Paying for nursing home care in Massachusetts | Fifty Plus Advocates

Cathleen H. Summers

A study by the U.S. Department of Health and Human Services says, ?people who reach age 65 will likely have a 40 percent chance of entering a nursing home. About 10 percent of the people who enter a nursing home will stay there five years or more. This year, about nine million men and women over the age of 65 will need eldercare. By 2020, 12 million older Americans will need eldercare. Most will be cared for at home; with family and friends as the sole caregivers for 70 percent of the elderly.?

A new population of seniors and those nearing senior status are looking for some type of financial means to pay for long term care (elder care) in case of failing health. Many have taken care of family members who had no means to pay for their care or have seen their parents entire retirement savings wiped out because of medical and nursing home costs.

In Massachusetts, the cost of privately paying for long-term care is between $11,000 and $13,000 per month. If an individual is unable to qualify for Medicaid, they will need to spend their own assets at the staggering rate of approximately $150,000 per year.

MassHealth, the Medicaid program in Massachusetts, is a government program that covers health and custodial care for the indigent. MassHealth now has a five-year ?look-back? period that penalizes transfers of money or assets when people apply for coverage. The look-back period is designed to discourage people from artificially impoverishing themselves by transferring assets to others so that they can qualify for MassHealth, thus having the government pay for their long-term care. MassHealth looks carefully at the applicant?s financial records, including current income and assets and any funds spent or property transferred out of the applicant?s name within the previous five years from the date of application for assistance. Any amount that MassHealth determines was given away or transferred to another (including a trust) for less than fair value may be considered by MassHealth as still belonging to the applicant.

The good news is that you may be eligible for certain exemptions such as the adult child caregiver exemption, which protects your family home. According to this rule, if your adult child lives in the home and has taken care of you for the past two years, thus keeping you out of a nursing home, you can transfer your home to that child without penalty. In other words, you can keep the home in the family and it cannot be attached by MassHealth to pay for nursing home expenses.

Additionally, there are exceptions with respect to an applicant?s primary home if he or she lives with a sibling or has a disabled child.

Five years is a long time. It is difficult to predict exactly what your needs are going to be. Having to repay a MassHealth lien can be onerous for a family, especially if your children have already spent their gifts on such things as home improvements for themselves. It is now more important than ever to do early planning to protect your hard earned assets in the event that nursing home care cannot be avoided.

Cathleen H. Summers is a founding partner of Summers, Summers & Associates, P.C., an elder law, estate and life planning law firm located in Acton, Mass. She may be reached at www.summersatlaw.com or by calling 978-263-0006. Archives of articles from previous issues can be read at www.fiftyplusadvocate.com.

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Source: http://fiftyplusadvocate.com/archives/7378

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