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Many will require long term care. Once long term care qualifies as a medical expense then long term care expenses are deductible as a medical expenses. At that point the issue normally becomes a cash flow problem more than a tax issue.
True. And at that point, you would rather have the traditional IRA with the larger balance. Which was the case with my father. He spent his last 9 years in a nursing home, and the last couple of years, with extra charges for additional nursing care, he paid no taxes on his IRA withdrawals.

In his case, a Roth conversion would have just been a gift to the Government.

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