In Massachusetts, the MassHealth program provides critical medical and long-term care to eligible individuals, including low-income families who cannot afford health insurance or older adults who require expensive nursing home care. However, in exchange for this aid, MassHealth may have the right to pursue reimbursement for benefits it paid to an individual from that person’s estate after their death. As such, surviving families often face complex legal issues as they probate the estate of a loved one who received MassHealth benefits.
If you’re in this position, the experienced estate planning and probate lawyers with Suprenant & Beneski, P.C. can help you protect your family’s assets and interests. Our lead partners are certified as elder law attorneys by the National Elder Law Foundation, a distinction conferred on only a handful of attorneys in Massachusetts. Contact us today for a case evaluation to discuss how we can help your family navigate MassHealth and probate.
Understanding MassHealth
MassHealth is the Commonwealth of Massachusetts’ version of Medicaid, a federally funded public health program that provides healthcare for qualifying low- and medium-income individuals. MassHealth can provide health benefits directly to members or provide financial assistance to help pay for healthcare insurance premiums. MassHealth offers various coverages or benefits based on a member’s age, family status, disability, employment, or HIV status.
U.S. citizens, nationals, legal permanent residents, or legal aliens who reside in Massachusetts, need assistance obtaining healthcare or insurance, and have low incomes (based on household size) may qualify for MassHealth.
MassHealth can pay for or help cover the cost of critical health services, such as doctor’s visits, hospitalization, therapeutic services, various forms of rehabilitation, behavioral health, and substance abuse treatment. MassHealth can also cover medical expenses such as:
- Prescriptions
- Emergency ambulance services
- Non-emergency transportation services to and from medical appointments and procedures
- Out-of-state emergency treatment
MassHealth also provides benefits and coverage for older adults who require disability or long-term care, including:
- Personal attendance services that facilitate living at home
- Long-term care services, such as home health aides or in-home nursing and rehab
- Long-term care/nursing home facilities
How MassHealth Can Impact Probate
Federal and state law requires Medicaid programs like MassHealth to pursue a process called “estate recovery,” in which they seek reimbursement from a member’s estate for benefits paid to the member during their life. MassHealth may undertake estate recovery from members who receive benefits after 55 or members of any age who permanently resided in a long-term medical or nursing care facility.
MassHealth can recover from most types of assets in a deceased member’s estate, including money from bank accounts or the proceeds of the sale of any real or personal property, such as a home or vehicle. MassHealth can recover up to the total amount of qualifying benefits paid to the member. However, if the amount of benefits exceeds the total value of the member’s estate, MassHealth will not pursue any unsatisfied amounts from the estate or the member’s family.
MassHealth can also exercise its discretion not to pursue estate recovery from a member. The agency may delay estate recovery if the deceased member has a surviving spouse, a surviving child under 21, or a surviving child of any age who suffers from blindness or permanent disability. MassHealth may waive estate recovery from a member with a total estate value of $25,000 or less. The agency may also waive estate recovery if it determines that pursuing its claim would place an undue hardship on the member’s family or heirs, such as when an heir has low income, provided care to a member before that member’s entry into a long-term care facility, or lives in the home MassHealth would recover from.
As a result of its estate recovery mandate, MassHealth can significantly affect the probate of a member’s estate, as the agency can secure reimbursement from assets such as the member’s home, personal property, or bank accounts.
Planning to Protect Assets During Probate
Families can mitigate the effect of estate recovery by MassHealth through effective estate planning. For example, families can use Medicaid trusts to protect assets from estate recovery by MassHealth. A Medicaid trust removes assets from a person’s estate, which can help them meet the income/asset eligibility requirements for MassHealth benefits and shield assets from recovery during probate.
However, the transfer of property ownership or establishment of trusts to shield assets from estate recovery must be done according to specific rules and procedures. Otherwise, transferred assets remain available for MassHealth’s recovery. As a result, families can best protect their interests by working with an experienced estate planning lawyer who knows the relevant laws and how to craft an asset protection strategy around them.
Navigating Estate Planning and Probate Considerations
Families should be aware of certain MassHealth considerations as they explore their estate planning options, including:
- Look-back periods: Medicaid trusts may not protect assets from estate recovery when established during the “look-back period,” as any assets transfers may count as part of the member’s estate.
- Irrevocability of transfers: When transferring assets or setting up Medicaid trusts, MassHealth members and families should be aware that such transfers are irrevocable. Families should ensure that Medicaid trusts make sense for their circumstances and feel comfortable with the permanency of the decision.
- Cost: Estate planning comes with costs, including legal fees to hire experienced counsel. Families should consider whether they qualify for delayed or waived estate recovery under MassHealth rules, in which case they may not need to undertake estate planning to protect assets from estate recovery.
How Our Firm Helps MassHealth Members and Their Families
Are you or a loved one preparing to apply for MassHealth benefits? If so, let the legal team at Surprenant & Beneski, P.C. help you protect important assets and guide your family through the probate process by:
- Reviewing your financial situation to determine the need for estate planning
- Evaluating options for ensuring MassHealth eligibility and protecting assets from estate recovery, such as setting up Medicaid trusts
- Drafting and helping your family execute estate planning documents
- Explaining your rights, options, and obligations after your loved one’s passing, including the potential for estate recovery by MassHealth
Contact Surprenant & Beneski to Discuss Your Rights and Options
Have you lost a loved one who received MassHealth benefits? If so, get the legal counsel you need to navigate the probate process and resolve any MassHealth claims. Contact Surprenant & Beneski, P.C. today for a confidential consultation to learn how MassHealth benefits may affect the probate of your loved one’s estate.