Paper reading long-term care insurance

How Do I Apply for MassHealth Long-Term Care Services?

At Surprenant & Beneski, P.C., our estate planning law practice has extensive experience assisting clients throughout Southeastern Massachusetts with their long-term care planning needs. We understand the complexities of applying for MassHealth (Medicaid) for long-term care services and are committed to guiding our clients through every step of this process. From initial application to possible appeals, our team is here to help you secure the government benefits you need.

How to Apply for MassHealth for Long-Term Care

Applying for MassHealth long-term care services can seem daunting, but, as with most chores, taking the process step by step with the help of competent professionals can make the process more manageable. To assist you in applying for MassHealth long-term care:

  1. We Will Make Sure You Gather All Necessary Documents, including proof of income, record of assets, proof of identity, and Massachusetts residency, as well as any medical records supporting your need for long-term care.
  2. We Will Help You Complete the Application by advising you on how to fill out the MassHealth Application for Seniors and People Needing Long-Term-Care Services. We will answer all your questions so your answers are thorough and accurate to avoid delays.
  3. We Will See That You Submit Your Application online, by mail, or in person at a MassHealth Enrollment Center in a timely manner, making certain that you keep copies of your submitted documents for your records.
  4. We Will Assist You in Responding to Requests for Additional Information that  MassHealth may request. While you may find such requests stressful, for us they are routine and simply needed to process your application, so we can help you reply promptly to avoid processing delays.
  5. We Will Help You Deal With the Waiting Period Calmly. Once your application is submitted, we will support you as you wait out the bureaucratic delay until you receive a notice of approval or denial. Approval will include details about the coverage and any potential cost-sharing responsibilities. Denial typically necessitates an appeal which we will take action to implement as quickly as possible.

How to Appeal if Your Application is Denied

If your application is denied, you have the right to appeal by:

  • Reviewing the denial letter to understand the reason(s) for the denial so you can address them in your appeal.
  • Requesting a fair hearing by filing a request within the timeframe specified in the denial letter, typically 30 days.
  • Preparing for the hearing by gathering additional evidence or documentation to support your appeal. This is best done with sound legal advice.
  • Attending the hearing to present your case to the hearing officer, arguing clearly 

and concisely why you believe the decision to deny was incorrect.

Why You Must Plan for MassHealth Ahead of Time

Early planning for MassHealth eligibility will significantly ease the application process by preparing in advance for the 5-year Medicaid look-back period. Doing so will greatly improve your chance of receiving the benefits you and your family require to pay the high costs long-term care without significantly diminishing the size of your estate.

Anticipating the need for long-term care and understanding MassHealth eligibility requirements can help you arrange your finances accordingly (e.g. by creating trusts) to avoid common pitfalls that lead to application denials or asset transfer penalties.

Why Working With a Strong MassHealth Attorney Is Essential

Navigating the MassHealth application process is complex and can be overwhelming. Working with a seasoned MassHealth attorney from Surprenant & Beneski, P.C. can significantly increase your chances of receiving the help you need. Our services include:

  • Pre-application planning and asset protection strategies.
  • Assistance with gathering and submitting the required documentation.
  • Expert guidance on the application process to avoid common mistakes.
  • Representation in appeals, should your application be denied.

Because we are intimately familiar with the MassHealth application process and with many of the Mass Health personnel, we are well-prepared to cope with any challenges that may arise during the process.

Contact Our Experienced MassHealth Attorneys Today

Most of us are aware of the stress surrounding bureaucratic undertakings like applying for MassHealth long-term care benefits. Do yourself a favor and contact our knowledgeable attorneys before you tackle this difficult, often frustrating task to give yourself the advantage of partnering with skilled, caring professionals.