Medicaid Planning Lawyers

Helping Massachusetts Families & Individuals Tie Medicaid Benefits to Estate Planning

A key estate planning instrument is how one utilizes the “spend-down” process for assets and debts, so that an individual may be eligible for Medicaid and have the nursing home bills paid by Medicaid/MassHealth after he or she has exhausted any private insurance or personal resources.

We help clients fulfill their planning goals of both Medicaid asset protection and long-term security.

Our firm focuses our practices on elder law such as Medicaid planning for estates and Medicaid and estate recovery.

Medicare and the bulk of private health insurance policies do not pay for the high cost of nursing home care, which is why Medicaid is so important in helping families meet the costs associated with long-term care. We can guide you through the Massachusetts Medicaid/Medicaid spend-down rules so that your end-of-life bills can be paid, and your “nest egg" is saved and protected for your spouse and loved ones.

We are ready to explain how Medicaid applications work for Massachusetts residents, Medicaid application process filing, and the Medicaid planning timeline for each practice area, tailored to you, such as Medicaid trusts.

Medicaid Spend-Down Rules & the Medicaid Planning Timeline

MA Medicaid plans is an essential part of our practice areas—we concentrate on the most up-to-date Medicaid eligibility information. Our knowledgeable team can educate you on the Medicaid planning timeline. Reliable legal advice is key to safeguarding yourself and your family. We assist our clients with long-term Medicaid planning and apply Medicaid eligibility spend down assets financial options for Medicaid and Medicare. 

You may ask, what exactly does the spend-down process involve?

It is incumbent upon the patient receiving medical assistance to have a very clear understanding of specific standard assets that can be quite complex, including the ramifications if these assets were sold or transferred, because by definition, they are countable assets for Medicaid spend-down purposes.

There are several important factors and questions surrounding Medicaid and long-term care that we handle for our clients in our MassHealth Medicare consultation. Marsden Law offers a free 15-minute telephone consultation appointment. We can help you with understanding Medicaid and long-term care to guide you through the Medicaid planning timeline for your specific practice area, such as Medicaid trusts.

Understanding Medicaid Eligibility and Asset Limits

Medicaid is a government program that helps individuals with limited income and resources pay for medical care, including long-term care and nursing home services. However, to qualify for Medicaid in Massachusetts, applicants must meet certain eligibility criteria, including limits on assets.

Asset Limits for Medicaid Eligibility:

• Individual Applicants: In Massachusetts, individuals applying for Medicaid must have less than $2,000 in countable assets. These are assets that can be easily converted into cash.
• Married Applicants: For married couples, the rules are different. The spouse applying for Medicaid (the “community spouse”) may have up to $2,000 in countable assets, while the non-applying spouse (the “spouse at home”) can keep more assets, up to $137,400 (as of 2024).

Exempt and Non-Exempt Assets:

Some assets are exempt from the Medicaid asset limit, meaning they are not counted toward the total when determining eligibility. These include:

• Primary Residence: The home may be exempt if the applicant lives in it or intends to return home, and if the home’s value is below a certain threshold (around $906,000 for a single person in 2024).
• Retirement Accounts: Certain retirement accounts, like IRAs or 401(k)s, may be exempt as long as the funds are not currently being accessed.
• Vehicles: One car may be exempt if it is used for transportation.

Non-exempt assets are those that are considered liquid and easily accessible. These include:

• Savings accounts
• Investment accounts
• Second homes or real estate

If you exceed the Medicaid asset limit, you may need to go through the spend-down process, where you reduce your assets to qualify.

Medicaid Trusts: Protection of Assets

A Medicaid Asset Protection Trust (MAPT) can help preserve assets while ensuring eligibility for Medicaid.

• What is a Medicaid Trust? A Medicaid trust allows you to place assets in a trust, making them unavailable for Medicaid eligibility purposes. Once assets are in the trust, they are no longer considered part of your estate.
• Benefits of Medicaid Trusts:
  • Protects Assets: It helps protect the home, savings, and other valuable property from being counted towards Medicaid’s asset limits.
  • Ensures Medicaid Eligibility: Properly set up trusts can allow individuals to qualify for Medicaid without having to exhaust all their savings.
• Creating and Managing a Medicaid Trust: Working with an experienced attorney to create a Medicaid trust ensures that the trust is set up correctly and follows all Medicaid rules. These trusts often have a five-year look-back period, meaning that if assets are transferred into the trust within five years of applying for Medicaid, they may still be counted.

Income Limits and Medicaid Eligibility

In addition to asset limits, Medicaid also has income limits that must be met. These limits vary based on whether you are single or married.

• Income Limits for Individuals: For a single applicant in Massachusetts, the monthly income limit is typically around $2,742. If you earn more than this amount, you may not qualify for Medicaid unless you can reduce your income.
• Income Limits for Married Couples: The income limit for a couple depends on how much the non-applying spouse earns. In cases where the community spouse’s income is too high, Medicaid may allow for a spousal income allowance, which helps ensure the well-being of the spouse not applying for Medicaid.
• Strategies to Reduce Income:
  • Converting excess income into non-countable assets, such as purchasing an exempt asset (e.g., home improvements or funeral plans).
  • Using a Miller Trust (also called a qualified income trust), which can allow higher income individuals to qualify for Medicaid by placing income into a special trust.

Nursing Home Care and Medicaid

Medicaid is often essential for paying for nursing home care, as private insurance typically does not cover these costs.

• How to Apply for Medicaid for Nursing Home Care: To apply for Medicaid coverage for nursing home care in Massachusetts, you will need to fill out an application, provide financial documentation, and undergo an assessment to determine your eligibility. This process can be complicated, so working with a Medicaid planning attorney is highly recommended.
• What Medicaid Covers: Medicaid covers a range of nursing home services, including:
  • Room and board in a licensed nursing facility.
  • Skilled nursing care, therapy, and medical treatments.
  • Long-term care services like assistance with activities of daily living (ADLs), including bathing, dressing, and eating.

Understanding the application process and the services covered by Medicaid can help you make informed decisions about your long-term care planning.

By planning early and understanding how Medicaid eligibility works, you can protect your assets, ensure your eligibility for benefits, and make the best choices for your long-term care needs.

Dedicated Medicaid Application Process Attorneys Serving Worcester County & All of Massachusetts

Marsden Law is a small firm, but one that is growing very rapidly: currently with seven employees. Our small size allows us to better interact with all our clients in order to fully learn their dreams, concerns, and goals relative to their circumstances of how to apply for Medicaid. Additionally, our small size allows us to provide work in a very timely manner and ensures that the services we offer are promptly provided to our clients.

Our legal firm in Boston can help successfully tailor a strategy for your long-term benefits. We assure you will receive the utmost care from the Marsden Law staff.

Frequently Asked Questions (FAQs)

• What is Medicaid Spend-Down, and How Does It Work?
  Medicaid spend-down refers to the process of reducing your countable assets to qualify for Medicaid benefits. This can be done by paying off debts, purchasing exempt assets, or transferring assets to a Medicaid-compliant trust. Understanding the spend-down process is essential for those facing high medical costs and seeking Medicaid assistance for long-term care.
• How Can a Medicaid Trust Protect My Assets?
  A Medicaid Asset Protection Trust (MAPT) allows you to transfer your assets into a trust that is not counted when determining Medicaid eligibility. This strategy helps preserve assets like a home or savings while ensuring you qualify for Medicaid benefits. It's important to work with an attorney to ensure the trust complies with all Medicaid regulations, including the five-year look-back rule.
• Can I Use Powers of Attorney to Help with Medicaid Planning?
  Yes, powers of attorney (POA) can play an important role in Medicaid planning. A durable power of attorney allows someone you trust to manage your financial and healthcare decisions if you become incapacitated. This can be useful for handling Medicaid applications, managing assets, and ensuring your estate planning is in order. It’s important to have a POA in place before you need it to ensure smooth decision-making during the Medicaid process.
• How Do Income Limits Affect Medicaid Eligibility?
  Income limits for Medicaid vary based on your household size and whether you're applying as an individual or a couple. In Massachusetts, individuals generally must earn below $2,742 per month to qualify. If your income exceeds this limit, strategies like creating a Miller Trust or spending down income on non-countable assets can help you qualify.
• Can I Apply for Medicaid if I Have More Than $2,000 in Assets?
  If you have more than $2,000 in countable assets, you may not qualify for Medicaid immediately. However, you can reduce your countable assets through the spend-down process, transfer assets into a Medicaid-compliant trust, or convert assets into exempt categories (like your primary home or a prepaid funeral plan). Consulting with a Medicaid planning attorney is essential to understand the best strategies for qualifying.
• What is the Role of Powers of Attorney in Long-Term Care Planning?
  Powers of attorney are critical in long-term care planning because they allow someone you trust to make decisions on your behalf, particularly in the event that you become unable to manage your own care. With a POA, a designated person can help handle Medicaid applications, manage finances, and make healthcare decisions that align with your wishes. It's important to establish this legal document well in advance of any health decline.
• Do I Need a Lawyer to Help with Medicaid Planning?
  While it's not required, hiring a lawyer to assist with Medicaid planning is highly recommended. An attorney can guide you through the complex eligibility rules, help create Medicaid trusts, and ensure that you qualify for benefits without losing your assets. Legal advice can help you avoid common pitfalls and ensure that your long-term care needs are met.
• How Can I Protect My Home When Applying for Medicaid?
  In Massachusetts, your home may be exempt from Medicaid’s asset limits, but only if certain conditions are met. For example, you must live in the home or intend to return to it after receiving care. If you plan to apply for Medicaid and want to protect your home, a Medicaid Asset Protection Trust (MAPT) can help safeguard the property for your family while allowing you to qualify for benefits.

Find out how Marsden Law can help you tie your Medicaid application to other estate planning to achieve success — get the legal advice you need by calling (800) 828-7854 today.