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.
What Is MassHealth?
MassHealth is a federal and state program that supports long-term care for seniors (age 65 or older) with 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 it at some point.
MassHealth Eligibility: Countable Assets and Income Limits
To qualify for MassHealth 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:
- 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 $130,380 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 The Heritage Law Center
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.
You Have to Begin Preparing for MassHealth Well Before You Need It
When determining whether a person is eligible for MassHealth, there’s a 5-year look-back period, meaning that MassHealth will investigate your bank accounts and other financial records going back 5 years from the time of your application. If it’s discovered that you transferred sizable assets during this period, whether to another person or to a trust, your application for MassHealth benefits will be denied in the present and a disqualification period will be imposed.
While there are several types of MassHealth coverage, MassHealth Standard is the most complete and is the type most commonly used by the elderly. 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, you and your family will realize what a blessing it is, since you will now be covered for:
- 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 services
- 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 nursing care, but they are facts of life. Confronting these issues and preparing for them 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 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. Making one mistake during this application process 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.
Be Proactive — 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 free initial consultation.