MASSHEALTH ELIGIBILITY DIVISOR INCREASED TO $267

When a MassHealth Long-Term Care applicant has made what MassHealth determines is a “disqualifying transfer of resources”, MassHealth imposes a period of ineligibility for payment of nursing facility services. When calculating the period of ineligibility, MassHealth uses the average cost to a patient paying privately for nursing facility services in the Commonwealth. Periodically, this figure is revised to reflect increased costs. Effective May 1, 2008, the average cost to a patient paying privately for nursing facility services in the Commonwealth increased from $256 a day to $267 a day.

The date MassHealth receives the application or eligibility review form determines which amount to use when calculating the period of ineligibility or “penalty period”.

• If received before May 1, 2008: use $256.
• If received on or after May 1, 2008: use $267.

For example, for an application filed prior to May 1, a transfer of $100,000 would have caused 391 days of ineligibility. The same transfer would cause 375 days of ineligibility for an application filed after May 1.

-Adapted from: “ MassHealth Revised Eligibility Divisor to $267”, The Margolis & Bloom Weekly, 6/02/08 and MassHealth Eligibility Operations Memo 08-09 , “Average Cost for Nursing Facility Services” May 15, 2008.

 

06/08