Elder Law FAQs
Long-term care insurance covers the risk that you may at some point in your life be placed into a nursing home by paying for some or all the expenses associated with nursing home care. It also frequently covers assisted living care or care in your home. Long-term care insurance can be a very valuable tool that can help you avoid depleting your estate in order to pay for nursing home care. Nursing homes greatly vary in cost depending on the quality of the home and the geographic area of the country in which the care facility is located. At a minimum, you can expect to pay several thousand dollars a month for decent nursing home care, which can rapidly deplete an individual’s savings.
Medicaid, or MassHealth in Massachusetts, is a state and federally funded program that provides health coverage for individuals with low income and assets. MassHealth also assists with the cost of long-term care (nursing homes) and will provide services at home.
As a couple where only one spouse requires MassHealth, the spouse in the community can keep assets totaling $119,220 and all of his/her income. There are options for protecting additional assets. It is important to contact an attorney specializing in elder law to discuss the options.
If only one spouse requires care, the home is usually protected and MassHealth cannot look to the home to pay for the cost of care. It is important to contact an attorney specializing in elder law to discuss protecting the home.
MassHealth will assist with the cost the following services at home: personal care attendant, adult day care, home health services, etc. There are income and asset thresholds for the home care program, but there are numerous covered services.
The answer is: it depends. For community MassHealth, there is currently no transfer penalty imposed. The same cannot be said of MassHealth coverage in a long-term care facility; there is a five year transfer penalty for this program. In either case, all assets transferred within five years of filing a MassHealth application must be disclosed, and a transfer made to qualify for community MassHealth could disqualify an individual from MassHealth coverage in a long-term care facility.
Medicare does not provide coverage for long-term care, such as nursing home care. Medicare will pay for up to 100 days of skilled nursing care per illness. A patient must be hospitalized for the illness, and the patient must receive a high level of care in a nursing home that couldn’t be provided at home or on an outpatient basis. After 20 days of nursing home care, there is a large copayment required of the patient for the remainder of the stay.
If a child removes money from your joint account, that could be considered a transfer to him. Currently, MassHealth has a “look back” period on transfers of assets within the past 60 months. This means that any gifts or other transfers of assets you made in the 60 months before you applied for MassHealth will be assessed in order to determine your eligibility. If you did transfer assets in the five year period before applying for MassHealth, you could be subjected to a penalty. Therefore, if you made a transfer of assets in the past five years, you should not apply for MassHealth without consulting an elder law attorney because the penalties could be severe.
No, if you anticipate needing MassHealth at any point in the foreseeable future, it’s prudent to seek the advice of a qualified elder law attorney. There are steps you can take to protect your assets which may not be available when you actually need MassHealth. Some of those steps may include transferring your assets or establishing trusts. An elder law attorney with expertise in MassHealth planning can evaluate your situation and advise you on the most prudent steps to take in order to preserve your rights and maximize benefits.