MassHealth Planning

MassHealth is the federal Medicaid program as administered in Massachusetts.  Contrary to what most people think, Medicare, which covers all persons over age 65, does not pay for long term health care, including nursing home care, beyond the first 100 days.  Unless you have long term health care insurance, you will need to pay for any nursing home care you may need beyond that first 100-day period.  Because the cost of nursing home care can be more than $5,000 per month, most people will not be able to pay privately for such care for very long before completely draining their family’s assets.  Once a person has no assets above $2,000, she can apply for MassHealth, which will provide nursing home care coverage.

In order to be eligible for nursing home benefits under MassHealth, an applicant must have assets of no more than $2,000, including both retirement and non-retirement assets.  The applicant’s spouse may keep approximately $110,000.  There is no limit on income, but the bulk of whatever the applicant receives in income must be paid to the nursing home each month for her care.  At the time of applying for benefits, the applicant must provide bank statements for a period of 60 months before the date of the application.  This 5-year period is called the “look-back period.”  If MassHealth finds that there were any “disqualifying transfers” – that is, any transfers that were made for the purpose of depleting assets in order to qualify for MassHealth – it will deem the applicant ineligible for benefits.  The period of ineligibility is one month for every $8,370 transferred (as of 2012 – this figure is adjusted yearly).   Because of these rules, it is important to discuss your application with an experienced elder law attorney before filing.  In addition, Attorney Harvey can assist you in transferring assets in order to preserve them for your family long before any application is required.