How Much Money Can You Have In The Bank To Qualify For Medicare Massachusetts

MassHealth will pay for nursing facilities, habitation health services, and some of the costs of assisted living -- for those who qualify, medically and financially.

In Massachusetts, Medicaid (chosen MassHealth) is a very common source of funding for long-term care, particularly for people who take used up their own assets to pay for an assisted living facility or nursing dwelling house. In 2018, the average daily price of a individual room in a nursing dwelling house in Massachusetts was $420. Individual health insurance policies generally exercise not cover long-term intendance, very few people purchase private long-term intendance insurance policies, and Medicare coverage for long-term care services is very limited. Fortunately, Medicaid is at that place to pick upward the tab for many people. In a recent year, MassHealth paid for nursing homes for approximately lxx% of nursing home residents in Massachusetts.

There are many different ways to become eligible for MassHealth, and at that place are specific eligibility rules for long-term care services similar nursing homes (rather than for doctors' appointments, hospitalizations, and so on). For application information, visit MassHealth online or past phone at 800-841-2900.

MassHealth's Income Limit for Long-Term Care

If you are 65 or older, you can qualify for MassHealth if your income is at or below 100% of the federal poverty rate, or $i,041 per month in 2019. People who receive SSI already qualify to receive MassHealth.

If your income is above the limit but you lot demand assist with nursing dwelling costs, you even so might be able to qualify for Medicaid if you lot're already paying for a nursing home or accept other significant medical expenses. A MassHealth worker will make up one's mind your excess monthly income to see if you authorize. Excess monthly income is income left over later on subtracting Medicare or other health insurance premiums, a personal needs assart, and any spousal or family maintenance needs allowances. That corporeality, multiplied by 6, is the "deductible" that y'all must see in a six-month period to be eligible for MassHealth. You must show proof that your nursing home costs or medical expenses equal the required deductible corporeality. Once yous bear witness medical expenses that equal your deductible, then you are eligible for MassHealth for the entire six-month period.

MassHealth's Resource Limit for Long-Term Care

To qualify for any blazon of Medicaid coverage in Massachusetts, you lot must have no more than than $ii,000 in resources, or $iii,000 for a married couple. Resources are assets similar coin and property.

Some property does not count toward the resource limit. In Massachusetts, one car of any value is exempt, as long as a household fellow member is using it. Personal belongings are too exempt. Your home is exempt up to an equity value of $878,000 (in 2019). You can exempt more equity if you have a spouse or a minor or adult disabled child living in the home.

Retirement accounts, stocks, bonds, certificates of deposit, life insurance policies with cash value, and depository financial institution accounts are all counted every bit resources.

Spousal Maintenance Allowance in Massachusetts

If you have a spouse who is going to go along to live independently (pregnant not in an establishment, likewise known as a "community spouse"), then Massachusetts will allow you every bit a couple to keep more income and assets to support that spouse.

Your spouse will be allowed to keep some income each month, known as a monthly maintenance needs assart. The amount will depend on how much income the customs spouse has. Every bit of Jan 2019, the minimum community spouse income allowance is $2,057.50 per month, and the maximum is $3,160.50 per month. If your spouse needs more than income than the maximum allowed, you can asking a hearing to enquire for more.

If you lot and your spouse together accept $126,420 (as of 2019) or less in assets, and then your spouse volition be allowed to keep all of the assets. This amount is known as the community spouse resource allowance. If you take more than $126,420 in assets, yous will be required to spend down your avails until you accomplish the $126,420 eligibility limit for a community spouse. If you demand to be able to keep more $126,420 in assets in club to back up your customs spouse while remaining eligible for Medicaid, you can asking a hearing to request that this amount be raised.

Personal Needs Assart

If you receive MassHealth and alive in a nursing home, you lot volition be expected to spend nearly of your income on your room, board, and medical care. Nursing home residents receiving MassHealth can continue only $72.80 per month as a personal needs allowance.

When a Nursing Habitation Is Medically Necessary

MassHealth volition pay for a nursing domicile only when it is medically necessary. Y'all must show MassHealth that you "encounter the nursing facility level of care," meaning that you need the kind of care that can only be provided in a nursing home. In Massachusetts, there are two ways to run across the nursing habitation level of care. Start, you lot can bear witness that you need at least one "skilled service" daily. Skilled services are usually provided by nurses. Examples of skilled services are injections, wound care, catheter care, and monitoring of unstable atmospheric condition.

The second fashion to run across the nursing dwelling level of care is by showing that you have a medical or mental condition that requires a small corporeality of skilled nursing aid simply substantial assistance with activities of daily living. (Activities of daily living include bathing, dressing, toileting, eating, transferring, and mobility.) You must show that you demand skilled nursing services at least three times a week.

Read on to find out when MassHealth pays for assisted living facilities and home health care.

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