Individuals with significant medical issues may require care in a skilled nursing facility - more commonly known as a nursing home or SNF. The cost of such care averages over $11,000 per month for an individual. Most people living in a nursing home pay out of their own pocket for long-term care until they become eligible for Medicaid, a Federal reimbursement program administered by individual states. [Medicare is an entitlement program; Medicaid is a form of welfare.] To be eligible for Medicaid, an individual must become “impoverished” under the program’s guidelines.
In Massachusetts, Medicaid is administered by the Division of Medical Assistance (“MassHealth”). In order to qualify for federal reimbursement, the state program must comply with applicable federal statutes and regulations. To be eligible for MassHealth coverage, an individual must show medical and financial need by reviewing five years asset history and extensive inquiry into all other assets and transfers within the same time period. Without proper planning, nursing home residents can lose the bulk of their savings.