Why Some Nursing Homes Mislead Elders Regarding MassHealth/Medicaid

A nursing home once told a client of mine (let’s call her Mrs. Elder) not to apply for MassHealth (also known as Medicaid) for her husband because if she did apply for MassHealth, the MassHealth agency would put a lien on her house. This is misleading. MassHealth regulations specifically set forth that a MassHealth lien cannot be placed when there is a spouse living in the house. Because Mrs. Elder is a spouse living in the house, a lien could not be placed on Mr. and Mrs. Elder’s home.

Luckily, Mrs. Elder ignored the nursing home and came to see me for assistance in getting her husband on MassHealth. If she had followed the advice of the nursing home, she would have impoverished herself by privately paying for Mr. Elder’s nursing home care to the tune of $11,000 per month. Instead, with my assistance, she was able to get her husband on MassHealth by purchasing an immediate annuity meeting certain requirements set forth in MassHealth regulations. Most of her husband’s income (approximately $3,000 per month) went to the nursing home, but that was far less impoverishing than the private pay rate of $11,000 per month. Together Mrs. Elder and I also accomplished getting Mr. Elder’s name off the deed to their home and changing her will so that her husband did not directly inherit from her, but instead was the beneficiary of her testamentary trust.

Why would a Nursing Home discourage an Elder from applying for MassHealth?

The answer is simple. Private pay is more money. Nursing homes get roughly 65 cents on the dollar for elders on MassHealth in contrast to those who are privately paying. In other words, if Mrs. Elder is privately paying for Mr. Elder’s nursing home care in the vicinity of Easton, Stoughton, Brockton, Bridgewater, Norton, Mansfield, Canton or Raynham, MA, she would be paying somewhere in the neighborhood of $11,000 per month whereas the MassHealth reimbursement rate (plus patient pay amount) would be approximately $7,000-$8,000 per month.

Applying for MassHealth Long-Term Care Benefits and Dealing with the MassHealth Agency

No one should attempt to apply for MassHealth long-term care benefits without the assistance of a professional.

Elder law attorneys are an important resource as they know the ins and outs of the eligibility requirements for MassHealth long-term care benefits (and the application process itself) and often assist elders in applying for MassHealth and dealing with the MassHealth agency.

Elders also need to be mindful of “estate recovery” as the Division of Medical Assistance is entitled to recover against the probate estate of any individual for whom MassHealth benefits were paid when he or she was age 55 or over. In order to do so, the agency must file a timely claim against the estate. Typically, there is no probate estate when an elder is on MassHealth as the asset limit is $2,000. However, many elders on MassHealth own a home as the home is often noncountable.

When the applicant is married, an elder law attorney can assist by providing legal guidance regarding the steps to be taken to protect the home from an estate recovery claim.

When the applicant is unmarried, an elder law attorney can assist by providing legal guidance regarding the steps to be taken so that the home is noncountable (and, under certain circumstances, regarding the steps to be taken to protect the home from an estate recovery claim).

Nothing in this Article should be considered legal advice as this is a complicated area of the law.


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“Brigitte has been my Estate Attorney for many years. She took care of my Parents' Estate as well. She did a fantastic job for my parents and as they each passed she was helpful with every aspect of their estate. She is a genuine and wonderfully sincere woman. She is very well informed and up-to-date on Elder Law and handled our family losses with much compassion. She has a wonderful network of individuals and attorneys who specialize in other areas of law and they were instrumental in assisting me with problems that arose with my parent who suffered from dementia. I highly recommend Brigitte.”

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Brigitte von Weiss is an estate planning lawyer and elder law attorney serving clients in Easton, MA as well as nearby towns and cities, including Abington, Bridgewater, Brockton, Canton, East Bridgewater, Foxboro, Mansfield, Norton, Randolph, Raynham, Rehoboth, Rockland, Sharon, Stoughton, West Bridgewater and Whitman.

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