lives. Without a plan for that cost, the wealth a couple built over decades can go to care instead of to children and grandchildren, and a will can only pass on what care has not already spent. This page is the plain-English map: what care costs here, what the government actually pays, what the coverage options honestly are, and how the whole thing connects to the estate plan, written by the desk at our firm that does this work every week.

Two people usually arrive at this page. The 55-year-old who just watched a parent need care and swore their own kids would never carry that scramble. And the adult son or daughter, researching for Mom at midnight, tabs full of facility names and no idea how any of it gets paid. Both of you are in the right place, and both of you should know the honest premise up front: long-term care insurance is not right for everyone, some families should self-fund and some should sit with an elder-law attorney instead, and telling you which one you are is the first job of the first conversation.

What is long-term care, and who ends up needing it?

Long-term care is help with the business of daily living, bathing, dressing, eating, moving safely, whether at home, in assisted living, or in a nursing facility. It is mostly not medical care, which is precisely why medical insurance mostly does not pay for it. Someone turning 65 today has almost a 70% chance of needing some type of long-term care in their remaining years, per the Administration for Community Living, and women typically need it longer than men, 3.7 years versus 2.2 on average. The honest counterweight: about a third of 65-year-olds may never need care at all. Nobody knows which third they are in, and that uncertainty is the entire reason planning exists.

What does long-term care cost in the Harrisburg area?

Source: CareScout 2025 Cost of Care, Harrisburg area, PA; projections assume 3% annual growth. Individual provider pricing varies.

The number that reorganizes most families' thinking: three years in a private room, which is not uncommon, can exceed $540,000 at today's local rates. And the backdrop is tightening: Pennsylvania has lost 37 nursing homes and 4,318 certified beds since 2020 per LeadingAge PA's 2026 report, which is pushing more care toward home, where the costs and the family labor live. Our guides on local senior care options and what aging in place really costs map both paths in detail.

Does Medicare or Medicaid pay for long-term care?

Far less than families assume, and learning this early is worth real money. Medicare pays nothing for ongoing custodial care; its skilled nursing benefit caps at 100 days after a qualifying three-day inpatient stay, and observation status does not count toward those days. Medicaid does pay for long-term care, but only after assets spend down to eligibility levels, with a 60-month lookback on transfers and spousal protections that are real, partial, and capped. The full fine print, including Pennsylvania's 2026 spousal figures, lives in our Medicare and Medicaid guide, and the strategies families use to protect assets, including why the revocable trust everyone trusts does nothing here, live in our asset protection guide. One more Pennsylvania reality worth knowing exists: the state's filial responsibility law can reach adult children for a parent's unpaid care bills, covered plainly in our filial law guide.

What are the ways to pay for care?

Four, usually combined, and each has a legitimate use. Self-funding works when assets are deep, at the price of every care dollar coming out of the surviving spouse's income and the estate. Family provides most care in America, 63 million caregivers strong, at a cost in hours, careers, and savings that lands unevenly on adult children. Medicaid is the safety net, after spend-down, with less choice about where and how care happens. And insurance shifts the risk: for a knowable premium, the care bill becomes largely the carrier's problem instead of the family's. The right mix depends on your assets, your health, and what you want protected, and that mix, not a product, is what the first meeting maps.

Standalone policies, hybrid life policies, and riders: which is which?

General characterizations; policy terms vary materially and are medically underwritten. Guarantees are based on the claims-paying ability of the issuing insurance company.

The full plain-English comparison, including the fine print that becomes big print at claim time, is in our coverage and asset protection guide, and retirees weighing pensions against the care gap, especially SERS and PSERS members, should read the state worker's guide, including its section on repositioning old policies tax-free through Section 1035 exchanges.

What does Pennsylvania's Partnership program add?

The underused bridge for families in the middle: Partnership-qualified policies carry dollar-for-dollar Medicaid asset protection, meaning in general terms that every dollar of benefits the policy pays allows a dollar of family assets to be protected from Medicaid spend-down. It is the state's own incentive to plan privately, most families have never heard of it, and whether a policy is Partnership-qualified is a five-minute verification at our desk.

How does this connect to your estate plan?

Directly, and this is the part that makes care planning a family decision instead of a personal one. Unplanned care costs are the quiet force that empties estates before wills ever speak: the inheritance goes to the facility, the surviving spouse lives on what remains, and the family's plan on paper described assets that no longer exist. Planned properly, the pieces reinforce each other: coverage keeps care from consuming the estate, life insurance proceeds pass to named beneficiaries outside probate and generally exempt from Pennsylvania's inheritance tax, and the trust and beneficiary work on our estate planning and generational wealth pages assumes its assets will still be there. We coordinate all of it with your elder-law attorney and tax professional, three seats at one table, which is how this work actually succeeds.

Who should probably NOT buy long-term care insurance?

Honesty being the house policy: families with assets deep enough to comfortably absorb a $540,000 care event may reasonably self-insure, and families of modest means may be better served planning toward Medicaid with an elder-law attorney than paying premiums that strain the budget. Health can also decide for you, since coverage is medically underwritten. Roughly a third of 65-year-olds may never need care, premiums on standalone policies can rise, and a policy that lapses protected nobody. If any of that describes you, you will hear it from us in the first meeting, and the meeting will still have been worth it, because you will leave knowing which category you are in instead of wondering.

The guides, all in one place

Everything on this page goes deeper in our plain-English library, written for Central Pennsylvania families: Does Medicare cover long-term care? | Senior care options in the Harrisburg area | Protecting assets with trusts and life insurance | Pennsylvania's filial responsibility law | SERS, PSERS, and the care gap | What aging in place really costs. Our two-page printed guide is also available: download the PAC long-term care planning guide (PDF).

Who runs this desk?

Christian Joseph Marrazzo, Life and Health Insurance Agent, and the third generation of this family firm. His grandfather opened PAC Financial in 1972; his father Steve built the practice serving Pennsylvania school employees; Christian runs the insurance desk with a focus on the conversation families put off longest. Because the firm is independent, he compares standalone policies, hybrids, and riders across multiple highly rated carriers rather than selling one company's shelf, and because the advisory side of the firm sits ten feet away, the care plan and the retirement plan get built to agree with each other. Connect with him on LinkedIn, or meet the whole family on our team page.

Is this conversation worth an hour for your family?

Four questions, answerable tonight. Could your family name, today, how three years of care would be paid without touching the inheritance? Does anyone know whether the life insurance you already own carries a care rider, or counts as a Medicaid asset? Has anyone verified whether any policy in the house is Partnership-qualified? And if the answer to the first three is "no idea," who exactly is going to figure it out, and when? Clean answers mean you are ahead of nearly everyone, and we will happily confirm it. A wince means the hour is worth it: bring your existing policies, or bring nothing but questions, and we will put the whole picture on one page in plain English, including telling you plainly when coverage is not your answer. The first conversation costs nothing and carries no obligation.

Call (717) 564-6400, or send an email tonight; it will be on our desk in the morning.

Christian Joseph Marrazzo, Life and Health Insurance Agent
(717) 564-6400 | LinkedIn

PAC Financial | 5291 Devonshire Road, Harrisburg, PA 17112 | Open Monday through Friday, 9:30 to 5:00 | Serving Harrisburg, Mechanicsburg, Hershey, Camp Hill, Carlisle, Middletown, and communities across Dauphin and Cumberland counties

This material is for informational and educational purposes only and should not be construed as specific insurance, investment, tax, or legal advice or a recommendation. Long-term care insurance is not right for everyone; self-funding and Medicaid planning with a qualified elder-law attorney are legitimate alternatives depending on individual circumstances, and trust, Medicaid, and estate matters require qualified legal and tax professionals. Medicare, Medicaid, Partnership, and Pennsylvania inheritance tax rules described are general, current as of August 2026, and subject to change; individual eligibility and outcomes vary. Insurance policies are medically underwritten and contain exclusions, limitations, reductions of benefits, waiting periods, and terms for keeping them in force; premiums on standalone policies are not guaranteed and have historically increased on existing policyholders; rider terms vary materially; guarantees are based on the claims-paying ability of the issuing insurance company. Cost figures per CareScout 2025 Cost of Care, Harrisburg area, with projections assuming 3% annual growth; statistics per the Administration for Community Living and LeadingAge PA as cited. Insurance services offered through PAC Financial, which is not affiliated with Osaic Wealth, Inc. Securities and advisory services offered through Osaic Wealth, Inc., member FINRA/SIPC; PAC Financial and Osaic Wealth are separately owned. This communication is strictly intended for individuals residing in the states of CO, DE, FL, GA, MD, MI, NC, NJ, NY, PA, SC, VA. No offers may be made or accepted from any resident outside the specific state(s) referenced. Check the background of your financial professional on FINRA's BrokerCheck.