Hiring an attorney to assist with MassHealth, or Massachusetts Medicaid, applications can save individuals significant time, money, and stress. Many older Massachusetts residents assume that they can quickly complete their MassHealth application. Unfortunately, the MassHealth application can be incredibly challenging. At Surprenant & Beneski, PC, our skilled elder law attorneys have extensive experience navigating the complex MassHealth rules. We help our clients preserve as much of their assets as legally possible while successfully applying for Medicaid.
1. Nursing Homes / Skilled Nursing Facilities Are Often Poorly Equipped to Handle Medicaid Applications
When an individual enters a nursing home, the nursing home staff often offers to submit their client’s Medicaid application. In some instances, nursing homes fail to submit accurate, thorough applications on behalf of their clients.
In one example, a nursing home failed to provide a copy of the patient’s health insurance card or verify that his insurance company terminated his coverage. As a result, MassHealth denied the patient’s application. Unfortunately, nobody caught the mistake. As a result, the patient received a large bill from the nursing home. Keep in mind that many nursing homes in Massachusetts cost $12,000 or more per month. A skilled attorney would have submitted a complete application on the patient’s behalf, avoiding massive bills and significant stress.
2. You May Be Surprised to Find That You Are Eligible for Medicaid
At Surprenant & Beneski, PC, we know that there are several common misconceptions regarding who qualifies for Medicaid or MassHealth. Many Massachusetts residents view Medicaid as a government-sponsored health insurance program for the poor. While MassHealth is designed to help individuals without significant assets, middle-class individuals may also qualify. For example, owning your home or primary residence will not automatically exclude you from qualifying for Medicaid.
Currently, Medicaid will not cover individuals that receive $2,000 in countable assets. The asset limit for stay-at-home spouses is $137,400 (2022). Nevertheless, even if your assets exceed these figures, our attorneys may still be able to provide legal strategies to spend-down your assets. You must fill out the application correctly to avoid a denial of coverage. Our attorneys can investigate your whole financial picture and help you determine whether or not you qualify for Medicaid.
3. It’s Not Too Early To Begin Thinking About MassHealth Coverage
The need for long-term care often sneaks up on people. In the business of daily American life, many Americans fail to prepare for future long term care needs adequately. Pre-planning for long-term care can prevent a lot of stress. Addressing the potential for long-term care is more cost-effective than facing an unexpected admission into a costly long-term care facility. MassHealth engages in a five-year financial look-back period.
Submitting a hasty application will prevent you from arranging your finances most advantageously before the look-back. Our attorneys regularly offer counsel for those facing a health-care crisis in which you’ve had to unexpectedly admit yourself or a loved one to a nursing home. You may still have options to preserve some, if not all, of your assets. If you’re in a crisis, contact one of our skilled MassHealth attorneys today to schedule your initial consultation
4. Our MassHealth Case Manager Can Help
At Surprenant & Beneski, PC, our clients have the opportunity to work with Silvia, our dedicated MassHealth Case Manager. In response to a growing need, we have a dedicated full-time staff member to successfully guiding families toward MassHealth acceptance. Silvia has helped hundreds of clients receive long-term care coverage from MassHealth.
Silvia has significant experience navigating the stringent Medicaid application process. She helps clients with the following tasks:
- Gathering all of the essential documents and information
- Communicating with Medicaid representatives
- Communicating with long-term care facilities
- Explaining complex issues to clients
- Ensuring that applications, appeals, and related paperwork are submitted on time
Facing prohibitively expensive long-term care costs can be extremely expensive. The application process is confusing, and it is easy for clients to miss an essential part of the application. During the stressful time of entering a nursing home unexpectedly, it is even easier to make a mistake while filling out the application. Silvia compassionately assists clients and their families as they move through the process. Out clients regularly rave about Silvia and have referred to her as a “rock star” for helping them through what is often a difficult time in their lives.
5. It is Wise to Create Estate Plans With Long-Term Care in Mind
Our Southeastern Massachusetts law firm successfully helps clients in emergency MassHealth situations. However, prevention is always the best goal in estate planning. That’s why we recommend that clients initiate the estate planning process as early as possible. Sometimes clients assume that they don’t have enough assets to justify engaging in estate planning. Individuals of all income levels and ages can benefit from estate planning. Our attorneys often come up with estate planning strategies that our clients had not considered. Clients of all income levels benefit from having a will and forming a basic plan for retirement planning.
Medical costs continue to increase, with some nursing homes charging $12,000 or more per month per resident. Are you worried that you might not qualify for MassHealth and concerned that you won’t be able to pay for long-term health care insurance? If so, we can help. Our attorneys have helped hundreds of clients achieve successful outcomes in stressful situations.
Contact Our MassHealth Attorneys Today
Engaging in proper planning will save you and your family from significant angst. Our clients are often surprised by how much money and time they save through estate planning and long-term care planning. Don’t let the need for long-term care wipe out all of the assets that you’ve worked so hard to gain throughout your life. Whether you need immediate help in applying for MassHealth/Medicaid benefits or you’re looking towards the future, we can help. Contact Surprenant & Beneski, PC today to schedule your initial consultation and learn how we can help you.
©Surprenant & Beneski, P.C. 35 Arnold Street, New Bedford, MA 02740, 336 South Street, Hyannis MA 02601 and 45 Bristol Drive, Easton MA 02375. This article is for illustration purposes only. This handout does not constitute legal advice. There is no attorney/client relationship created with Surprenant & Beneski, P.C. by this article. DO NOT make decisions based upon information in this handout. Every family is unique and legal advice can only be given after an individual consultation with an elder law attorney. Any decisions made without proper legal advice may cause significant legal and financial problems.