Understanding Medicaid and Long-Term Care
Planning for long-term care is a reality many seniors and their families face. In Massachusetts, Medicaid (MassHealth) can cover the high costs of nursing homes or in-home assistance. But navigating the application and eligibility rules can feel overwhelming. At Senior Resource Center Inc., we help families throughout Massachusetts—including Boston, the South Shore, Cape Cod, Danvers, Lexington, and Framingham—understand their options and plan effectively.
Long-term care costs in Massachusetts can exceed $150,000 per year for nursing home care. For many families, without proper planning, these expenses can quickly deplete savings. Fortunately, understanding Medicaid planning help is key to protecting your assets while ensuring quality care.
Who Qualifies for MassHealth Long-Term Care
MassHealth considers multiple factors:
- Age and Disability: Applicants must generally be 65 or older, or meet disability criteria.
- Medical Necessity: You must need assistance with daily activities such as bathing, dressing, or mobility.
- Marital Status: The rules and regulations are different for single individuals while there are many exemptions in spousal situations.
- Income Limits: MassHealth reviews your monthly income to determine eligibility.
- Asset Limits: Individuals must have countable assets under $2,000 and approximately $160,000 in spousal situations ( significantly more with proper planning).
- Caregiver + Disabled Child Exemptions: Sometimes all or some of an individual’s assets are protected in these situations.
Example Scenario:
Imagine a retired couple in the South Shore who had spent decades building their life together, a cozy home, some savings, and a few small investments. One day, one spouse began experiencing serious mobility challenges, making daily activities like cooking, bathing, and even getting out of bed increasingly difficult. The couple was worried, not only about finding the right care, but also about the high cost of long-term care and what it might mean for the home and savings they had worked so hard to build.
Feeling overwhelmed, they reached out to us. We sat down with them to review their income, assets, and care needs. Together, we created a clear plan to apply for MassHealth while ensuring their home remained protected in the stay-at-home spouses name as well as a sizable portion of their savings.
The process wasn’t just about paperwork; it was about peace of mind. By having a step-by-step plan and guidance from experienced professionals, the couple felt a sense of control return to their lives. They were able to focus on each other’s well-being rather than worry about financial devastation.
Although this specific case is hypothetical, situations like this happen time and time again for families, highlighting the importance of early planning and expert guidance but also in “emergency” situations when prior proper planning was not done.
Common Misconceptions About Eligibility
- “I have to give away all my money.”
Not true. Strategic planning allows you to protect assets legally. - “The five-year lookback makes it too late.”
With careful guidance, even assets within the five-year lookback can be protected through planning. - “I can’t qualify if I already need care.”
It’s never too late. There are steps that can help even if care has already begun.
How We Help
At Senior Resource Center Inc., we provide comprehensive elder care resources in Massachusetts, guiding families through:
- Evaluating eligibility
- Preparing MassHealth applications
- Structuring finances to protect assets
- Offering ongoing advice on long-term care planning
FAQs
Q: Can I keep my home if I apply for MassHealth?
A: Often, yes. MassHealth has exemptions for a primary residence, especially if a spouse continues living there, a caregiver child lives there, or the MassHealth recipient has a disabled child.
Q: What is the five-year lookback?
A: MassHealth reviews financial transfers made in the five years prior to application. Proper planning can navigate this rule safely.
Q: Can I apply if I live outside Boston or the South Shore?
A: Absolutely. We help families statewide, including Cape Cod, Lexington, Framingham, and Danvers.
💬 Ready to get help with Medicaid long-term care? Fill out the contact form below to speak with one of our team members.
