YOu could put your assets in a trust and preserve your estate for your heirs and then let the "state" or medicaid (both synonomous with "your neighbor or taxpayers) take care of you
Actually Old, depending on the kind of trust you set up that's not exactly true.
Plus, the "lookback" provision for putting money into a trust is 5 years, rather than the 3 years they look back for family gifts.
There are many downsides to Living Trusts. One of them is that you hit the highest tax rates much quicker. Also, if you have any control over the Trust at all, then it will be considered an asset, both for Medicaid purposes and for inheritance tax purposes.