Helmuth Cremer, and Pierre Pestieau, Means-tested long term care and family transfers, IDEI Working Paper, n. 826, May 2014.


One of the pervasive problems with means-tested public long term care (LTC) programs is their inability to prevent individuals who could afford private long term services from taking advantage of public care. They often manage to elude the means-test net through "strategic impoverishment". We show in a simple model how this problem comes about, how it affects welfare and how it can be mitigated.


Long term care; means-testing; strategic impoverishment; opting out; public insurance; altruism;

JEL codes

  • H2: Taxation, Subsidies, and Revenue
  • H5: National Government Expenditures and Related Policies

Research partnership

Scor Chair

Research theme

Longevity Risk, Long Term Care (Social) Insurance