By Elizabeth A. Caruso, Esq.
This is a trick question; partial myth and partial fact, but for the most part, it is a myth.
Seniors today have myriad options to turn to for assistance as they grow older and their needs increase. The home-care industry is bigger than ever and more and more assisted-living facilities are being built in our area every day. There are also long-term care facilities, but these are typically everyone’s last resort.
MassHealth is what Medicaid is called In Massachusetts, and it has been a hot topic in the news. For those who qualify, MassHealth will pay for in-home care, assisted living, and long-term care, but the qualifications for each service are very different. Programs under the Community MassHealth umbrella – that is, the senior is still living in the community and not a long-term care facility – have income-based qualifications. Long-term care coverage has income and asset-based qualifications. I’m not going to get into the minutiae of how to qualify for MassHealth in this article; instead, I want to highlight the different levels of care and the general payment options.
Community MassHealth will pay for in-home care. The number one thing I hear from seniors is that they want to stay in their home. Programs under the Community MassHealth umbrella will allow those who qualify to do just that – receive care in their home that allows them to continue to reside where they want. Those who do not meet the income requirements for Community MassHealth can private pay for in-home care.
Many people confuse assisted living and long-term care facilities. Assisted-living facilities are based on a hospitality model. The senior is the guest and the staff is trying to make their experience the best possible. The medical care component of the “assistance” is minimal. It’s mostly helping with transfers, dressing, medication management, etc.
In contrast, long-term care is a medical model where the senior receives 24/7 medical care. There is only one Community MassHealth program that pays for assisted living called PACE. This program has regional qualifications, in that it is not offered universally across Massachusetts, in addition to income qualifications. For those who don’t qualify, assisted living is entirely private pay. Long-term care is paid by MassHealth for those who meet the income and asset requirements.
An elder law attorney can help you understand your options for senior care based on your health, wishes, and financial situation. Knowledge is definitely power in the senior-care world.
About the Author: Elizabeth A. Caruso, Esq. is an attorney at Legacy Legal Planning, LLC, in Norwell. She has been practicing estate planning, probate, and elder law on the South Shore for more than a decade. If this article has sparked questions for you, please feel free to reach out via phone 781-971-5900 or email elizabeth@legacylegalplanning.com to schedule a time to discuss your unique situation.
