$184,143 was the median annual cost for nursing home care in Massachusetts in 2023.
That’s a daily rate of about $505!

Source: Genworth 2023 Cost of Care Survey for Boston Area Massachusetts

Medicaid provides health insurance to millions of Americans nationwide including adults who are low-income, children, pregnant woman, elderly adults, and people with disabilities.  Medicaid is administered by the states, according to specific federal regulations.  In Massachusetts, the Medicaid program is called MassHealth.  MassHealth is a combined program, including both Medicaid and the Children’s Health Insurance Program.  With respect to seniors, MassHealth has programs to provide health-related coverage in the community as well as long-term care settings, such as nursing homes.

Medicaid is administered by the states and funded with state and federal money.  It provides coverage to low-income adults, children, pregnant woman, elderly adults and people with disabilities.  Medicare is a federal program that provides health coverage to adults 65 years and older and to those under 65 who have a qualifying disability, regardless of their income.

The eligibility rules for MassHealth can be complicated.  As a senior who may be looking for services, MassHealth may look at both your asset holdings as well as your income levels.  Additionally, if you are married, the asset holdings of your spouse may also be considered for certain programs.  Usually, an applicant for MassHealth may not have more than $2,000 in his or her name*.  In 2024, the applicant’s spouse may have no more than $154,140.00 in assets.

Becoming eligible for some long-term care benefits, such as Frail Elder Waiver (FEW) or PACE (Program for All Inclusive Care for the Elderly), you must usually meet medical-need requirements, and adhere to each program’s different asset and income rules.

*Please note that these figures do not mean that one must spend down all of their money before qualifying for MassHealth. There are several asset protection measures that can be taken in advance with the assistance of an elder law attorney.

Applicants to the Medicaid (MassHealth) program often find the process overwhelming.  An application for benefits, identifying the appropriate program that you would like to obtain (such as community-based care, waiver programs, PACE, or long-term care benefits) must be completed and submitted. A complete list of your asset holdings must be included and will be reviewed to determine the extent of your asset holdings (and income, if applicable).  Giving away assets during the 60-month period prior to your application may disqualify you or your spouse, under specific circumstances.  Additionally, you need to ensure that you meet certain time requirements for responding to inquiries that the MassHealth eligibility review may make about your financial situation and health needs.

At Generations Law Group, our staff are very experienced in dealing with and interpreting MassHealth eligibility regulations.  We can provide you with an assessment of your circumstances and help you identify which MassHealth program may best meet your needs.  Additionally, we help our clients properly plan for MassHealth eligibility, including protecting assets whenever possible.

For those that may not qualify for MassHealth, there are other asset protection measures to consider when planning in advance for long term care. At Generations Law Group, we look at the whole picture of your individual situation, and help you plan for your future.