MassHealth has many programs available to help seniors stay at home with services and supports instead of being forced to move to a skilled nursing facility for support. This is typically what our seniors prefer and bonus, it also costs the Commonwealth of Massachusetts a lot less money to pay for care at home than for care in a skilled nursing facility.
The Income Trap
The problem is, to be eligible for MassHealth assistance with the cost of home care, a senior is limited to $2,742 per month of gross income. If their income is even $1 dollar over that limit, they have to meet a deductible and spend down their income in excess of $542 before they can get services. It is nearly impossible for the senior to spend everything except for the $542 on medical care and still be able to pay other bills, such as rent, taxes, insurance, and food.
As a result, often one of two things happen. The senior either ends up going to a skilled nursing facility where MassHealth will cover their full cost because there is no income limit (costing the Commonwealth more and forcing the senior out of their home too soon) or the senior stays home with insufficient care, putting them in danger. The latter can also mean higher costs if it results in repeated hospitalizations.
The Massachusetts chapter of the National Academy of Elder Law Attorneys, (“MassNAELA”) has filed legislation to correct this problem. The current bills are HD753 and SD608. A fact sheet can be found here. These bills correct the issue by allowing a senior who is over the income limit to meet the deductible by just spending down their income that is over the limit. For example, the current threshold for benefits is $2,742. If the senior’s income is $3,000, they would have to spend $258 per month on their medical expenses before they could get assistance instead of $2,458 per month on medical expenses, which is the current law.
To support the law, MassNAELA is seeking real-life stories that will show the legislators the reality of this issue. If you or someone you know has been in the situation where this income threshold precluded you from getting MassHealth, please email me at email@example.com to tell us what you did as a result. If you work with seniors and you see this happening, please tell them to email me too.
Please help us help MassNAELA fix this so more seniors can stay home with less costly supports and services. Thank you in advance.