When a loved one requires round-the-clock care, you might hear the daunting statement, “Eventually, when there are no assets left, you will need Medicaid.” This is a broad and often misleading claim.
It’s crucial to understand that the terms “Medicaid” and “MassHealth” are essentially interchangeable. There are extensive regulations governing the application, acquisition, and use of Medicaid in nursing home settings (though community-based programs are also relevant, they are not the focus of this article). The legal experts at Falco and Associates P.C. dedicate their careers to advising families on the optimal times and methods for obtaining Medicaid while legally protecting as many assets as possible.
The outcome of each case can vary significantly depending on several key factors. These include whether the individual needing care is married, has any disabled children, or has been cared for at home by an adult child. Other important considerations are whether any gifts were made within the past five years, which could affect Medicaid eligibility, or whether proper estate and Medicaid asset protection planning was undertaken five years prior. Your estate and Medicaid planning attorney is responsible for considering all these factors and exploring every option to minimize the financial burden of constant care.
One notable option, which was available before March 2024, then phased out, and recently reinstated, involves constructing a plan that pools all assets exceeding the permissible amount into an approved “D4C” trust. While the specifics of this strategy are beyond the scope of this discussion, the end result is a significantly reduced nursing home payment rate. The assets in the pooled trust can be used for the benefit of the nursing home resident, thus alleviating some of the financial strain.
If you have a loved one who may soon need nursing home care, or if they are currently in a hospital or rehabilitation center and the next step seems to be a nursing home, we urge you to consult with us. We are committed to devising a plan that ensures comprehensive care at the lowest possible cost.
-Anthony Falco Esq., Founder
