Determining whether you’re eligible for the significant benefits of MassHealth can be puzzling, especially as you approach age 65. In this blog, the experienced elder law attorneys at Surprenant & Beneski, P.C., will clarify how reaching retirement age can affect your eligibility for MassHealth benefits in Southeastern Massachusetts. We will take a careful look at the key factors and considerations that impact your eligibility under Massachusetts state law.
MassHealth Encompasses Several Different Plans
In order to understand MassHealth eligibility for seniors, you must be aware that there are a number of different plans offered by MassHealth for those over 65:
- Standard
- CommonHealth for disabled individuals
- CarePlus for individuals eligible for both MassHealth and Medicare
- Limited provides restricted coverage
- Buy-In allows individuals eligible for Medicare to enroll in MassHealth which will help cover Medicare premiums and cost-sharing
- Senior Buy-In (SBI) for individuals over 65 who are eligible for Medicare to help to pay for their Medicare Part A and Part B premiums.
These programs offer various healthcare coverage options for seniors in Massachusetts under the umbrella of MassHealth.
Significant Differences With MassHealth When You Turn 65
There are two major changes in MassHealth eligibility as you reach your 65th birthday:
An Income Limit for MathHealth Standard Goes Into Effect
At 65, the income limit for the MassHealth Standard plan decreases so you must earn less to qualify. Unfortunately, this means that some people who have depended on MassHealth Standard throughout their lives due to a disability, may suddenly be excluded because their income is a bit too high.
There Is Now a Substantial Asset Limit To Qualify for the Standard Plan
The other big change in MassHealth as you age also works against the best interests of seniors. As long as you are under 65, there is no asset limit, meaning that MassHealth does not examine your bank accounts, trusts, or investments. Once you turn 65, however, you will only be permitted to have $2,000 in countable assets. Even worse, state law has not raised this amount in a great many years.
Some Good News About Eligibility for MassHealth for Seniors
Fortunately, there are some bright spots regarding healthcare options for those over 65 in Massachusetts.
- Certain assets are not counted towards the $2,000 maximum, including your primary residence (unless you are single and the equity exceeds $1,071,000 in 2024), one vehicle, household belongings, term life insurance policies, and whole life insurance policies having a face value of $1,500 or less.
- Disabled individuals no longer eligible for MassHealth Standard after 65 may be eligible to enroll in MassHealth CommonHealth. This plan has no income or asset limits although it does require participants to work at least 40 hours a month.
Other options: the Senior Buy-In or MassHealth Buy-In
Senior Buy-In
The Senior Buy-In offers coverage of the deductibles and coinsurance of Medicare-covered services, in addition to the Medicare premium. Although it has a slightly higher income limit than MassHealth Standard, it permits a substantially higher asset limit which can be extremely helpful to older residents who have put away extensive savings.
The MassHealth Buy-In
The MassHealth Buy-In is also a possibility for those who are not eligible for either CommonHealth or Senior Buy-In, as it has a higher income limit than the Senior Buy-In. The benefit of the MassHealth Buy-In is that MassHealth will pay the Medicare Part B premium.
Contact Our Experienced MassHealth Attorneys Today
As you can see, navigating MassHealth eligibility is a complex matter, especially after you reach the age of 65. Working with one of our knowledgeable elder law attorneys can make all the difference. We will answer all your questions, address all your concerns, and assist you in discovering which MassHealth program you’re eligible for and which offers you the most comprehensive coverage. Contact us now to discuss your health needs and your best options.
