When a loved one requires nursing home care, families often worry that all of their savings and property will need to be spent before help becomes available. Because the cost of long-term care can be significant, many families eventually rely on MassHealth (Medicaid) to help cover nursing home expenses.
MassHealth eligibility rules limit the amount of countable assets an individual may own. However, not all property is treated the same. Certain assets are considered exempt, meaning they are not counted when determining eligibility.
The rules also differ depending on whether the applicant is single or married. Understanding these distinctions can help families make informed decisions during what is often a stressful time.
MassHealth Asset Limits: Single vs. Married Applicants
Because the rules differ depending on marital status, the following chart provides a simplified overview of common MassHealth asset exemptions.
| Category | Single Applicant | Married Applicant (Community Spouse at Home) |
| Countable Asset Limit | $2,000 | Nursing Home Spouse: $2,000 |
| Community Spouse Allowance | Not applicable | Up to approximately $162,000 in countable assets (CSRA) |
| Primary Residence | May be exempt if intent to return home or certain family members reside there | Exempt if the community spouse continues to live in the home |
| Vehicle | One vehicle typically exempt | One vehicle typically exempt |
| Personal Belongings & Household Goods | Exempt | Exempt |
| Burial / Funeral Arrangements | Prepaid irrevocable arrangements typically exempt | Prepaid irrevocable arrangements typically exempt |
| Retirement Accounts | May be countable depending on structure | Often treated more favorably when owned by the community spouse |
While this chart provides a general overview, each family’s situation is unique and MassHealth eligibility rules can be complex.
Exempt Assets for a Single Individual
For a single person applying for MassHealth long-term care benefits, the individual generally must have no more than $2,000 in countable assets. While this limit may seem restrictive, several types of property are not counted when determining eligibility.
Common exempt assets include:
- Primary Residence: A home may be exempt if the applicant intends to return home or if certain family members reside there. However, MassHealth may later seek reimbursement from the estate through the estate recovery process.
- Personal Belongings and Household Goods: Furniture, clothing, and personal effects are not counted.
- One Vehicle: Typically one automobile is exempt regardless of value if used for transportation.
- Irrevocable Burial Arrangements: Prepaid funeral and burial plans that meet MassHealth requirements are generally exempt.
- Certain Life Insurance Policies: Depending on the type and face value of the policy, some life insurance may not count toward the asset limit.
Exempt Assets for Married Couples
When one spouse requires nursing home care but the other spouse continues living at home, MassHealth rules are designed to prevent the healthy spouse from becoming impoverished. The spouse living at home is commonly referred to as the community spouse.
Under federal guidelines, the community spouse may retain a portion of the couple’s assets through the Community Spouse Resource Allowance (CSRA). Under current limits, the community spouse may retain up to approximately $162,000 in countable assets, though this amount is adjusted periodically.
In addition to the CSRA, several assets are typically exempt:
- Primary Residence: If the community spouse continues to live in the home, the residence is generally exempt.
- Vehicle: A vehicle used by the community spouse is typically protected.
- Household Goods and Personal Belongings: Furniture and personal effects remain exempt.
- Burial Arrangements: Qualified prepaid funeral arrangements are typically protected.
- Retirement Accounts: In some circumstances, retirement accounts owned by the community spouse may receive favorable treatment depending on how they are structured.
Why Planning Is Important
While certain assets are exempt, many assets remain countable when determining MassHealth eligibility. These may include:
- Bank accounts
- Investment accounts
- Additional real estate
- Certain life insurance policies
- Non-exempt retirement accounts
Without proper planning, families may be required to spend down substantial savings before qualifying for MassHealth assistance.
Additionally, MassHealth applies a five-year lookback period, meaning that certain transfers made within five years of applying for benefits may result in a period of ineligibility.
Final Thoughts
Understanding which assets are exempt when a loved one requires nursing home care can help families navigate an already difficult situation.
Because MassHealth eligibility rules vary based on marital status, asset ownership, and prior financial transactions, careful planning is essential.
Senior Resource Center, Inc assists families with long-term care planning and MassHealth eligibility. Our team works closely with clients to protect assets, preserve financial stability for spouses and families, and help ensure loved ones receive the care they need.
