Massachusetts Medicaid benefits are one of the few sources of payments for nursing home care when you need routine custodial care, rather than skilled medical services. However, actually qualifying for Medicaid and getting your nursing home costs paid for can be very complicated – especially for seniors who may have a life savings that they want to protect.
To make sure you can get nursing home care when you need it, you should speak with an experienced legal professional about Massachusetts medicaid coverage. The Law Offices of James A. Miller, P.C. provides legal representation in Worcester and surrounding areas to clients who want to get Medicaid coverage for essential nursing home care.
Making plans in advance of the time when you need care is the key to making sure you can get nursing home benefits covered, so give us a call today to find out how we can help you.
When Does Massachusetts Medicaid Pay for Nursing Home Care?
Massachusetts Medicaid is called MassHealth and it will pay for nursing home care when you need the level of services that only a nursing home can provide. You can demonstrate the need for nursing home services by showing you require at least one skilled service on a daily basis, such as monitoring of an unstable medical condition or requiring a catheter to be cared for. You can also demonstrate the need for nursing services by showing you require help with routine activities of daily living, such as mobility, dressing, eating, or toileting.
To be eligible for MassHealth to pay for your care when you meet these criteria, you also must meet the income and resource limits for Massachusetts Medicaid eligibility. Unfortunately, this is where many seniors have problems. MassHealth financial eligibility rules as explained in 520.003 explain that the asset limit for an individual is $2,000 and the asset limit for a couple living together is $3,000. In other words, if you have worked and amassed any amount of assets over the course of your life, you are likely going to be disqualified from receiving Medicaid nursing home coverage.
This is a big problem for seniors since Medicare and private insurance policies aren’t going to pay for nursing care that is required when you only need custodial care. These types of policies only pay for coverage for a limited time and only pay in situations where skilled medical services are essential. If you have just gotten older or sick, you need care, and you can’t get Medicaid, you are going to have to spend down your personal assets.
Qualifying for Massachusetts Medicaid
There may be options available to you to try to ensure you can qualify for Massachusetts Medicaid coverage, without you having to spend all of the money you’ve acquired or sell property you own. Avoiding the mandated spend-down of assets is very complicated, as MassHealth wants to try to restrict coverage only to people who really do have limited assets. As a result, if you have transferred assets for less than fair market value within five years of the time when medical care is needed, the transfers could end up disqualifying you from Medicaid coverage for a period of time.
The rule requiring an assessment of transferred assets in the five year period before you try to get Medicaid coverage is called the five year lookback rule. You should discuss with a Medicaid planning lawyer about what your options are for making plans well in advance of the time that you need nursing home care so you can make transfers and protect assets well before you need nursing care.
If you or someone in your family will need care sooner, a Massachusetts Medicaid planning lawyer may also be able to help protect some assets while obtaining Massachusetts Medicaid benefits.
How a Massachusetts Medicaid Lawyer Can Help You
Th Law Offices of James A. Miller, P.C. is dedicated to helping clients protect their wealth and ensure that they can get nursing home care paid for when and if they need it. The sooner you contact us to get help with the Medicaid planning process, the greater the chance that we can protect the maximum value of your assets. You cannot afford to wait, unless you want to put your legacy at risk.
To learn more about Medicaid benefits and Medicaid planning in Massachusetts, join us for a free seminar. You can also give us a call at 866-370-3888 or contact us online to find out more about the personalized assistance with Medicaid planning that our legal team can provide to you.
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