Medicaid / MassHealth Planning for Long-term Care

What is Medicaid Planning?

Medicaid, through its state affiliates, is the largest single payer for nursing home care. While estimates vary, it is safe to say that Medicaid pays between 45% and 65% of the total nursing home costs in the United States. While on the surface, this may sound encouraging for families whose loved ones require nursing home care, it is important to be aware that Medicaid is a means-tested program, meaning that the applicant’s income and financial assets are closely analyzed prior to acceptance into the program. Persons must meet strict financial guidelines in order to qualify. However, should an individual qualify, Medicaid will pay for 100% of their nursing home costs at a Medicaid approved skilled nursing facility. Medicaid is known as MassHealth in the Commonwealth of Massachusetts.

What are the Benefits of Medicaid Planning in Massachusetts?

Long-term health care can be expensive and residents of a nursing home can exhaust their life time savings very quickly. To avoid such burden there is Medicaid/MassHealth. In general, Medicaid Planning  helps you create ways of making your assets and income inaccessible for the purpose of payment.

Another two goals that would be accomplished by doing timely Medicaid Planning:

  • Preserve assets for your loved ones
  • Provide for your healthy spouse (if you’re married).

There are several strategies developed by attorneys over the years to rearrange ones’ finances and legally shelter assets from the state. Medicaid Planning, if done by a professional, is completely ethical and used by people who are looking to maintain their lifestyle and protect their loved ones and assets even after they are no longer able to do it themselves.

How can a MassHealth Planning Lawyer Help?

MassHealth is a needs-based medical assistance program that is administered by federal and state governments. The program is aimed at helping low-income families, the elderly, people with disabilities and individuals under other drastic circumstances to afford or have free access to necessary medication. Medicaid provides a range of medical services, but you must be eligible to apply.

State and federal governments commonly change rules and regulations regarding Medicaid eligibility; therefore, the process may become complicated if you aren’t up-to-date with the most recent policy changes. It is advised to see a licensed Medicaid planner or an experienced Medicaid planning attorney to guide you through the process and to take care of any concerns.

These Medicaid Planning strategies and the Medicaid rules themselves can be complicated, which is why you should call a knowledgeable and experienced MassHealth Planning attorney at our office. Even the smallest mistakes in completing the planning or applying for Medicaid can result in denial. To ensure that your Medicaid planning tools are developed and implemented correctly – seek professional assistance.

WHAT WE CAN DO:

  • Evaluate your financial situation in relation to MassHealth eligibility
  • Advise on available options to obtain Medicaid coverage
  • Provide legal advice to help preserve your life savings, income and estate against creditors
  • Help obtain for your loved ones the care they need and deserve

MassHealth planning is an undeniably a complex process. The application process is time consuming. The consequences of being denied by MassHealth can often be severe and may have negative impacts on the security and health of the individuals applying for help. Therefore, consulting with an attorney or professional MassHealth Planner is recommended. The Law Office Surprenant & Beneski, PC will help you structure your financial resources, such as relocating assets, and prepare any documentation, such as trusts and estates, to ensure your highest chances of being accepted to the MassHealth program.

Strategies to Help You with Eligibility

Irrevocable Trusts are widely used as a MassHealth eligibility strategy.  For an Irrevocable Trust, any property (real or personal) placed in an irrevocable trust will be excluded from your assets, for MassHealth purposes as long as it falls within the 5 year look back period. With a proper beneficiary, the principal that you deposit into the trust will be sheltered from the state and can be preserved for your heirs. Generally, such trusts must be created and funded for a specific period of time for this strategy to be an effective MassHealth planning tool.

The Law Office of Surprenant & Beneski PC is comprised of a group of experienced, leading MassHealth planning attorneys in Massachusetts who will help with your concerns regarding Medicaid. Our partners are 2 of only 25 Certified Elder Law Attorneys in the Commonwealth of Massachusetts. A CELA is an attorney who has demonstrated expertise in elder law and special needs, passed a rigorous examination, maintains continuing education and involvement standards, and has been recognized by his or her peers and colleagues.

At Surprenant & Beneski, PC, we have a dedicated Medicaid Planning team led by Attorney Erin Nunes and Case Manager, Silvia Sales.  As our dedicated MassHealth Case Manager, Silvia, works one on one with families to help them become MassHealth qualified, providing compassionate support and guidance.

©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.