Medicaid Planning Assistance in Worcester & Burlington

As you might imagine, only those with significant financial assets will plan to self-pay for nursing homes. On the other end, those with few assets or savings will easily qualify for Medicaid benefits should they require nursing home or assisted living care. Those in the “financial middle” are of particular concern. This group may have assets—possibly even significant assets—yet not enough to comfortably fund a $300,000 or larger long-term care outlay at the end of their lives.

The choices this financial group of elderly adults may face can look fairly stark. Long-term care insurance could potentially be purchased; however, premium hikes are likely. A “hybrid” life/long-term care policy could be an option, although the cost could be prohibitive. Some in this group will plan to use the sale of their home to cover long-term care costs, yet if one spouse requires long-term care while the other is relatively healthy and wants to remain in the family home, this is not a viable option. In the end, relatively few people are able to self-pay for long-term care over an extended period of time, making Medicaid the primary way to pay for long-term care.

There are a variety of ways to ensure you are eligible for Medicaid benefits should the time come, while protecting the assets you have worked for over your lifetime. The Law Offices of James A. Miller, P.C., can assess your unique situation, then help you determine the best way to plan for your future, and for long-term care. Attorney James Miller has a deep understanding of Massachusetts Medicaid rules, garnered from years of helping others just like you protect their assets while still qualifying for Medicaid.

About the Firm

What are the Medicaid Rules for Eligibility in the State of Massachusetts?

The following information should answer many of your questions regarding Massachusetts Medicaid planning.

  • What is MassHealth?—In the state of Massachusetts, Medicaid is known as MassHealth, and is a common source of funding for nursing homes and assisted living facilities for those who have used up their own assets to pay for care. Private health insurance policies generally do not cover long-term care, and Medicare coverage is extremely limited. According to a com news report, MassHealth pays for about 70 percent of nursing home residents in the state. There are, however, specific eligibility requirements that must be carefully considered, with the help of a Massachusetts elder law attorney.
  • MassHealth Spousal Maintenance Allowance—Perhaps one spouse will be going into a nursing home or assisted living facility while the other is able to continue living independently in the family home. If this is the case, the state will allow the couple to retain a larger amount of income and assets to support the “community spouse.” This is known as monthly maintenance needs allowance, and the amount will depend on the income of the community spouse. As of January 2019, the minimum/maximum community spouse allowances were $2,057.50 and $3,160.50. If the two spouses together have $126,420 or less in assets, then the community spouse may keep all those assets. If there is more than the allowed amount, there must be a “spend-down” of assets until the eligibility limit is met.
  • MassHealth Resource Limits for Long-Term Care—Massachusetts residents who qualify both medically and financially may take advantage of MassHealth benefits for long-term care, so long as their resources do not exceed the allowable limits. As of 2019, you are allowed to have no more than $2,000 in resources (money and property) for one person, or $3,000 for a married couple. You are allowed certain exemptions: one car, so long as a household member is using it, personal belongings, and your home depending on your specific circumstances. Life insurance policies with a cash value, checking and savings accounts, CDs, stocks, bonds, and retirement accounts all count as financial resources.
  • When is a Nursing Home Considered Medically Necessary?—MassHealth only pays for a nursing home or assisted living facility when you meet the “nursing facility level of care.” This means you require a specific level of care that can only be provided in a nursing home. You must either be able to show that you require at least one skilled service each day (an injection, catheter care, monitoring of certain conditions, etc.) or that you have a mental or medical condition which requires significant levels of assistance with the daily tasks of life, such as getting dressed, taking a bath, or eating.

Getting Help with Medicaid Planning from the Law Offices of James A. Miller, P.C.

If you are in need of Medicaid planning help, Attorney James Miller can help; James understands what a difficult time this is for you or for family members helping a loved one qualify for MassHealth. He has extensive experience and knowledge regarding the ins and outs of MassHealth qualification and will use all his resources to help you qualify for these much-needed benefits. Contact the Law Offices of James A. Miller, P.C. today.