Ask An Expert: Aging In Rhode Island

Rhode Island is a wonderful place to grow older, but as we age, planning ahead becomes more than just a good idea.

It’s essential.

In this edition of Ask An Expert, I sat down with a local elder law attorney to unpack what it means to get older in Rhode Island.

We discuss estate planning and healthcare access to how taxes and long-term care can shape our later years.

Let’s dive in…

• 1️⃣ What exactly does “elder law” cover, and why does it matter in Rhode Island?

  Expert’s Take:
  
  Elder law touches every part of aging from estate planning, wills, trusts, powers of attorney, long-term care, Medicaid eligibility and even guardianship issues.
  
  In Rhode Island, where the cost of living and healthcare is high, elder law planning helps families protect assets, qualify for care, and ensure that a lifetime of savings doesn’t disappear overnight.

• 2️⃣ What are the most common mistakes you see people make with estate planning?

  Expert’s Take:
  
  The biggest mistake is waiting too long.
  
  Many people assume they don’t “need” estate planning until they’re elderly or sick., but by then, options are limited.
  
  Another mistake is failing to update wills or beneficiary designations, especially after major life changes.
  
  Rhode Island’s estate tax threshold is about $1.8 million for 2025, so even modest estates that include a home and retirement savings can face taxes if not structured properly.

• 3️⃣ How does Rhode Island’s estate tax differ from the federal one?

  Expert’s Take:
  
  The federal estate tax exemption is about $13.6 million per person, but Rhode Island’s threshold is much lower.
  
  It’s under $2 million, and that gap catches many families by surprise.

  A home in South County, retirement accounts, and life insurance can easily exceed that number.
  
  With proper planning through trusts or charitable giving families can often reduce or eliminate the state tax hit.

• 4️⃣ What should people know about long-term care costs?

  Expert’s Take:
  
  It’s eye-opening.
  
  Nursing home care in Rhode Island can run $10,000–$14,000 per month, and assisted living averages $6,000–$8,000.
  
  Medicare doesn’t cover long-term care. it only covers short-term rehabilitation, and that’s where Medicaid planning comes in.
  
  Families can protect certain assets and still qualify for care, but the rules are strict, especially the 5-year “look-back” period for asset transfers.

• 5️⃣ Can you explain that “look-back” rule a bit more?

  Expert’s Take:
  
  Sure. When someone applies for Medicaid to cover long-term care, the state reviews the past five years of their financial records.
  
  If assets were given away or transferred for less than fair value, it can trigger a penalty period where the person is ineligible for coverage.
  
  That’s why early planning is critical and waiting until a crisis limits your options.

• 6️⃣ How do Medicare and Medicaid interact in Rhode Island?

  Expert’s Take:
  
  Medicare is federal and primarily covers hospital and short-term medical care.
  
  Medicaid is a state-federal partnership that helps low-income residents, including seniors, pay for long-term care.
  
  Many people end up “dual eligible,” meaning they have both.
  
  Rhode Island’s PACE program (Program of All-Inclusive Care for the Elderly) can be a great resource for those balancing both systems.

• 7️⃣ What about access to doctors and healthcare services for seniors here?

  Expert’s Take:
  
  Access can be challenging.
  
  Rhode Island has a shortage of primary care and geriatric doctors, particularly in rural South County and on Block Island.
  
  Many doctors limit new Medicare patients due to reimbursement rates.
  
  That’s why it’s smart to establish care early and consider telehealth options, which expanded significantly post-pandemic.

• 8️⃣ How do state and local taxes impact retirees?

  Expert’s Take:
  
  Rhode Island has made progress. Pension income and Social Security are partially exempt for lower- and middle-income residents, but property taxes remain a big burden.
  
  Some towns offer “tax freeze” or deferral programs for seniors, but they vary by community.
  
  It’s worth checking with your local assessor’s office — Narragansett, South Kingstown, North Kingstown and New Shoreham because each have slightly different rules.

• 9️⃣ What legal documents should every Rhode Island senior have in place?

  Expert’s Take:
  
  At minimum:

  • A will

  • A durable power of attorney

  • A healthcare proxy or living will

  • A HIPAA release
    

  These documents ensure someone can act on your behalf even if you can’t without going through the courts.
  
  For many, a revocable living trust is also worth considering to avoid probate and maintain privacy.

• 🔟 What’s your best advice for families just starting to plan?

  Expert’s Take:
  
  First and foremost, don’t wait.
  
  Start the conversation early before a health crisis forces decisions, and make it a family discussion, not just a legal one.
  
  The peace of mind that comes from knowing your wishes are clear, your assets are protected, and your care is covered is invaluable for you and for those who love you.

Closing Thought

Planning for the future doesn’t have to be intimidating. Like anything else, it starts with good information and honest conversations.

Rhode Island is a place where community matters and that includes looking out for our older neighbors, our parents, and ourselves.

If you found this helpful, share it with someone who’s beginning to think about these same questions.

You might just help them take the first and most important step to protecting themselves as they get older.