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Long-term care & MassHealth

The cost of an assisted living facility or nursing home can quickly deplete a person’s life savings, making the discussion of long-term care and planning extremely important. Our office will carefully review the client’s options for long-term care for themselves or a family member. The advice given will depend on multiple factors such as: the client’s individual situation, marital status, income and assets, entitlement to federal, military or state benefits, and the client’s current physical and mental health.

Options for long-term care include:

Staying at home with appropriate services in place

Private health care services and community based services provided by MassHealth can be used to keep a frail elder in his or her home for as long as possible.

https://www.mass.gov/dds-home-and-community-based-services-waivers

Living with a family member

Many people choose to move an aging parent or other elder to their home to avoid the cost of alternative care. An in-law apartment may be considered or remodeling the existing space to make it handicap accessible and comfortable for the elder. When appropriate, this option may benefit the elderly person, while preserving their assets for future generations. Living with family may not work indefinitely, but could work until the elder needs a higher level of care.

Assisted living facilities

For elders who wish to downsize to apartment living but can still live independently, an assisted living facility may be a great option if the person can afford it. An assisted living facility has staff members on-site to provide a wide range of services to the resident, such as meal preparation, medication management, transportation services, housekeeping and personal monitoring. Some facilities have group dining rooms, gyms and pools while others are more modest. The cost of an assisted living facility will depend on the services and amenities that are offered, but typically the price ranges from $4,000.00 to $8,000.00 per month.

Nursing home

The decision to move to a nursing home is a difficult one. It is often the last resort for a person who needs 24-hour custodial care due to physical and/or mental deterioration. Common reasons for nursing home care include dementia, Alzheimer’s disease, stroke, advanced Parkinson’s disease, ALS or diabetes. Nursing home care is  the most expensive level of long-term care, ranging from $9,000.00 - $14,000.00 per month. 

Planning for the cost of long-term care:

There are many options for the payment of long-term care, including long-term care insurance, creating an irrevocable income-only trust or a pooled trust, and applying for federal, state or military benefits that may subsidize the cost of long-term care. The earlier a person starts to plan for long-term care, the more options they will have. Please contact our office to discover a way through the maze of long-term care financing and asset protection.

Do I qualify for MassHealth coverage for Nursing Homes?

In order for MassHealth (Medicaid) to cover the cost of a nursing home, the applicant must be eligible both physically and financially. As of 2020, the nursing home applicant must have less than $2,000.00 of countable assets at the time of the application. If the applicant is married, then the spouse may only keep $128,640.00 of countable assets. Navigating through MassHealth coverage qualifications can be difficult without the knowledge of an expert. Please call our office if you are considering MassHealth nursing home benefits for yourself or your loved one so that we can answer your questions. We will guide you through the process with care, compassion and competence.

Is an Irrevocable Income Only Trust (a/k/a “MassHealth Trusts”) right for me?:

MassHealth will exclude assets transferred into a qualifying irrevocable income-only trust from being countable, provided that the trust contains certain provisions and the assets were transferred at least 60-months prior to the application. It’s important to know the inherent risks and potential benefits that this type of irrevocable trust may have. Depending on the client’s personal and financial situation, a client may be discouraged from creating this trust. While for some this could be an excellent planning tool, to others it could cause unintended harm and become detrimental to the family. Please contact our office for a discussion on whether or not you should consider an irrevocable income-only trust as part of your long-term care plan.

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