An estate planning attorney will be able to help you and your partner develop a comprehensive estate plan. It is important to have a plan in place for both your financial affairs and health related decisions. As an estate planning attorney, I can tell you that good estate plans will include a trust, will, power of attorney and health care directive.
The health care directive addresses your concern regarding having some authority in handling your partner's medical care. It will allow your partner to appoint a health care agent to make medical decisions on his/her behalf if he/she is unable to and it will outline his/her preferences for medical care.
For the situation with your partner where long term care planning is needed, it would be a good idea to consult an estate planning attorney who also understands elder law issues to help your partner preserve his/her assets. I regularly work with clients who have long term care needs and think it it is very prudent of you to be planning in advance as to avoid "crisis planning".
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I agree with Attorney Tran. You need a qualified estate planning attorney. If the estate planning is set up properly, the question of whether or not to get married depends more on personal preference. Legally, you should be able to protect each other, whether you are married or not.
You will definitely want to consider durable power of attorney forms, no matter what other planning you decide on. These forms allow the person you select, (presumably each other), to make medical and financial decisions for you, if you ever become incapacitated. It is especially important in cases like this, where there are other people who might otherwise jump in and want to be involved. You need to clarify your intent so that what you want will happen, no matter what.
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I think an attorney familiar with estate planning in California would be able to answer your questions and document your decisions.
First and foremost - your concerns about medical costs and possibly long term care: If you can afford it, there is fine insurance available to cover these costs. As to controlling each other's care, health care powers of attorney should be sufficient to give either of you authority to manage the care of the other if circumstances require. As you may have seen from a recent AVVO post I did, these powers can even give each of you the right to make funeral arrangements for the other.
There is no question that our tax code contains a bias in favor of married individuals, and a qualified estate planning attorney should be able to give counsel on that, as well as wills, trusts and so forth.
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All the attorneys here provide you with excellent advice. You and your partner need to consult with an estate planning attorney to discuss all your options. You'll want to consider whether to establish a trust, but whether or not a trust is best for you, you and your partner should at least have a will, financial powers of attorney and advanced health directives in place. You and your partner are also wise to be concerned about long term care costs and long term care planning as these costs can be astronomical. There are estate planning/medical planning options available that will protect your assets
Disclaimer: The above answer does not create an attorney/client relationship. My responses are intended to provide general information about the question posted. I am licensed to practice in the state of California. The information provided on this site should not be used as a substitute for conferring with or hiring a competent legal advice from a licensed attorney that practices in the subject area in your state.