Navigating Long-Term Care in Massachusetts

Massachusetts does not participate in the federal long-term care partnership program; however, homeowners can protect real estate if they own a qualified LTC policy. Plus, quality care providers are available throughout the state, in addition to many insurance solutions with consumer protections are available.

While many qualified care providers are available throughout Massachusetts, costs are rising due to the increasing demand. Rapidly increasing costs for care services throughout Massachusetts are becoming burdensome on residents and their families for those who do not have Long-Term Care Insurance.

The variety of quality care options available throughout Massachusetts for those who require long-term health care services include:

• adult day care centers
• assisted living facilities
• continuing care retirement communities
• home health care providers
• memory care facilities
• rehabilitation facilities
• traditional nursing homes

Top insurance companies have several insurance options to help residents safeguard income and assets, protect lifestyles, and preserve a legacy. Plus, policyholders will have access to quality care options giving loved ones the time to be family instead of caregivers.

Plus, all tax-qualified Long-Term Care Insurance policies in Massachusetts have several consumer protections in addition to federal tax benefits.

Federal Partnership Program

The Commonwealth of Massachusetts does not participate in the federal long-term care partnership program; however, it offers special benefits if you own a qualified Long-Term Care Insurance policy. If you own a long-term care insurance policy that meets coverage requirements, you can be exempt from some MassHealth eligibility and recovery rules. These rules determine whether your home will need to be sold in order for you to become eligible for MassHealth benefits, and/or whether you or your estate may need to repay MassHealth for any of the long-term care expenses it paid on your behalf.

The policy must have a certain level of benefits available to pay for nursing home care in order for you to qualify for the MassHealth eligibility and recovery exemptions. When you enter a nursing home, your policy must cover at least $125 per day for at least 730 days, except where the actual cost is less, regardless of whether the policy counts days or dollars toward the benefit level, and not require an elimination period (days that services must be provided before your policy will begin to pay) of more than 365 days, or in lieu of a waiting period, a deductible of more than $54,750.

It should be noted that, although a long-term care insurance policy may satisfy the MassHealth minimum coverage requirements at the time it is purchased if an insured uses the policy to pay for non-nursing home benefits (e.g., home health care, personal care or assisted living benefits), the amount of benefits remaining available to pay for nursing home care may be less than what is necessary to meet the MassHealth minimum coverage requirements.  Depending upon the original maximum benefit and the benefits that may have been used, the policy may not meet the MassHealth minimum coverage requirements on the day you enter a nursing home.

Therefore, when buying a policy, you should keep in mind that use of non-nursing home benefits may reduce available nursing home benefits below what is required to meet the MassHealth minimum coverage requirements.

If you have a qualifying long-term care insurance policy, are institutionalized, and you notify MassHealth that you do not intend to return home, you may be exempt from the general recovery rules protecting your home.

Policy Example

Example: you purchased a policy with 730 days of nursing home and home health care Coverage. Prior to entering the nursing home, you used 100 days of coverage to pay for home health care services.  On the day you enter the nursing home, you would have 630 days of coverage left to pay for nursing home care. This is less than the minimum of 730 days of nursing home coverage required for certain MassHealth exemptions. Therefore, when buying a policy, you should keep in mind that use of non-nursing home benefits may reduce available nursing home benefits below what is required to meet the MassHealth minimum coverage requirements.     

Reciprocity

Since Massachusetts does not participate in the Long-Term Care Partnership Program there is no reciprocity if you move into the state from another state owning a Partnership Long-Term Care Insurance policy. Your policy benefits are available in the state, but the additional dollar-for-dollar asset protection offered by the original state’s partnership program would not be honored. 

Medicaid - MassHealth

Long-Term Care Medicaid spend down is $2,000. A spouse’s minimum asset allowance is minimum of $26,076 up to a maximum of one-half of countable assets up to $128,640.   Your spouse’s minimum monthly income allowance is $2,155. * The home equity limit is $906,000.

For more information about the Medicaid program visit www.medicaid.gov. The MassHealth site is www.mass.gov/topics/masshealth.

Products Approved in Massachusetts

A variety of products are approved in Massachusetts for Long-Term Care planning. These include tradition policies and asset-based plans.

Tax Incentives

There are no current state tax incentives for long-term care insurance, federal tax incentives still apply.

Reverse Mortgages in Massachusetts

Reverse mortgages are available in Massachusetts. A reverse mortgage is a home equity loan where the borrower does not have to make payments.

This type of mortgage can increase monthly income, eliminate mortgage payments, and even fund Long-Term Care Insurance. However, Kansas has many rules on these products, and you should seek the help of a qualified and licensed mortgage broker. 

If you have significant equity in your home and you and your spouse are at least 62 years old, you can get a reverse mortgage to turn your equity into funding long-term health care, pay for an LTC Insurance policy, pay bills and add to your retirement lifestyle.

The home must be the principal residence without any tax liens. 

Learn more about reverse mortgages by clicking here.

_{*The federal government sets a new minimum and maximum amounts each year, but states can set their own minimum requirements at any level between the federal limits. This information is based on the best available sources.}