MassHealth (Medicaid in Massachusetts) has programs that provide help to seniors who are clinically eligible for nursing home care so they can stay at home with helpful health and support services. Many seniors prefer to stay in the comfort of their homes instead of going to nursing homes, so these seniors need access to long-term care in their homes. Also, it costs Massachusetts significantly less money to pay for home care than nursing home care.
Seniors must qualify for these programs by having $2,742 or under per month in gross income. The issue is that if the senior earns just $1 dollar above the $2,742 limit, they must pay a deductible and spend down their income in excess of $542 before they can qualify for home services. That means they would have to spend every dollar of income over that $542 on medical care, leaving them $542 to live on every month to pay for life’s expenses like insurance, food, rent, taxes, etc.
This results in:
- The senior going to a nursing home because MassHealth will cover that cost since qualifying in that case doesn’t have an income limit
- The senior staying at home but not having the care they need to stay safe
Why We Need a Solution
70% of adults aged 65 years and older will require long-term care at some point and more than a million Massachusetts residents are age 65 and older. So, there’s an incredible need right now to fix this problem.
We also need to prepare for the future. Baby boomers are the second-largest age group after their children, the millennials. That large population of baby boomers will all be age 65 and older by 2030.
The Massachusetts chapter of the National Academy of Elder Law Attorney (MassNAELA) is trying to fix the issue with legislation they have filed. The Community Care Bill – An Act to Support Equal Access to Community Care for Elders and the Disabled (see fact sheet) would help lessen the financial obstacle of trying to qualify for MassHealth’s community-based services for such programs as Home and Community Based Services Waiver (HCBS) and Programs of All-inclusive Care for the Elderly (PACE). The bill indicates that if income is above the eligibility limit, people would only pay a premium that is the amount of income above the program’s income limits.
So, if the senior’s monthly income is $2,900, they would have to spend $158 per month ($2,900 income -$2,742 limit) on medical expenses to be eligible for the MassHealth community services vs. what they have to spend now which is $2,358 a month.
How You Can Help
The bills are HD753 and SD608, and you can help them pass by contacting your state representatives and senators, and telling them why this issue matters. They can be found at https://malegislature.gov/StateHouse/Contact. You can email, call, or write to them.
Many older adults with disabilities want to remain at home, which means these seniors need access to long-term care in their homes. MassHealth’s home care services need to be reasonably accessible to them. In that way, we’ll meet the goals of enabling these residents to remain safely in the community and keeping the costs of caring for them lower for the state of Massachusetts.