Why is it that some nursing homes mislead elders about MassHealth (also known as Medicaid)? Recently, a nursing home told my client (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. The 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, Abington, Avon, Bridgewater, Brockton, Canton, East Bridgewater, Foxboro, Mansfield, Norton, Randolph, Raynham, Rehoboth, Rockland, Sharon, Stoughton, West Bridgewater, and Whitman, Massachusetts, 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 $7000-$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. Nothing in this blog should be considered legal advice as this is a complicated area of the law.