Employer benefits
Long-term care planning San Ramon
September 5, 2026
By Jamie Hargrave, Cadence Capital Investments
Long-term care planning San Ramon
Employer benefits
A guide to long-term care planning San Ramon. Learn to coordinate assets and insurance with local care costs to create a dependable financial strategy.
Approximately 70 percent of adults turning 65 will need some form of long-term care services during their remaining years, according to figures published by the U.S. Department of Health and Human Services. Long-term care planning coordinates your financial resources with your care preferences so that a health event does not force decisions under time pressure.
This article covers the levels of care available in the East Bay, how care is typically funded, what Medicare does and does not cover, and how California's Medi-Cal asset rules changed in 2026. It is educational and is not tax or legal advice. Consult your CPA or attorney about your situation.
Cadence Capital Investments is not affiliated with, endorsed by, or sponsored by Chevron Corporation.
• Care ranges from non-medical help at home through assisted living to skilled nursing, at very different costs.
• Medicare does not cover long-term custodial care.
• California reinstated a Medi-Cal asset limit effective January 1, 2026, along with a 30-month look-back on asset transfers.
• Several funding decisions, including triggering a long-term care policy and transferring assets to an irrevocable trust, cannot be undone.
• Cadence Capital Investments is fee-based, not fee-only, and does not provide legal or tax advice.
Long-term care planning prepares for future health and personal needs by matching care preferences against available resources. It is broader than selecting an insurance policy.
Care in the East Bay generally falls into three levels:
In-home care. Non-medical help with daily activities such as dressing, meal preparation, and medication reminders.
Assisted living. Residential settings offering meals, social engagement, and varying levels of personal assistance.
Skilled nursing. Medical care and rehabilitation for complex or chronic needs.
Costs in the Bay Area run above national averages, and they vary considerably by facility and level of care. Published cost surveys, including the Genworth Cost of Care Survey, provide regional figures that are updated periodically. Rather than planning from a single number, request current pricing directly from facilities in the communities you would actually consider, since the range within San Ramon and the surrounding Tri-Valley is wide.
Beginning while a need is still hypothetical leaves more options open than beginning after a health event. That is the practical argument for treating care costs as a planning variable early rather than a crisis later.
All financial strategies involve risk of loss and past performance is not indicative of future results.
Because Bay Area care costs are high, relying on a single funding source concentrates a lot of risk in one place.
Households with substantial assets often plan to pay from portfolio cash flow. It offers the most flexibility over where and how care is delivered. The analysis worth running is what several years of high monthly costs would do to portfolio longevity and to the income the household depends on, particularly if the need arises early in retirement.
Traditional long-term care policies provide a benefit for care needs over a defined period, subject to an elimination period and policy terms. Hybrid policies combine a life insurance death benefit or annuity value with the ability to access a portion for care.
All insurance and annuity benefits are subject to the claims-paying ability of the issuing company. Annuities are insurance contracts, not investments. Policies carry premiums, fees, elimination periods, benefit triggers, and inflation rider choices that materially affect what coverage delivers, and they should be reviewed in detail before purchase.
Insurance products are offered through licensed affiliates and agents, and an affiliate may earn a commission on any policy recommended. That is a conflict of interest, and the compensation applicable to any recommendation is disclosed before the recommendation is made.
Medicare is designed for acute medical care and short-term rehabilitation, not long-term custodial care. Custodial care means assistance with daily activities such as bathing and dressing.
Per Medicare.gov, skilled nursing facility coverage requires a qualifying hospital stay and is limited to up to 100 days per benefit period, with coinsurance applying after the first 20 days. These rules are specific and subject to change; confirm current details at Medicare.gov.
Medi-Cal is California's Medicaid program and covers long-term care for those who qualify financially.
Effective January 1, 2026, California reinstated an asset limit for non-MAGI Medi-Cal programs, which include the programs paying for long-term care. The limit is $130,000 for an individual, increasing by $65,000 for each additional household member. A 30-month look-back period on transfers of non-exempt assets also applies.
Two points the headline figures leave out and that matter for most married households here. Where one spouse enters a nursing facility, spousal impoverishment protections allow the at-home spouse a separate Community Spouse Resource Allowance, which is a substantially larger figure and is adjusted periodically. And not all assets are counted: the primary residence is generally exempt, along with one vehicle, personal belongings, and certain retirement accounts in payout status. Current enrollees are generally required to report assets at their annual redetermination in 2026 rather than immediately.
California also pursues estate recovery after death in defined circumstances.
These rules are detailed, they changed recently, and eligibility turns on specifics. This is educational and is not legal advice. Consult a qualified elder law attorney about Medi-Cal eligibility and asset planning.
A care event changes the withdrawal pattern a plan was built around, sometimes substantially and often with little notice.
Larger distributions raise taxable income, which can move you into a higher bracket and can increase Medicare premiums through income-related monthly adjustment amounts. Where Required Minimum Distributions are already being taken, generally beginning at age 73 under current law, those amounts can be directed toward care costs rather than reinvested.
The sequencing question is which accounts to draw from and in what order, and it becomes more consequential when the amounts are larger. This is not tax advice; work it through with your CPA.
Where a retirement package includes a pension election or employer plan balances, those choices affect what is available to fund care later. A monthly pension payment provides recurring income that persists through a care event; a lump sum provides liquidity that can be deployed but must be managed.
We provide retirement planning for Chevron employees and retirees. Cadence Capital Investments is not affiliated with, endorsed by, or sponsored by Chevron Corporation.
Triggering a long-term care policy. Filing a claim starts the elimination period and sets policy terms in motion. Understand the benefit triggers and the elimination period before filing.
Irrevocable trusts. Transferring assets to an irrevocable trust for Medi-Cal planning means permanently giving up control of those assets. With the 30-month look-back reinstated, transfers made within that window can affect eligibility. Cadence Capital Investments does not provide legal advice or draft legal documents, and does not advise on Medi-Cal eligibility strategy. These decisions belong with a qualified elder law attorney, and we work alongside one rather than in place of one.
Pension elections. The choice between a lump sum and a monthly payment form is generally irreversible once payment begins, and it changes what is available to fund care.
Social Security timing. Claiming permanently sets the monthly amount, subject to a limited twelve-month withdrawal window that requires repaying benefits received.
Powers of attorney and healthcare directives. A financial power of attorney allows a trusted person to manage your affairs if you cannot; a healthcare directive records your medical preferences. These should be coordinated with the financial plan. We do not draft them; consult a qualified attorney.
We encourage a second opinion and a family conversation before any permanent step.
Assess. Review your health status and family history to anticipate the kind of care you would prefer.
Map assets and income. Identify income streams and account balances, and size the gap between them and plausible care costs.
Evaluate funding. Compare self-funding against insurance options, examining what each actually delivers and at what cost.
Review on a schedule. Costs, health, and program rules change. We meet quarterly.
Investment advisory services at Cadence Capital Investments are offered through Prosperity Financial, a Registered Investment Advisor, which acts in a fiduciary capacity with respect to the advisory services it provides. Securities are offered through Fortune Financial Services, LLC, a Registered Broker/Dealer and member FINRA and SIPC. Insurance and annuity products are offered through licensed affiliates and agents, which means the firm is fee-based rather than fee-only. That conflict is disclosed in our Form CRS.
Not custodial care. Medicare covers acute medical needs and short-term rehabilitation. Per Medicare.gov, skilled nursing facility coverage requires a qualifying hospital stay and is limited to up to 100 days per benefit period, with coinsurance after the first 20 days. These rules are subject to change; confirm current details at Medicare.gov.
Bay Area costs run above national averages and vary widely by facility and level of care. Published surveys such as the Genworth Cost of Care Survey give regional ranges that are updated periodically, but the most reliable figure for planning is current pricing from the specific facilities you would consider. Costs also rise over time, so a plan should account for increases rather than a single present-day number.
Medicare is a federal health insurance program covering acute care and short-term rehabilitation. Medi-Cal is California's Medicaid program and does cover long-term custodial care for those who qualify financially. Effective January 1, 2026, Medi-Cal reinstated an asset limit of $130,000 for an individual, plus $65,000 per additional household member, with a 30-month look-back on transfers. Eligibility rules are detailed; consult an elder law attorney.
It depends on your assets, your income, your health, and what a policy would cost relative to self-funding. Benefits are subject to the claims-paying ability of the issuing company, and elimination periods, benefit triggers, and inflation protection materially affect what coverage delivers. An affiliate may earn a commission on any policy recommended, which is disclosed before the recommendation.
This is a legal question rather than a financial planning one. Strategies exist, they interact with the reinstated look-back period, and they carry permanent consequences. Cadence Capital Investments does not provide legal advice or draft legal documents. Consult a qualified elder law attorney, and we will coordinate the financial side with whatever they recommend.
Qualified long-term care insurance premiums may be deductible as medical expenses up to age-based limits published by the IRS, and benefit payments from qualified policies are generally not taxable within limits. Using distributions from retirement accounts to fund care raises taxable income, which can affect brackets and Medicare premiums. Consult your CPA about your situation.
Generally not once payment begins. The choice between a lump sum and a monthly payment form determines what cash flow and what liquidity are available if care is needed later, which is why the two decisions are worth considering together rather than sequentially.
This article is for general informational and educational purposes only. It is not individualized investment, tax, or legal advice, is not a recommendation to buy, sell, or hold any security or insurance product, and does not account for your specific circumstances. Investing involves risk, including the possible loss of principal. Past performance is not indicative of future results.
Long-term care planning involves financial, tax, and legal considerations. Cadence Capital Investments does not provide legal advice, does not draft legal documents, and does not advise on Medi-Cal eligibility strategy. Consult a qualified elder law attorney and your CPA before making any irreversible decision.
Government program rules, asset limits, premiums, and tax figures are stated as of the publication date and are subject to change; Medicare.gov, IRS.gov, and the California Department of Health Care Services publish current information. Care cost figures vary by source, by facility, and over time.
Advisory services offered through Prosperity Financial, a Registered Investment Advisor. Securities offered through Fortune Financial Services, LLC, a Registered Broker/Dealer, member FINRA / SIPC. Insurance and annuity products are offered through licensed affiliates and agents; product guarantees are subject to the claims-paying ability of the issuing company. Because an affiliate may earn commissions on certain products, Cadence Capital Investments is fee-based rather than fee-only.
Cadence Capital Investments is not affiliated with, endorsed by, or sponsored by Chevron Corporation or any other employer, plan sponsor, plan administrator, or government agency named in this article. Nothing in this article is a comparison to, or an assessment of, any other advisory firm.
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