The Problem with “I’ll Just Use Medicaid”

One of the themes that comes up often in conversations with clients is the idea that Medicaid might be their fallback plan for long-term care. Not because they think things will “go bad,” but because they’re worried they might not have enough saved—or they simply don’t want to spend down the assets they’ve worked so hard to build.

I understand both feelings. Many of my clients grew up in households where you didn’t ask for help, you didn’t waste money, and you saved for the future because that’s what responsible people did. So the idea of paying for long-term care, especially when the price tag looks outrageous, can feel uncomfortable.

But relying on Medicaid is not a financial plan. And most of the people who consider it aren’t the people Medicaid was designed to serve.

What Medicaid really is

Medicaid is a government program meant for individuals who truly cannot afford to pay for their own care. I want to say that respectfully, because there’s nothing wrong with needing help. But Medicaid exists to support people with very limited financial resources.

It was not designed for people who’ve built meaningful savings, lived below their means, and invested wisely for decades but now feel reluctant to spend money on themselves. And in most states, you don’t qualify unless you spend your assets almost down to nothing. That’s not really in line with the careful, intentional way you’ve managed your finances—and it may not give you the dignity or control you expect when you need care.

The level of care you receive matters

There’s another part people often overlook: when Medicaid is the payer, you typically don’t get to choose where you receive care. Many higher-quality facilities either don’t accept Medicaid at all or have very limited availability.

I’m not speaking from personal experience here, but in conversations with professionals who work in elder care, I’m told that Medicaid-funded facilities can sometimes operate with fewer resources and thinner staffing. When funding is limited, care can reflect that.

This is your quality of life we’re talking about, not just a budget line item. You deserve care that supports your dignity, comfort, and well-being. That’s hard to guarantee when your options are constrained by a government reimbursement schedule.

My goal is simple: I want my clients to age well and, when the time comes, to leave this world with grace and the right kind of support. I’m not convinced relying on Medicaid alone achieves that.

Your money was meant for you

Another theme I hear often is the desire to leave money behind, especially for children. That’s a natural and generous instinct. But there’s an underlying question here: Should protecting an inheritance come at the expense of the care you deserve?

If you have a child or family member with special needs, that’s a completely different conversation. There are ways to plan responsibly and safeguard assets for their future.

But when it comes to adult children who simply prefer you not spend your money, especially money you saved for retirement, there’s a hard truth worth saying kindly: This money was meant to take care of you. That’s why you spent a lifetime saving it.

You didn’t put all this work in just to deny yourself the care, comfort, or independence you’ve earned.

A more balanced way to think about this

Here’s what I want you to remember:

• You spent years planning, saving, and investing.
• Those assets are there to support you—your health, your comfort, your quality of life.
• Using your resources to secure good care isn’t irresponsible. It’s exactly what the money is for.

Medicaid is a safety net. It’s not a strategy. And it certainly isn’t the first line of defense for people who’ve worked hard and saved carefully.

If you’re unsure how long-term care fits into your broader financial picture—or worried about whether you can afford the kind of care you want—let’s talk it through. We can look at your options, build a thoughtful plan, and make sure your later years reflect the dignity and quality of life you’ve earned.