My new client was recently widowed. She is healthy, living on her own in the house she shared with her husband for many decades. She is comfortable financially with significant savings in addition to the home, but by no means wealthy. Her four children all have families of their own and they and their spouses have good jobs, so they don't need her financial support.
I met with her and her son. They asked whether the mom should put her home, and perhaps some of her savings, into an irrevocable trust in order to protect them in the event she needs long-term care. She also expressed her steadfast wish to stay at home.
The short answer to this question is, yes. In addition to providing assistance with the cost of nursing home care, MassHealth provides some assistance with the cost of care at home or otherwise referred to as "in the community." However, the assistance is supplemental as opposed to the comprehensive coverage for nursing home care and there are a variety of different programs available, so you will need to the choose the one that best fits your parents’ needs. A few of the programs available are the Personal Care Attendant, Adult Foster Care, and Community Choices.
MassHealth (Medicaid) is the main payment source for nursing home care in Massachusetts (and nationally). Its eligibility rules are complicated and often misunderstood. Here are the basics:
1. Countable Assets Limit. The nursing home resident is limited to $2,000 in “countable” assets. Most assets are counted against this limit, except for the home (in most instances), one automobile, a prepaid funeral plan, and personal belongings, such as clothing and furniture.
We recently received this question from one of our readers:
Since when does a nursing home require that all assets be given to them, including life insurance policies before going on MassHealth? Why should they get every penny while the person is alive and after they die too?
The families of nursing home residents moving from private pay to MassHealth coverage in nursing homes often ask whether they should maintain their Medicare supplemental insurance policies. We generally tell them that it’s up to them because it makes not financial difference.