Mom is in assisted living and rapidly approaching need for skilled nursing care. When her money runs out she will not be eligible for medicaid because her social security income puts her just over the limit. Home care is not an option. How will she pay for nursing home care at that point?
MassHealth's Income Limit for Long-Term Care
If you are 65 or older, you can qualify for MassHealth if your income is at or below 100% of the federal poverty rate, or $1,041 per month in 2019. People who receive SSI already qualify to receive MassHealth.
If your income is above the limit but you need help with nursing home costs, you still might be able to qualify for Medicaid if you're already paying for a nursing home or have other significant medical expenses. A MassHealth worker will determine your excess monthly income to see if you qualify. Excess monthly income is income left over after subtracting Medicare or other health insurance premiums, a personal needs allowance, and any spousal or family maintenance needs allowances. That amount, multiplied by six, is the "deductible" that you must meet in a six-month period to be eligible for MassHealth. You must show proof that your nursing home costs or medical expenses equal the required deductible amount. Once you show medical expenses that equal your deductible, then you are eligible for MassHealth for the entire six-month period.
In particular, this paragraph: 2) Medicaid Planning – the majority of persons considering Medicaid are “over-income” or “over-asset” or both, but still cannot afford their cost of care. For persons in this situation, Medicaid planning exists. By working with a Medicaid planning professional, families can employ a variety of strategies to help them become Medicaid eligible. Read more or connect with a Medicaid planner.