There are dozens of other nuances, maybe hundreds. Did I mention the need for a qualified lawyer? If you want to do some homework first, the book “How to Protect Your Family’s Assets From Devastating Nursing Home Costs” will give you a sense of what questions you need to ask.

However, you may want nothing to do with this. It would not surprise K. Gabriel Heiser, the lawyer who wrote the book. He’s heard from colleagues over the years who wanted no part of this work. This confused him, he said in an interview this week, given that many of them handled estate planning for wealthier clients. There, they helped people avoid paying millions to the government, whereas Mr. Heiser’s work merely helps clients get the government to pay a few hundred thousand for care on their behalf.

That bit of relativism, however, does not erase a basic fact: Anyone who engages in legal Medicaid planning is attempting to qualify for a government program for the indigent when they do have at least some assets that could pay for their care.

Janet Kinzer, who lives in Silver Spring, Md., and whose father died last year at 92 with assets to spare, offered the most stinging rebuke: People who engage in such planning are privileged enough to be aware of it and can afford the legal fees. Shouldn’t tax dollars go only toward the care of people who lack such access?

The retorts are numerous. I heard several versions of the following in recent weeks: I’m a taxpayer and paid into this system. I was thrifty, and my neighbors were not. They went on vacation. In fact, I watched them go when I was home at Christmas, and they came back with suntans. And now my heirs should get nothing? To accuse me of gaming the system is absurd; I just don’t want to be taken by it.

If this sounds a bit like a sense of entitlement, that may not be far-off. In fact, several readers echoed something that Marcia Perna told me when I interviewed her about her late mother a few weeks ago. In plenty of other countries, she said, the government would pay for long-term care for everyone.

Now, take that to its logical conclusion. Here, Medicare pays the surgery and drug bills for people with heart disease and cancer. But dementia patients, like Ms. Perna’s mother, need expensive supervision, which Medicare generally doesn’t pay for. That’s not fair, one might argue, so doing everything legally possible to get a dementia patient eligible for Medicaid is like a form of political protest that corrects an inequity.