Applying for MassHealth, to help your family with nursing home costs isn’t always simple. And it isn’t so quick. But it doesn’t have to overwhelm you. And there are people who can help. Just like we’re helping Marilyn"* and her family. Marilyn faced a MassHealth application process that proved to be particularly burdensome to her -especially with her busy schedule at work, at home caring for her husband John and being a heavily involved grandmother. She simply felt lost in all of the application requirements.
So it wasn’t a surprise when she called and asked us for help. We then went to work right away to help her through the application process.
Continue reading to hear about Marilyn’s background, how she got to needing MassHealth’s help, and see how we organized her finances to make the process much smoother. Below you will also find an opportunity to request our free MassHealth checklist. The same checklist we used with Marilyn to help get organized prior to submitting a MassHealth application.
Marilyn and John - Their MassHealth Story*
Marilyn and John have been married for over 30 years. They raised a wonderful daughter together and have 2 grandkids. They bought and modernized a beautiful home in a desirable suburb of Boston. And they added a finished 3 season room off of the dining room to watch Red Sox games in the fresh air. Later, they upgraded an entire unit on their lower level so that their daughter and her family could live together. Everything was going great…that is until one day when John was diagnosed with MS.
At first John tried to pass it off. it wasn’t affecting him too seriously. he would still drive and go about town. He was retired and collecting disability from his former company and from social security. So income was comfortable. And he had time to enjoy the days. Then one day he had a car accident that almost injured somebody - No more “passing it off.”
Despite the efforts and new medications, John’s mobility declined until he was confined to a wheelchair. A few more years passed and John had to remain in the lower level apartment. Health aides visited to take care of John’s “Activities of Daily Living” like bathing but much of the work (too much) still fell on Marilyn’s shoulders.
Eventually it became too much as taking care of John (who weighs 3xs what Marilyn weighs) proved too dangerous for Marilyn to continue. Every time John would lose his balance, he would lean on Marilyn, and each time it got harder and harder to hold him upright. Even with the home health aides coming daily, Marilyn couldn't no longer do the physical work and keep John safe. So she made the difficult decision to move John to a reputable nursing care facility. That’s when she realized that without Masshealth’s help, the $15,000/mo bill would impoverish her in three and a half years.
It was then that she also realized how overwhelming the process of applying for Masshealth actually is. Documentation requirements include medical insurance information, income information, 5 years of asset history, 5 years of itemized expenses over $1,000 explained, and more. Furthermore, there are multiple forms that need to be filled out correctly giving permissions for this and that, not to mention the legal and financial preparation that should be done prior to application.
Masshealth with High Assets
Marilyn’s assets were more than the $128,640 (in 2020) that Masshealth allows the healthy spouse to keep while the sick spouse applies for benefits. So she took advantage of using what industry vets call a “Medicaid annuity**” which simply means Marilyn transferred her excess assets (over the allowed $128,640 limit ) into an annuity to have it paid back to her as income over the next 8 years. If she did not do this, she would be required to spend it down on John’s nursing care at $15,000 per month until it was spent down all the way to only $128,640 remaining before Masshealth would start covering John’s expenses.
As you can imagine, organizing all of this information, straightening out the numbers and preparing the finances prior to application can be overwhelming. fortunately for Marilyn, we have helped her through the entire process. Marilyn still had to do a lot of work on her end, but having a clearly outlined plan, a checklist and a step by step process to go from considering her options to completed application and getting John into a care facility made things a lot easier on her mind. And Marilyn definitely slept better at night knowing she had experts*** reviewing and guiding her through the process.
Want a Leg Up on the Masshealth Process?
if you’re facing this situation, and could use some information and/or guidance, start by requesting our Masshealth checklist that Marilyn used - which was prepared by an experienced elder law attorney - which neatly lists the documents and data that you will have to gather to prepare a Masshealth application.
If you’d like a copy of that checklist, just let me know where to email it by filling out this form below. And if you’d also like to have a discussion about how this would all specifically apply to you, check the box to schedule a free call with me, Chris. Let me know if you have any questions in the comment box below. And thanks for visiting us on the web.
*Names changed for privacy
**”Medicaid Annuity” is not an official term. It simply describes the process of purchasing an immediate annuity thereby making an asset become an “income” for Masshealth application purposes.
***Our team of experts includes attorneys, CPAs, a CFP and other professionals. We are independent advisors and in no way are we affiliated with Masshealth or the State of Massachusetts. Masshealth is the Massachusetts version of Medicaid.