I have set out below some of the Long Term Care MassHealth Eligibility requirements in Massachusetts. These guidelines apply to people who are over 65 and who are in a nursing home, or will be when they are receiving MassHealth coverage.
- The applicant may have $2000.00 in countable assets.
- If married, the applicant's spouse, living in the community, may keep: $101,640 [$99,540.00 in 2006] in countable assets. This amount may be increased in certain circumstances as a result of an appeal.
Now, what is meant by "countable" and "non-countable"?
Countable assets include, but are not limited to:
- cash, most savings bonds, retirement accounts, CD's, stocks, mutual funds, bank accounts,
- the home of a single applicant, in certain circumstances, see below for treatment of the home;
- a second home, or a vacation home.
Non-Countable Assets are:
- the home of the community spouse, see below for treatment of the home;
- the home of a single applicant, in certain circumstances, see below;
- a vehicle;
- irrevocable burial trusts, or prepaid funeral contract;
- life insurance policies if the total face value for each spouse is $1500.00 or less. Term life insurance policies are not counted;
- burial plots;
- up to $1500.00 set aside in a burial account for the applicant and the applicant's spouse.
Special Rules for the Home
- Your home is not countable if you have moved to a medical facility and
- you intend to return home,
- you have long term care insurance that meets certain requirements, or
- certain relatives, such as a spouse or disabled or minor child, live in your home.
- If the equity interest in the home is over $750,000.00, you may be ineligible for payment of long term care services, unless one of the following relatives lives in your home:
- your spouse;
- a permanently and totally disabled child;
- a blind child; or
- a child under the age of 21.
How income is treated by MassHealth:
- An applicant's income will usually be applied towards the care they are receiving in the facility, this is called the Patient Paid Amount.
- An applicant is allowed to keep $60.00 per month for personal needs. [$72.50 in 2008.]
- If an applicant pays for health insurance, they will be able to deduct this amount from their Patient Paid Amount.
- The spouse at home does not have to contribute any of their income towards the cost of the applicant's care.
- The spouse living in the community may be allowed to keep some of the applicant's income, depending on the spouse's income and shelter expenses (the cost to maintain the home.)
There are additional rules that may apply to your situation. You can find more information on the MassHealth Programs on the Mass.gov website. If you need assistance preparing for filing a MassHealth Application, you may wish to contact an attorney.