Medicaid Planning for the Single Non-Parent: Huh?

The heading of this posting says it all: I see very little reason for a single individual with no children to do Medicaid planning. Now let me explain why:

First, Medicaid is designed to transfer family wealth. And yes, a niece, nephew, brother or sister are all considered family. But it is very rare that siblings or aunt / uncles share the same bond and sense of responsibility that are indicative of the parent / child relationship. Parents will sacrifice a great deal for their children, but most aunts and uncles have much more limited boundaries. I do see exceptions, but they are rare.

Now for the real heart of the topic, and don’t be surprised when you read this: The services provided for under Medicaid are inferior to privately paying for care. True, care providers that are Medicaid approved must be certified and do require additional government oversight, but the real issue is the money involved. Medicaid pays a pre-determined fee to these organizations, and their margins are not particularly high. As such, the wages these firms pay their employees is significantly lower than private-pay care providers, meaning the actual care givers are at the lower-end of the supply and demand chain. Private pay organizations are paid for out of your pocket, have somewhat less regulatory oversight, and can afford more experienced caregivers. Thus, if you don’t have beneficiaries you are naturally inclined to make sacrifices for (such as a spouse or children) you are probably-and-rightfully entitled to spend your money on your care instead of transferring it to other individuals.

If you read my blog posts you are aware that I am strongly opinionated on many issues, and I am convinced the cavalry of those opposing my views are saddling up to retort my suggestions. However, I stand by this assertion for one last reason: Your nieces and nephews usually don’t have the same attachment to you as children would, and if you are in a situation where you are in need of personal care they are usually less likely to visit you, insist on the care you desire, and accept the financial sacrifices associated with properly caring for a close relative.

If you are an individual who fits the criteria listed above I ask you to consider whether you would rather transfer your money to more attenuated relatives and thus sacrifice the quality of your care, or use the funds for the best aging-related care possible and leaving the whatever is left over to these family members. If you find yourself in the latter category, consider focusing on estate planning rather than elder care and Medicaid planning.

Q FOR YOU: Who are you willing to sacrifice your care for so that they may be financially enriched?

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