The decision to recommend that a client go onto Medicaid, the government-sponsored healthcare program for people with low income and minimal resources, is both simple and difficult.

The simple part comes down to finances, determined case by case, says Maureen Whelan, a fee-only planner with offices in Garden City, Croton on Hudson and Tarrytown, NY. “If the client doesn’t have any assets to protect, it won’t take them long to qualify for Medicaid,” she says. “But if someone can afford it, they should pursue purchasing at least a minimal long-term care benefit” instead.

The difficult part, says Steve Mathieu, a Manchester, New Hampshire-based financial and estate planner specializing in clients age 55 and up, comes down to loss of control, “Beause once you go on Medicaid, the government dictates many aspects of your life, including the level and type of care that you’ll receive and where you’ll live.”

“Some people no longer care. They don’t have any assets to protect and they’re okay with the government making all their decisions,” Mathieu says. They may transfer ownership of what few assets they have to a loved one in order to qualify for the program.

But others, he says, “don’t want to surrender control.” So while they may not have many assets to protect, if there’s any way they can, they need to purchase a long-term insurance policy to avoid the government program.