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Comment by ransom1538 | Hacker News Reader

What ever you save with your blood sweat and tears will be burned on medical expenses. Your best bet (after being diagnosed with something severe) is to convert all your last savings to cash, give it to a loved one, explain to the government you are broke, and die on the street. [1][2]

Nursing homes and hospices are designed to suck out your funds until you are dry, then dump you on state aid.

1. https://www.senioradvisor.com/san-jose-ca/how-much-do-san-jo...

"The average annual cost to seniors nationally is $80,300 for a semi-private and $91,250 for a private room in 2015"

2. I originally had "in a state funded hospice", but opo pointed out that medicare will strip you of your benefits due to their claw back system. You may want to look into committing a felony, for state funded care.

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There's loopholes. If you are married, your best bet is to convert all your cash into an irrevocable single premium immediate annuity in your spouse's name. Your spouse's income doesn't get taken by Medicaid to pay for your expenses, it's not a gift since you're purchasing something of equal value, and it's not an asset because you can't cash it out immediately.

Basically, the strategy turns $100k into something like $6k/yr for the rest of your spouse's life (depending on age and gender), and makes you eligible for Medicaid. That said, you probably want to buy a slot in a nursing home that accepts Medicaid first, then "run out of money" and apply for Medicaid once you're in the nursing home. It's illegal to kick you out if they accept Medicaid and you're transitioning from private payment to Medicaid.

That said, nursing homes are hellholes, and I'd rather die with relatively minimal palliative care, in my own home, with friends and family visiting. That doesn't require BS like this. There's some circumstances where the Medicaid route may be better, so it's nice to know of this option.

This. Len Tillem, a lawyer who used to host a show on the old KGO 810 in the bay area, was telling this strategy for years. In fact, many go to his law offices for such trust setups for medical, etc.

This is not good advice. Enough people have given away all their assets to qualify for Medicaid, that there are rules to prevent this:

>...To prevent candidates from simply giving away their money or resources to qualify for Medicaid, the federal government implemented the “look-back period”. This is a set period of time prior to the individual’s application during which the Medicaid administering agency reviews all the financial transactions that the senior has made. If a transaction is found in violation of the look back period’s rules, the applicant will be assessed a penalty. Penalties come in the form of a period of time that the applicant is made ineligible for Medicaid.

https://www.payingforseniorcare.com/medicaid/look-back-perio...

The "lookback period" is usually 5 years.

Also since nursing homes lose money on medicaid patients they tend to have limits on how many medicaid patients they will accept. If you are on medicaid, you might not be able to to find a reasonable nursing home that will accept you.

A better answer us to buy long-term care insurance. If you go into a nursing home and you eventually have to go on medicaid, it is illegal for them to kick you out.

My plan is to intentionally OD on opiod patches if it gets to the point where I'm too sick to live independently and am burning through savings to suffer like that.

The gift route gets clawed back; the system is designed to take all your money first before subsidizing care.

In my country(India), if you go to government hospitals(which is the only place the poor can go), its not uncommon to see doctors advise euthanasia to seriously ill patients(burn victims, cancer, organ failures) who are poor. Its just that there are no real treatment option at their income level.

And death is easy to bear and forget than living through the pain of seeing your family go through helpless moments, and the humiliation of poverty till the eventual arrival of death.

Human life takes a lot of make up and dressing to make it look good.

There is something deeply disturbing and saddening in the honesty of your comment and sibling comments regarding this topic.

There are some lives that I simply don't consider worth living.

Nah, I get that part. The part I don't get is where did we, as a society, fail so badly for people to even consider the things that I read around this thread.

If you're going to die, might as well die on your terms

Better hope you’re able to do it for yourself when the time comes. I’ve thought the same after watching my parents deal with my father’s Alzheimer’s.

As a person who had grand parents with Alzheimer’s, it's starting to sound like this is my better option. I can go through pain, suffering, and what not completely with it or I can slowly go out without knowing or understand anything that is going on. I think I will take the latter.

A good living will and instructions for trusted friends/family/SO to carry out goes a long way for that.

Its easy to take your life, its impossible(for decent people at-least) to take some one else's life.

Friends and family aren't exactly hitmen.

Most people aren't that 'rational' (or willing to go to jail)

Im thinking the same thing, however i am still young. My mom has been telling me your views on death change as you get older and closer to it.

If my grandfather's fight with liver cancer was any indication, I'll accept it when my time comes, too.

I've had a similar experience with most of my grandparents, they suffered unnecessarily while we were unable to do anything. One grandmother died peacefully only because she had Alzheimer and she was out of touch, but the early period of Alzheimer was unbelievably degrading to her and to our memory of her. Why would anyone want to go through that?

This can actually be done, but only over the course of a few years, or the government will insist on their cut (or deny you benefits). I honestly don’t know why there aren’t riots over the state of healthcare (and elder care is the worst part) in the US. It’s not like this isn’t going to happen to all of us who aren’t lucky enough to die quickly.

there aren't riots over the state of elder care because the elderly can't riot

I dunno. They have families. I’d be up for throwing a brick or two, knowing what I know about it.

The cynic in me believes that as much as those family members may hate the state or elder care, they much prefer it to the alternative, ie having their relatives move in with them and taking care of them themselves.

No, but they do vote, and they may just vote for an angry populist.

If nobody has taken the keys to their Lincoln away, the elderly can do much more than riot.

Before following this advice you should really consider checking out a state funded hospice. I'm willing to bet you'll be looking for the exits within 10 minutes.

Long term care insurance should be purchased after age 60 to offset those care costs: https://en.wikipedia.org/wiki/Long-term_care_insurance

um but the got. will notice the big sale

I'm pretty sure most government aid programs are solely based on income.

Several govt programs will look back at your finances about five years and go after those assets as well.

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