People living in New England might assume that Medicaid coverage is roughly the same everywhere, regardless of what state offers coverage. However, an applicant’s home address can have a profound impact on the application process, their eligibility for benefits and even how they access Medicaid benefits.
When looking at MassHealth, which is the Massachusetts Medicaid program, and the Medicaid program in New Hampshire, there are significant differences that older adults planning for their future long-term care needs must understand to adequately protect themselves.
MassHealth has unique state rules
MassHealth is an umbrella program that includes both the Children’s Health Insurance Program (CHIP) and standard Medicaid. Children, families, people with disabling medical conditions and older adults all receive medical coverage through the same program.
As is true of Medicaid in every state, MassHealth is a state program partially regulated by federal rules. Massachusetts used federal waivers to expand MassHealth coverage. More vulnerable people may be eligible for MassHealth, especially later in life when dealing with intensive long-term care needs, than in states with standard Medicaid programs.
Those in New Hampshire can access Medicaid benefits through the standard waiver system when they require home or community-based services. They can also apply for benefits to pay for their nursing home costs.
Factors, including household income and the severity of medical challenges, directly influence eligibility for long-term care benefits through Medicaid or MassHealth. Applicants in Massachusetts may be able to qualify for community and in-home support with higher income levels than applicants in New Hampshire.
Those planning for future Medicaid eligibility need to work with an attorney familiar with state-specific rules. Clarity on income and asset restrictions, as well as the potential waivers available to applicants, can help older adults maximize their benefits and decrease the likelihood of coverage delays due to Medicaid lookback penalties. They can also potentially protect resources from estate recovery efforts after they die.
Changing asset ownership, making strategic gifts, completing a spend-down plan and funding a trust can all help those concerned about their future Medicaid or MassHealth eligibility. Consulting with an experienced elder law attorney familiar with New England Medicaid programs is of the utmost importance for those concerned about covering long-term care costs in their golden years. A lawyer’s guidance can help people to better ensure that they are eligible when they need support the most.