Do you have a plan to pay for any long-term care you need in the coming years? If your answer is no, you might be a candidate to apply for MassHealth, the Medicaid program in Massachusetts. Few Americans have the resources to pay for years of nursing-home care. MassHealth coverage could pay for that care, but getting it requires you to first complete the lengthy and complicated MassHealth application. For people who are older than 65, or getting close, the time to apply for MassHealth could be right now.
Who Should Apply for MassHealth?
The first thing to understand about MassHealth is that there are several programs under its umbrella. As the state’s Medicaid program, MassHealth provides health coverage for medium-, low- and no-income residents of all ages. MassHealth also provides long-term care benefits to people who are older than 65, or younger residents who need these services. Anyone who can’t afford to pay for their own long-term care should consider applying for MassHealth.
If you’re eligible for coverage and anticipate needing long-term care services in the near future, you may be a good candidate to apply for MassHealth. Even if you don’t need long-term care services now, but may need them in the future, you may want to look into the application process right away. It can be lengthy, and there’s a five-year lookback period – so even if you don’t need long-term care services for another five years, you may need to move assets around starting right now in order to be approved for coverage later on.
Who Can Apply for MassHealth?
MassHealth has strict eligibility requirements for all of its programs. How a pregnant teenager qualifies for health benefits could be different from how a disabled adult qualifies, for example.
As an applicant for long-term care services, you must be a full resident of Massachusetts. You must be a U.S. citizen or be able to prove you have eligible immigrant status. (Refugees, asylum seekers, lawful permanent residents and the dependents of military members are examples of noncitizens who may have this status.) You must also meet MassHealth’s strict financial eligibility requirements.
To qualify for long-term care benefits, an individual must have no more than $2,000 in countable assets. If the applicant has a spouse who will continue to live in the community, the spouse may have assets worth up to $128,640, as of 2020. (Eligibility figures may be increased each year.) An applicant’s community spouse may also keep a home worth up to $893,000, as of 2020. Once MassHealth starts to pay for an individual’s long-term care, the person may only keep $72.80 per month as a personal needs allowance.
MassHealth’s five-year lookback period could complicate your chances of being deemed financially eligible for long-term care. When you apply, you’ll be asked to provide verification of your assets over the previous 60 months. This is because MassHealth wants to make sure that applicants don’t simply transfer their assets to others at the last minute in order to make the program pay for their care. There are very specific ways in which applicants can get rid of their assets while still qualifying for coverage. An estate planning attorney can help you understand your options.
How Do You Apply for MassHealth?
When you’re ready to apply for MassHealth, the first step is to gather your most recent tax returns and any other documents related to your financial assets and current health insurance coverage. The MassHealth application for long-term care benefits asks for dollar amounts related to your income, assets and deductions. Applicants have to answer questions about their bank account balances, property and vehicles they own, trusts they’ve established, stocks they own, rental income they collect – suffice it to say, you’ll have to provide a lot of specific information about your financial picture, in addition to answering questions about your personal history and your family. The application also includes several supplemental forms that some individuals will need to complete, depending on circumstances.
Your finished application, plus supporting financial documents, can be submitted by mail or fax. There are also five enrollment centers around the state where individuals can apply for MassHealth coverage in person.
It’s a long application and can be confusing for a lot of applicants. If you make a mistake, your application may be denied or delayed while you correct it. Even a minor mistake can add weeks or months to your wait for approval. You may not have the flexibility to wait those extra weeks if you need long-term care urgently. That’s why many applicants seek help from enrollment assisters who are experienced with applying for MassHealth and know how to complete the application correctly and quickly.
The attorneys at Ladimer Law have helped hundreds of Massachusetts residents apply for MassHealth coverage. We can make this process as quick and easy as possible for you, helping you secure the coverage you need with minimal stress. Do you have questions about applying for MassHealth? Reach out to Ladimer Law today.
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