[Porsche-O-Phile]

Yes, Medicaid planning is basically a way of keeping you from being hollowed out by nursing homes.

The problem is - if / when someone needs nursing home care, they WILL clean out everything you have. Houses, cash, retirement holdings, everything. They take it all and eventually (when the assets are all gone) say “oh you can’t afford to be here anymore” and kick you to a low-quality nursing home (usually paid for by Medicaid anyway).

The whole idea of Medicaid planning is to make the person destitute (i.e. they have no assets) so they go straight into a Medicaid-paid nursing home. The downside of course is that those facilities are often low quality and provide “minimum standard” type care. They’re not pretty places. I’ve been in several for various projects and research for relatives.

The alternative is to dump everything (all your assets) into a higher-quality (translation: expensive) nursing home and hope you die before the money runs out and you get kicked to the Medicaid type facility anyway. That strategy might make sense if you expect to decline quickly, if you have no heirs or you have very, VERY deep pockets. Otherwise Medicaid planning makes sense - although it has it’s own subset of problems (lower quality care, increased taxpayer burden, etc.)

There are no “winners”. It’s a question of what makes sense for you and your situation. In every case, SOMEONE is going to get screwed - either you, your heirs, the state / taxpayers, someone. It’s a complicated problem and when you start really getting into it, you realize just how screwed up our healthcare (particularly end-of-life healthcare) system is and why it’s probably going to collapse at some point (another discussion for another time...)

The “best case” is to line up your estate to go to your heirs as you wish and die quickly and suddenly, without a long, drawn-out period in your “golden years” in a home with little to no quality of life.

Sadly, many (most?) people now aren’t so lucky.