Are you, your spouse, or your parents in need of nursing home care in Massachusetts? Did you know nursing home care is not covered by Medicare?! Nursing home care must be privately paid for using your own funds, or can be covered by Medicaid, which is handled by MassHealth in Massachusetts.
Facing long-term care in a nursing home is one of the most stressful experiences a family can go through, often creating anxiety about the high cost of care and the quality. The annual cost of nursing home care in Massachusetts can top $180,000 per year (2020).
How will you pay for nursing home care?
Long term care insurance may pay for some or all of your nursing home care costs, depending on your coverage. If you don’t have long term care insurance, or your coverage is inadequate, you will have to pay privately, or depend on MassHealth to pay for your long term care.
Insurance plans, including Medicare, may cover most of the medical expenses of a hospitalization or illness, but will provide little or no coverage for nursing home care. Medicaid, known as MassHealth in Massachusetts, is a joint federal-state public benefits program that may pay for the high costs of long-term care. However, MassHealth has a complex set of eligibility rules. It has become increasingly difficult to plan for MassHealth coverage of long-term nursing home stays due to changes in MassHealth and the interpretations by MassHealth caseworkers. It’s never advisable to apply for MassHealth coverage of a nursing home stay on your own. Similarly, it’s not advisable to use a non-law office application service if you have assets. Just one mistake could cost tens of thousands of dollars in missed eligibility coverage and low cost application services are unable to advise you on how to protect assets. Often times people’s perceptions of MassHealth are incorrect. We will clarify the often confusing, MassHealth eligibility rules, evaluate your personal situation, and develop a long-term care plan that is within your means.
To qualify for MassHealth coverage of nursing home care, spouses cannot have more than $128,640 (2020) in countable assets and an individual cannot have more than $2,000 in countable assets. However, with proper planning you may be able to retain many assets and still qualify for MassHealth.
For example, it is a common misconception that your home must be sold in order to qualify. In certain situations your home can be treated as a non-countable asset.
Many seniors don’t like the idea of depending on MassHealth or assume that they will not qualify. MassHealth for long term care in a nursing home is NOT the same program as MassHealth for basic health insurance. You’ve worked hard all your life and spending down all your hard earned assets to pay for the nursing home may not be necessary. Many folks can and do qualify for MassHealth even with significant assets. Schedule a consult with us today to review your specific situation.
Let Vickstrom Law, PC, a firm experienced in Elder Law, assess your potential eligibility for MassHealth, guide you through the MassHealth application process, and coordinate efforts with the nursing home to make the transition, a smooth one, all while ensuring your hard earned assets are protected for your spouse and family.