GOOD NEWS FOR LONG TERM ARE AT HOME

Elders who qualify for nursing home placement may no longer need to chose between institutionalization or impoverishing their spouse in order to get services at home.

A MassHealth provision called the Home and Community-Based Waiver disregards a spouse's income, and assets that are in the spouse's name, when determining eligibility for MassHealth Standard. In the past when applying for MassHealth a spouse's assets were protected if the patient was in a nursing facility, but not if he/she were at home. This amounted to a financial incentive for institutionalization, which has now been remedied. Having MassHealth might allow a patient to get onto the PCA program, or might mean coverage for an adult day health program.

The qualifications are:

  1. Age 65 or older, or age 60 and permanently and totally disabled.
  2. Nursing home eligible as determined by the MassHealth.
  3. Have to have one or more of the following services administered by the Executive Office of Elder Affairs already in place: case management services, homemaker, chore services, social day care or respite.
  4. Financially eligible-
  • Income no greater than 100% of poverty ($671 month for the individual). If income exceeds this amount, the person might be eligible through a deductible. See the MassHealth booklet under CommonHealth pages 10-11 for an explanation of how the deductible is calculated (Note: the dollar amounts listed are slightly different from those used to determine deductibles for this waiver).
  • Countable assets no greater than $2,000. "Countable" for the purpose of this waiver includes joint bank accounts, but not assets that are in the spouse's name such as bank accounts, stocks and bonds. The usual rules apply, assets cannot be transferred for the sole purpose of obtaining MassHealth eligibility.


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