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  • Writer's pictureKathy L. McNair, Esq.

When paying for Nursing Home Care, what is the difference between MassHealth, Medicare, and Medicaid

1. MassHealth and Medicaid are the same.

It is helpful to understand that MassHealth and Medicaid mean the same thing. You have to meet certain financial requirements to qualify for this program, if you are over 65 years of age and single your assets need to be below $2,000. If you are applying for MassHealth/Medicaid and you are living in a nursing home, there is not an income limit, but you will need to contribute most of your income towards your care.

If you are married and your spouse is living at home, your spouse will be allowed to keep up to $137,400 in assets and all of his/her income. In some situations, your spouse may be allowed to keep some of your (nursing home resident's) income to help them stay living at home. There are rare situations where the spouse living at home may be able to keep more assets. If you are over the asset limit, it is important to meet with an elder law attorney to determine the best strategy for protecting the excess assets.

2, Most Americans over 65 automatically get Medicare.

Medicare is a different program. It is a federal program provided to most seniors over 65 regardless of their financial situation. Medicare pays for a short term stay a nursing home, following a three night stay at a hospital. Medicare won’t pay for more than 100 days in a nursing home. Most people don't get the 100 days, as you must be making progress toward your rehabilitation in order to be covered. Unless you have supplemental insurance, there is a co-pay after the first 20 days.

3. If you qualify for Medicaid/MassHealth you can also have Medicare at the same time. Between the two programs your medical bills should be completely covered.

If you or a family member needs nursing home care and wants to apply for MassHealth, we are here to help guide you through the MassHealth application and protect your assets. Please take the next step and call our office at 617-489-5900 or schedule a brief free consultation or by clicking:

Senior Solutions, Attorneys at Law, is an Estate Planning and Elder Law firm, serving the Greater Boston, Massachusetts area, since 2001. We are ready to help you with Medicaid Planning, Estate Planning, Probate, Guardianship & Conservatorships, Special Needs Trusts, and Fiduciary Services.

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