MassHealth for Long-Term Care Attorney
For over a decade, Matthew Karr, Esq., the principal attorney of the Heritage Law Center, has been meeting the needs of clients throughout eastern Massachusetts. In his role as an elder law attorney, he’s dedicated to helping seniors remain comfortable and financially secure, even if health problems intervene. One important part of this job is helping them and their families plan for eligibility for MassHealth (Medicaid in Massachusetts) for long-term care services provided either in a nursing home setting or in the community.
What Is MassHealth (Massachusetts Medicaid)?
MassHealth is a federal and state program that pays for health care for certain low- and medium-income people living in Massachusetts. The Heritage Law Center specifically deals with MassHealth Standard for seniors (age 65 or older) who need long-term care and have limited income and resources. Without MassHealth, all but the very wealthiest among us would be in danger of using up the accumulated assets of a lifetime during an extended period of long-term care.
Why Most Older People Need MassHealth
Long-term nursing care is extremely expensive, averaging $150,000 annually in the Boston area, and the reality is that approximately 70 percent of the people over the age of 65 will require long-term care at some point.
MassHealth Eligibility: Countable Assets and Income Limits
To qualify for MassHealth for long-term care benefits, seniors must meet strict financial eligibility requirements, including both a limit on countable assets as well as income. If they’re married and live with their spouse, both of their incomes and assets count in deciding if they can get MassHealth.
Income limits depend on the program you are applying for, but countable income includes:
- Wages, salary, tips, commissions (before deductions)
- Self-employment income (minus expenses)
- Social Security benefits
- Railroad retirement benefits
- Pensions and annuities
- Federal veterans’ benefits (minus allowed exclusions)
- Interest and dividends
- Rental income (minus expenses)
- Alimony payments
- IRA withdrawals
Note: COVID-19 stimulus checks don’t count as income.
Countable assets include but aren’t limited to:
- Cash
- Bank accounts
- Certificates of deposit
- Mutual funds
- Stocks and bonds
- Value of real property, except your home, if it meets eligibility requirements
- Individual Retirement Accounts, Keogh Plans
- Cash surrender value of life insurance
- Vehicles – One vehicle per household is non-countable if it is for the use of the individual living in the community. The equity value of all other vehicles is a countable asset.
- Revocable Trusts (regulations regarding trusts are complex)
- Retroactive Supplemental Security Income (SSI) and Retirement, Survivors and Disability Insurance (RSDI). Benefit payments beginning in the 8th month after receipt. (Non-countable in the month of receipt and for the next six months if deposited in a separately identifiable account.)
The basic rule for MassHealth long-term care eligibility is that if an applicant applies, whether single or married, they can have only $2,000 in countable assets in their name. If their spouse plans to continue living in the community, the spouse is allowed to keep approximately $154,140 in their name.
If someone applies to MassHealth with more assets than this they’ll be required to spend down those assets to the applicable limit. The assets can be spent on the applicant’s or spouse’s needs, including medical care, in-home supports like personal care and cleaning, home repairs, care repairs, regular monthly bills, eyeglasses, hearing aids, and mobility aids. They can also pay for burial and funeral expenses in advance.
Why You Need a Skilled MassHealth Attorney
Because MassHealth is only available to seniors with very low assets and income, it’s crucial to plan ahead for eligibility. Otherwise, your life savings can be greatly depleted or swallowed entirely by the high costs of long-term care. This is where the services of the Heritage Law Center become invaluable.
Elder law attorney Matthew Karr is well-versed in the numerous methods used to protect assets, so you’ll be eligible for MassHealth when it becomes essential for your well-being. He’ll help you plan for the future by:
- Creating irrevocable trusts
- Using strategic gifting
- Converting countable assets into exempt ones
- Engaging in legal spend downs
- Using annuities and long-term care insurance
Without the skilled assistance of a professional who knows the ins and outs of MassHealth and all the laws surrounding it, it may be difficult, if not impossible, to navigate the healthcare system with a steady hand and considered crisis planning.
You Have to Begin Preparing for MassHealth Well Before You Need It
It’s important to keep in mind the 5-year look-back period. When someone applies for MassHealth for long-term care, MassHealth has the right to examine an applicant’s bank and financial records for up to five years immediately prior to the date of application. If they discover a transfer of assets during this period, whether to a trust or to another person, they’ll impose a disqualification period on the applicant’s eligibility (a length of time the applicant won’t be eligible for MassHealth). This is one reason why it’s so important to start your Medicaid planning for MassHealth today.
MassHealth Standard
While there are several types of MassHealth coverage, MassHealth Standard is the most complete and is the type most commonly used by older adults (age 65 and older). MassHealth Standard is what pays for long-term care services for seniors that are provided either in a nursing home setting or in the community. In order to be eligible for this plan, you must be a U.S. citizen or legal alien and a resident of Massachusetts. Once you qualify for MassHealth Standard, you and your family will realize what a blessing it is, since you will now be covered for the following Medicaid benefits:
- Inpatient hospital services
- Outpatient services, including ERs, clinics, doctor visits, dentists, home healthcare
- Medical services: laboratory and imaging tests, physical and occupational therapy
- Prescription drugs and medical devices: dentures, eyeglasses, hearing aids, etc.
- Mental health and addiction services: inpatient and outpatient
- Transportation to and from medical settings
- Personal-care-attendant services
- Long-term care benefits and services
- Nursing home care
- Inpatient rehabilitation for chronic illness or injury
- Adult daycare
- Care related to an organ transplant procedure (if approved)
- Hospice care
If you qualify for Medicare as well as MassHealth, Medicare will pay for your prescription drugs through a Medicare prescription drug plan and MassHealth will contribute to copayments and deductibles.
Why Planning for MassHealth Is an Important Part of Estate Planning
No one likes to think about mortality or incapacity that requires long-term care in nursing homes, but they are facts of life. Confronting these issues and preparing for them through crisis planning can provide you with a sense of control and self-determination, as well as the peace of mind that comes from knowing that your hard-earned assets and your family’s stability will be preserved.
Use Our Expertise for Your MassHealth Application
MassHealth has a lot of complicated rules, and you have to file a detailed application in order to try to get financial help from it. The MassHealth application process can take up to six months, and if you make one mistake it can slow down your approval by weeks or even months. We’ll work with you through the burdensome and often confusing process to ensure that this time-sensitive application is properly completed and submitted to MassHealth.
Free MassHealth Planning Report
You can find more information in our free MassHealth Planning and Asset Protection Report.
Be Proactive in Your Healthcare Planning—Contact The Heritage Law Center Today
When it comes to preparing for MassHealth, you can trust Matthew Karr to guide you with efficiency and empathy. Acknowledging that the future may include incapacity for a prolonged period isn’t easy, but he’ll help you do so with dignity and foresight. Don’t let your discomfort about the topic keep you from receiving the benefits you deserve. Contact our Massachusetts elder law attorney today for a confidential consultation.
