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MassHealth Eligibility-Part 3


MassHealth Eligibility: Countable Assets

To qualify for MassHealth Standard for long-term care benefits, seniors must meet strict

financial eligibility requirements, including both a limit on countable assets as well as income. If

they’re married and live with their spouse, both of their incomes and assets count in deciding if

they can get MassHealth.

The basic rule for MassHealth long-term care eligibility is that if an applicant applies, whether

single or married, they can have only $2,000 in countable assets in their name. If their spouse

plans to continue living in the community, the spouse is allowed to keep approximately

$148,620 in their name. (2023 figures)

Countable assets include but aren’t limited to:

 Cash

 Bank accounts

 Certificates of deposit

 Mutual funds

 Stocks and bonds

 Value of real property, except your home, if it meets eligibility requirements

 Individual retirement accounts, Keogh plans

 Cash surrender value of life insurance

 Vehicles – One vehicle per household is non-countable if it’s for the use of the individual

living in the community. The equity value of all other vehicles is a countable asset.

 Revocable trusts (regulations regarding trusts are complex)

 Retroactive Supplemental Security Income (SSI) and Retirement, Survivors and Disability

Insurance (RSDI). Benefit payments beginning in the 8th month after receipt. (Non-

countable in the month of receipt and for the next six months if deposited in a

separately identifiable account.)

For home exemption, the Medicaid applicant must live in the home or have intent to return,

and in 2023, their home equity interest must not be more than $1,033,000. Equity interest is

the value of the home in which the applicant owns. The home is also exempt, regardless of

where the applicant resides or their home equity interest if a non-applicant spouse resides

there.


MassHealth Eligibility: Income Limits

In 2023, the monthly income limits for seniors seeking these MassHealth benefits is $1,215 for

an individual, $1,643 for a couple (both spouses applying), and $72.80 for residents of long-

term care facilities (this is the personal needs allowance).

Income limits depend on the program being applied for, but countable income includes:

 Wages, salary, tips, commissions (before deductions)

 Self-employment income (minus expenses)

 Social Security benefits

 Railroad retirement benefits

 Pensions and annuities

 Federal veterans’ benefits (minus allowed exclusions)

 Interest and dividends

 Rental income (minus expenses)

 Alimony payments

 IRA withdrawals

Spending Down Assets

If someone applies to MassHealth with too much value in their countable assets, they’ll be

required to spend down those assets to the applicable limit. The assets can be spent on the

applicant’s or spouse’s needs, including medical care, in-home supports like personal care and

cleaning, home repairs, care repairs, regular monthly bills, eyeglasses, hearing aids, and

mobility aids. They can also pay bills/debts like credit cards, mortgage payments, taxes, and car

payments even if those costs are owed by their spouse. Assets can also be used to pay for burial

and funeral expenses in advance.

If a person doesn’t spend down according to MassHealth rules, they could be disqualified for

MassHealth or have a penalty phase where their coverage would start at some future date.

Five-Year Look-Back

It’s important to keep in mind the five-year look-back period. When someone applies for

MassHealth for long-term care, MassHealth has the right to examine an applicant’s bank and

financial records for up to five years immediately prior to the date of application.

Typically, if they discover a transfer of assets during this period of $1,000 or more, whether to a

trust or to another person, they’ll impose a disqualification period on the applicant’s eligibility

(a length of time the applicant won’t be eligible for MassHealth). The length of the

disqualification period will depend on the amount of the gift/transfer. Penalties can be “cured”

by the return of the gift to the applicant.


So, let’s say you gave your granddaughter $5,000 toward her college education two years ago

and gave your son $8,000 to help with his home repairs four years ago. If you’re now applying

for MassHealth for long-term care, you would be disqualified from getting MassHealth for a

period of time because of those gifts. If your granddaughter and son repay you the money you

gifted them, that’s called a “cure.” Once you’ve spent down those countable assets according

to MassHealth guidelines, you could then become eligible for MassHealth if all other eligibility

requirements are met.


Contributor: Heritage Law Firm 2023-https://maheritagelawcenter.com/


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