Archive for the ‘Medicaid (MassHealth)’ Category

Single Elders Who Will Soon Need MassHealth Nursing Home: Act Fast to Set Aside a Cushion

Friday, December 4th, 2009

To qualify for MassHealth to pay for nursing home care, a single elder can have only $2,000 in his name. A big problem with allowing such a small reserve fund is that MassHealth doesn’t cover many needed services and medical items - like hearing aids, routine dental care, and eye glasses - and the elder is left with no way to pay for those items himself.

For anyone who will need MassHealth to pay for nursing home care, it is usually a good idea to try to set aside some funds to serve as a cushion to provide those necessary items that MassHealth won’t cover. For single elders,  the way to set aside a reserve fund is usually to deposit some amount of money with a “pooled trust.” A pooled trust is a trust fund, operated by a nonprofit organization, that pools together the deposits of its many elder and disabled members in order to streamline costs and maximize interest earned. The staff at the pooled trust keeps a separate running balance of each individual’s deposits. We have four pooled trusts in Massachusetts.

Until now, MassHealth has allowed elders to set aside some funds in a pooled trust to serve as a cushion for those uncovered “extras” that will inevitably be needed during a nursing home stay. MassHealth has permitted this transfer without imposing the usual transfer penalty.

But we just learned that this month, MassHealth plans to close this door and will no longer allow elders to set aside reserve funds in this manner. Therefore, if you are an elder or are caring for an elder who you think will need MassHealth nursing home care soon - whether that be in the next few months or the next year - you should speak with an elder law attorney this week about setting up a pooled trust account. In order to preserve a cushion to sustain a person through a nursing home stay, all of the paperwork for enrolling in the pooled trust must be completed before MassHealth changes the regulation, and they intend to make the change some time this month.

If someone you love will need MassHealth to pay for nursing home care soon, and they would like to set aside a reserve fund to pay for those items and services that MassHealth doesn’t cover, then you need to speak with an elder law attorney now. Time is of the essence.  

Tags:
Posted in Medicaid (MassHealth) | 5 Comments »

What Happens to My Special Needs Child’s Health Care Coverage When She Turns 18?

Friday, February 6th, 2009

The idea of a special needs kid turning 18 can be scary – that is when she is legally an adult and things start to change.  In another post I will address her legal decision-making power.  This post looks at health care coverage. 

If your child is on your private health insurance policy (i.e., the family plan you have through your employer), the good news is that she should be covered through age 25, so long as she is still your “dependent,” meaning that she receives over one half of her financial support from you.  After 25, if she is not employed, you will probably need to look at MassHealth. 

On the other hand, if your child has been on MassHealth as a minor, her current coverage will end somewhere between 18 – 22, depending on which program she has been enrolled in.  The good news here is that there are several MassHealth programs that she can switch over to as an adult.  

A word of warning – there are many different MassHealth programs, and they each of different enrollment criteria.  The enrollment process itself is long, tedious, and frustrating.  (If you’ve dealt with MassHealth in the past, you already know this.)  So if you are planning to enroll your child in MassHealth as an adult, get started on that process early.  Record-keeping is critical.  Keep all receipts related to medical care and medical purchases (doctor’s visits, prescriptions, equipment, even the little things from the pharmacy). 

The Boston Children’s Hospital and the Boston Bar Association wrote a good guide on this topic, see chapter 7 here. 

Tags: , ,
Posted in Adult Disabled Child, Medicaid (MassHealth) | No Comments »

MassHealth (Medicaid) Programs for Kids

Wednesday, February 4th, 2009

Some children don’t have private health insurance coverage through their parents, as a matter of fact, lots of kids – one in four Massachusetts children is on MassHealth (Medicaid). 

Applying for MassHealth is very confusing – there are several programs, they each have different enrollment criteria, and they provide different levels of coverage.  Check out this guide, produced by Children’s Hospital and the Boston Bar Association – chapter 3.  Scroll down to page 10 for a good overview of several different MassHealth programs.  The guide is written for parents of kids with mental health issues, but the insurance chapter applies to all kids.  

Tags: , , ,
Posted in Medicaid (MassHealth) | No Comments »

Being Paid to Care for Your Parents

Wednesday, January 28th, 2009

As their parents have needed increased hands-on care and errand-running, many “Boomers” have been squeezed trying to juggle caring for their parents and performing well at work.  Our current economy has produced a mixed blessing for some – lost jobs means time to address their parents’ needs, but without economic security.

One solution is a “caregiver contract.”  This is a written agreement between the parents and the adult children, laying out tasks the child will perform and a rate of pay.  Set up along with worker’s compensation and the usual payroll deductions, this provides an income stream to the caregiver while giving the parent what most elders want – being cared for by her own family.  Only an elder law attorney familiar with the ever-changing rules of Medicaid should draft a caregiver contract, so that it will protect the elder in the event she needs nursing home care in the future.  If not done correctly, a caregiving arrangement can result in a later denial of MassHealth nursing home benefits.

Tags: , , ,
Posted in Living at Home, Medicaid (MassHealth) | 1 Comment »

Rising Unemployment Means Rising Uninsured

Monday, January 12th, 2009

Rising numbers of unemployment inevitably lead to a significant number of people losing their employer sponsored health insurance.  Where do these people turn for insurance?  States provide Medicaid for people who meet their income and asset requirements.  Medicaid is much more generous with children, even the children of parents who themselves have too much money or assets to qualify.  So hopefully most kids will still have coverage.  But what about the adults?

The Kaiser Family Foundation, a nonprofit that does extensive nonpartisan, high quality research into health care finance matters, including Medicare, Medicaid, and private insurance, recently released a daunting report.  Their figures estimate in 2009, 5.9 people will lose their employer coverage, Medicaid and SCHIP (for kids) will pick up 2.4 million, and 2.6 million people will remain uninsured.  State governments provide some assistance to hospitals who treat uninsured, but of course with declining tax revenues, there will be less funding available for such reimbursement (the “compensated care pool.”)

Where will the funding come from to cover the 2.4 million new MassHealth and SCHIP enrollees?  And what about increasing funding to cover more of the people left uninsured?  Medicaid (and Medicare) already make up unwieldy percentages of state and federal budgets.  President Obama and his team have announced that they will take on these programs.  It will be a difficult but very worthy project.  I expect that NAELA, the organization supporting the nation’s elder law and disability law attorneys, will provide leadership on this issue.  Our organization has many individuals well schooled in these issues and passionate about redesigning the health care system to make it serve more people more effectively. 

Tags: , ,
Posted in Medicaid (MassHealth) | No Comments »

©Copyright 2009. Alexis Levitt. All rights reserved. Hingham, MA | 781.740.7269 | alexis@alexislevitt.com