Medicaid and MassHealth

If you don’t have long-term care insurance, then nursing home care is generally paid out of pocket. There are advantages to paying privately for nursing home care, especially if you are trying to enter a particular high-quality facility. But the expense is considerable – in some cases as high as $12,000 per month. Without proper planning, nursing home residents can easily lose the bulk of their savings to long-term-care expenses.

Those who qualify for MassHealth (or, in other states, Medicaid) may have the alternative option of having some of their nursing-home care covered by MassHealth. MassHealth will look at your “countable assets” to determine your eligibility. If you are eligible, MassHealth will pay up to $310 per day of your long-term-care costs. But to be eligible, you must be “impoverished” as defined by the strict laws governing MassHealth.

“Impoverished” is a bit of a strong word; you can actually own a home worth $828,000 and still qualify. So you don’t have to be completely destitute or even lose your home to receive government assistance. The three biggest problem areas are penalties for transferring assets, home equity, and annuities.

The primary objective of long-term-care planning is to protect your savings for you and your family. Helping you qualify for MassHealth nursing home benefits may be the best way of doing that. To know for sure, we must consider the MassHealth eligibility rules and the status of your income and your assets under those rules. Some types of assets “count” and others are “exempt,” meaning that they are ignored when determining eligibility.