Rules for MassHealth nursing home eligibility are designed to help cover the costs of long-term care. The rules are notorious for being complicated, which can lead to misunderstandings about whether you qualify and for how much coverage.

Countable Assets

There is a limit on “countable” assets—that is, the assets that count against your MassHealth eligibility. You can only have $2,000 in countable assets, which include savings accounts, bank accounts, second or other homes and retirement accounts. Generally, your main residence, one car, any prepaid funeral plans and your personal belongings do not count against this limit. If you are married, your spouse is allowed $128,640 in countable assets (as of 2020).

Income

Any income you receive will be paid to your nursing home, except for a personal allowance (as of 2020, this is set at $72.80). Income includes any social security or retirement benefits but does not include a spouse’s personal income. Some income may be able to be diverted to the spouse or any dependent children.

Transfers and Penalties

MassHealth and Medicaid frown upon asset transfers within five years of your MassHealth application. This is referred to as “spending down,” and is utilized by people who are concerned they have too much to qualify for state and federal benefits but can’t afford to pay for long-term nursing care on their own. The penalty is a period of ineligibility for MassHealth.

Recovery of Assets

Generally, a person using MassHealth will not have any significant assets, since it’s designed to cover expenses for indigent residents. However, when a nursing home patient dies, the state is entitled to recover what they paid to the nursing home from the patient’s estate. In many cases, the patient’s home is the only significant asset they own. That’s why it’s important to consult with an attorney. An estate-planning attorney can help you protect the family home for the benefit of your beneficiaries while still helping you receive financial and medical assistance.

Potential Exceptions

There are exceptions to every rule, and MassHealth has plenty of caveats for the variety of circumstances you may encounter. Depending on your family situation, your spouse may be able to retain more assets than usual, and you should be able to divert plenty of funds and/or assets for the benefit of dependents, particularly if they are disabled.

The best thing you can do to protect yourself and your family is to consult with an estate planning attorney. Because they are familiar with the labyrinthine rules and regulations, they’ll be able to provide specialized guidance to serve you.

Contact Us

Do you need assistance with MassHealth and Medicaid planning? Not sure if you qualify or need help understanding the rules? Call Baker Law Group, P.C. for more information and a free consultation. We’ll use our years of experience to ensure you and your family are well cared-for.

Our estate planning and elder law attorneys can help you plan your estate so that your assets are protected on behalf of your beneficiaries, and you’ll remain eligible for the maximum amount of Massachusetts state benefits.  View Attorney Profiles.

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