Is it All Right to Plan to Become Eligible for Medicaid?

From time to time we will help a client plan their affairs in a way to reduce the risk that their assets will all need to be spent on long term care before they become eligible for Medicaid to help pay for nursing home care.   This is sometimes called “custodial” support.    This planning is sometimes desired even by clients with substantial assets, since even a large estate can be quickly depleted by an extended period in a nursing home (think $13,000 a month).

Recently I heard from a client that she wasn’t sure she was comfortable with such planning, and wasn’t it wrong somehow?   Interestingly, before I understood how the laws work, many years ago, I wondered the same thing.    Unfortunately, there has been talk over the years that this planning is somehow morally wrong, and at one point the government was trying to prevent attorneys from being able to talk to clients about it.    Thankfully, those days are gone, but some undeserved stigma remains.    I told the client to rest assured, that the laws are written as they are, and it is within everyone’s rights to arrange their affairs to best take advantage of them, and that no one should feel uncomfortable because they do some planning to gain eligibility earlier than they might do so without planning.

It is interesting to think that without planning a person who needs “custodial care” because they become old or frail or sick, needs to nearly impoverish themselves before they can obtain help paying for the care needed, while a person who needs a heart transplant, or some other very expensive medical procedure, simply needs to have adequate insurance (for most seniors – medicare and a supplement).   Why is there such a disparity?

One thing to keep in mind, is that while there are some planning approaches that can work for a single person, there are more and better approaches available to married couples, so if you have a mind to engage in this kind of effort, it makes sense to do so as possible, while you are married and both of you are competent.   Of course, if not married, maybe you can find remedy that, but that is beyond the services we offer.