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I look at it this way:
Person A has $50,000.00 in the bank
Person B is broke

Person A gives $50,000 to the Nursing home and then they go on Medicaid
Person B walks right in.

In other words, eventually everyone will end up in Medicaid if they live long enough. Eventually, you will run through all of your money and your assets and be in the same situation as person B. The difference is that Person A had to pay $50,000, and Person B just walked right in.

The facilities that accept Medicaid charge MORE to the private payer than to the Medicaid receipient. So, the private payer is subsidizing the bed for the medicaid person. It is a "socialist" system whereby everyone is eventually equal, no matter how hard one worked all their life, everyone ends up broke.

The only ones that escape are the very very wealthy, since they can afford to hire their own private nurses and stay in extragravant private pay facilities.
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Elder Law Attorney Brett's (ElderlawWV) post should be an article!
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Excuse me ... that should read "ElderlawyerWV"
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what about the surviving spouse who has spent all their assets taking care of the ill spouse? Whay are they expected to live on? Why can there not be an amount of the common property set aside for that spouse?
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MBJtampa – There are allowances for the surviving spouse (they call it "community spouse").
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If the CSRA is over 130,000, then there are issues. My husband had early onset Alzheimers and I hopefully will live another 30 years. I am not working in order to care for him. I am not adding to my SS or a retirement. We are living on SS his IRA and investments with a 10% disbursement that we need to cover his bills but the remainder will not last my lifetime.
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It's not a question of morality, it's a question of the social contract; and when you live in a democracy you sign up to that contract. Don't like the terms? Then engage politically and change them.

Meanwhile, if you hide, or "shield" if you prefer, your assets from Medicaid you are in breach; and, yes, most people think it is bad faith to be in breach of contract, and most people would call that immoral.
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Morality is one issue but it is definitely illegal. And don't think Medicaid won't find it because they are like a dog with a bone!!!!!!!!!!!!
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I hear ya, MBJtampa.
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MBJ Check with an accountant about that 10% to make sure you are not exempt if it
s needed for medical care
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Is it fair for someone to work like a dog all their life and save every penny. Then have to pay $10,000 a month for a nursing home (because they have to subsidize people who for whatever reason don't have the money) After 10 months, they are completed depleted of their life savings and then they are forced into Medicaid. The only difference is they paid $100,000 and the bed next to them paid nothing. That is socialism.
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It's no more immoral than expecting the tax payers to support you.
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Actually, if you're on federal benefits of any kind, you are by law allowed to have up to a certain amount of money tucked away. You're also allowed to own one home as long as you live there, and one car is exempt for medical transport. Anything extra must be put into a trust, this is definitely legal. As for going on vacation, there are more ways to go on vacation including sharing a vacation with someone else willing to split the cost. There was a type of vacation I used to take years ago. When I had no car, what turned out to be a very good friend would come along distance to pick me up and take me back with him. I eventually found out that he had everything I needed at his house and that I would need no luggage, so I eventually stopped carrying any luggage. I could stay for a period of up to two weeks. Round-trip transportation was wonderful. Those were the good old days, but sadly he's no longer with us. There are multiple ways to take vacations when you're on any federal benefits, so don't go judging because you never know how someone else's situation is set up or the arrangements of it. When you're on federal benefits, you're very limited on what you can do because how much you can do of anything that costs money is very limited. This can leave you stuck at home all the time, which gets old. If you ever wonder why so many people are depressed, blame it on being mostly homebound because not everyone can do it. Again, never judge someone else's situation, you never know who may be helping them with those vacations and other stuff. Just because someone may turn up with new stuff and sometimes costly stuff doesn't always mean they're cheating the system because some of that stuff maybe gifts from others. Do your homework and about what kind of nice things actually show up at Goodwill for starters. Sometimes things show up when someone close to you happens to be helping at all jobs such as cleaning up buildings when someone moves and leaves behind property. I was recently gifted a very nice purse that can be worn as a backpack. This is a very fancy leather purse with lots of big pockets. This is a good example of being able to receive some of the good things in life without having to cheat the system. If someone shows up with a brand-new car, you never know that someone didn't receive an inheritance of some kind, please don't judge unless you can dig deeper and find out because you just never know. Definitely do your homework because I would hate to see you turn up red-faced if it turns out to be that person you thought was cheating the system really wasn't
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My MIL is currently in rehab but it is looking more and more like she will need long term care. I have POA even though she still has two sons, one being my husband. She lost three children, my husbands siblings in the last four years. At this time, she is bedridden and she weighs around 220. I have the agonizing decision of whether to bring her home or leave her in the NH. I went to the Business Office to see about the long term care and what happens when her money runs out. After reading about the Medicaid terms for my state, and speaking to the guy in the business office, I can see no way of hiding assets for her. The only thing she really has is money in the bank. She was the recipient of a $100,000 life insurance policy that one of her deceased children left her. Almost immediately after she received it, two other family members borrowed a combined 80,000. One of them has recently paid most of theirs back, but the other has not. I found out that unless that money is paid back, she will be penalized for however many months it would take (in NH cost) to pay it back. I also found out that funeral expenses etc. would need to come out of her funds before she ran out. Medicaid will take anything of value including any life insurance policies that she has. Unless that money is paid back before she runs out, the family will be responsible for her monthly NH bill. My husband and I could never come up with that kind of money. So, being honest about my thought process at first, I tried to figure out how we could hide the fact that those other family members still owed her money because I don't know if they will be able to come up with it, at least not enough even in monthly payments to make a difference. However, after looking into it further, I don't see how I can hide it. They look at 5 years worth of financial statements. I figure that honesty is probably the best policy if Medicaire needs to be in play. If you get caught being dishonest and hiding things, they will deny your loved one for sure. The way I see it, my MIL's life and well being is more important. I'm not sure yet what I am going to do, but I won't lie!
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The people I know who fit the family A scenario would rather die than accept aid.
The people I know who fit family B will take all the help they can and then complain it isn't enough.
Either way, it's a very complicated issue and most fall somewhere in between. It's not for me to judge another. It's legal to do a lot of things that I don't want to do. It's illegal to do some things I think are no big deal. We all draw the line where we see it. Morals and ethics are beautiful to strive for and are at the core personal. To go against your own moral code is always painful.
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To me the answer is simple - if you want to go on Medicaid and have the taxpayer pay for your care - follow the rules. I know there are ways to use trusts etc. One advantage for paying for your care if you have the money - is you have more to choose from. Especially before nursing home and Medicaid.

My mom's friends saved their money and invested. Now they are able to choose nice senior living / assisted living. These places are beautiful, have transportation to events and grocery stores, on site exercise, beauty parlors, etc.

My mom, on the other hand, spent money she had and more. She got nearly $300,000 when my dad divorced, also worked at jobs that paid great wages for 20 years before she retired. In spite of our advice and encouragement - she saved NOTHING and did not do a 401K. All she has right now is social security. (All the years she refused to save -she said she would live on SS). Now she sees what she can afford based on her social security. Not so nice. Safe, yes, but no amenities. Now she is not so happy.

Her solution - I am supposed to pay the $2,000 per month she needs for the nice senior living/assisted living so she can live with her friends and enjoy that lifestyle. I'd have to earn $36,000 per year MORE pre tax to be able to give her $2,000 per month. She was surprised, outraged, and threw a hissy when I said "no, I can't afford that".

So, while I will help my mom research what she can afford and it is not much beyond the basics, I am not willing to give her any more money. I turned off the tap about 5 years ago when she was constantly short for rent. She made decisions for 50 years of work life - so now she needs to live with them.

This is where I see the save vs spend pinch people - in retirement when they need senior living, in home services, assisted living - but not full nursing home care. What qualify of life will be had in the years when you need to live differently and have assistance.
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bag1115, so because of the relatives who borrowed $80,000, your mil won't be able to go on Medicaid? So what does that mean -- you will left paying for in-home help for her or you will have to take care of a 220 lb. bedbound woman? YIKES!

Kimber166, good for you for saying no to your selfish (sorry, no other word to use!) mother.
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Family "C", worked hard, both spouses have adult children, heirs to a trust.
At the same time, as each adult child has said: "Oh, there is money".
Money for themselves.
Meanwhile, my elderly both go without proper care.
One was removed from home, his assets and income still going to pay for that home and his wife's care. His wife, without enough care, not enough income from both would be enough for her care.  Because, NO ONE has acted on behalf of both parties. In concert, looking at the bigger picture. The delays have been criminal.
This is criminal.
They had their chance to do what is right.
Happy Valentines Day everyone, in advance. Because I am no longer keeping quiet, cannot care for your Mom, and your Dad by myself.
You all have mistaken kindness for weakness, I am coming after you all, without judgment, without hate, without malice, just the facts.
And the Lord himself will set it right.
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So glad that whatever forum JeanneGibbs was on prior to coming here (posted about 4 years ago), that she is a part of our caregiving family now.
Still reading the answers here. Trying to find a moral answer if ever family is at cross purposes, or only for themselves.
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Am I having a breakdown?
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One more winkle I want to add.

The whole business of ensuring that middle class families cannot pass on the accumulated wealth to the next generation is actually a concept that came around when we moved completely into health care FOR PROFIT. Remember where that money is going....into the pockets of the 1%.

There are more and more schemes to strip the lifetime savings or the middle class and move it into the hands of the investor class. Wealth is flowing up in all these systems.

When will we all wake up and STOP voting against our own self interest?

Meanwhile, privatization means improverishment for more.
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My view is kind of screwed up and I am basing this off of somebody. One of my friends is moderately autistic and when his grandfather died, both his son and daughter and all of the grandkids were left with trust funds. My friend's trust fund was meant to pay for higher education. He was never able to handle the most basic math and simple English paper in high school, even in special education. After a few years, that trust was reworked into a special needs trust and it's protected. His dad is his financial guardian and with the help of a lawyer, got my friend SSD and Medicaid. This is what bothers me is that I am affected badly by epilepsy and that has done a lot of damage to me in many ways and I have other health problems that makes it worse yet I can't get disability and I don't have a trust fund yet he can. My coworker's granddaughter has Down's Syndrome and her heart is super bad and she can't get disability and she has the reasoning of a 6 year old. Everyone who works pays into programs for the poor in case of hard times but I don't think that things should be hidden or put in trusts so a person can go on Medicaid. Use the money that was saved up first before you need to apply for Medicaid. It takes away from the people who truly need it not those who want to be like my grandmother, a Slovenian Jew. A Slovenian Jew has no problem spending other people's money but won't spend their own for their needs.
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Sorry if I made anyone uncomfortable with my being upset with "family C".
Neither spouse is on Medicaid, they are like family "A", and they are very proud, don't want handouts or anyone to spend money but family is not on board with getting them the care needed right now. But they are very concerned about their inheritance.

Just maybe my post was off-topic, sorry. I cannot give details because of their privacy. I just want them to have help soon.
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Why is there always someone who argues that since family X is getting to keep their trust, then I should also keep mine?

One has nothing to do with the other. You do not know the internal workings of that family. You cannot judge.

AND?..why is the whole topic framed in the terms of my needs are greater than yours?
Why isn't the topic framed...why is the top 1% paying far less than at any time in history? And isn't there a direct collection between the crashing middle class and the Largest income disparity in history?

Why can't we all have peace in old age? Because this scheme of drain the most vulnerable dry is in place to enrich the billionaires. 

In the famous words of John Adams...."we had better hang together, or we will assuredly hang separately".  

Stop grousing about what someone gets in service, and start voting!
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Absolutely, I think it is immoral. Why should the rest of the nation/government have to pay for her care when she has the assets to do it?
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It is not unethical to do what is legally allowed to protect a family's assets. It is in the public interest for savers to have an incentive to save. It is in the public interest for the widowed spouse to have enough assets and income to stay out of poverty.

According to one way of thinking, family A is hurting the economy by hoarding their income and not supporting growth! To be content, worry about how you are choosing to live, not about others.
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I just saw the 4 year old post and am not going to read through all of the responses. My mom is in memory care. Dad died 5 years ago. They were very frugal and had property assets. As trustee and guardian, I was concerned about protecting the homestead for the four heirs vs paying since they had assets. The reality pointed out to me was that my siblings could and would sue me if I sold moms house and used that to spend down to Medicaid. So the house sits. Also, if you don't take advantage of the way the laws are written, you are stupid (to put it bluntly). The laws need to be changed to do away with asset protection. I have long term care insurance, and have lived frugally, but no more. I am going to enjoy more for the hard work and refuse to let my children think they should give up their lives to care for me when I am old with dementia. That is absurd!
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Nope. It's not right that the government has all the money and the people have nothing. They will try to strip you dry if you let them. It's time for the people to take a stand instead of allowing the government to run their lives and tell them what they can and can't have. I mean, you need enough to survive and what they give is not enough.
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I remember seeing a comment as to why the elderly poor are discriminated against (particularly by Hollywood) while money goes to so many other groups, some being foreign countries who hate us. I'm going to by un-"PC" and say I suspect the answer has to do to some degree with which way the elderly are likely to vote.
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I too have just seen this post and not read through all 4 years of posts. My Mom is currently in AL and will soon have used up her savings and need to apply for Medicaid. That is what should be done...the money is NOT your inheritance until they are dead. Until then it should be used to pay for their expenses.
That being said..my husband has PK, dementia and post-polio syndrome and still at home. I had to retire early(62) to take care of him. If he needed to go into a nursing home I would end up living in poverty the rest of my life - how is that fair? I worked hard and saved my $$ to enjoy retirement when it got here. The way our country takes care of the elderly is a disgrace and looks like it won't get better any time soon. NH costs are outrageous, they can charge what they want because they know there is a shortage and this too is only going to get worse as the baby boomers age. They just keep these people (most have no idea what is going on) alive so they can get paid, roll them out into a room each day and leave them there asleep or staring into space. This is no way to live and if the person were able to say it would agree. Something has to be done to help these people out, it is not only sad for the person but effects the lives of family members that can't live a normal live either.
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