Spouses resources almost all spent down for nursing home. Other assets belong to community spouse. It appears that community spouse will keep all income of the NH spouse directed back through a QIT setup. We don't know how Medicaid will arrive at a figure of who gets to keep how much and who must spend down most or all assets.
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MassHealth under the Home and Community Based Services Waiver,
Another way to get home health services is through one of Massachusetts’s Medicaid Waiver programs.
To qualify for one of MassHealth's Waiver programs, you must have income at or below 300% of the SSI Federal Benefit Rate, or $2,163 per month in 2014. You also must have less than $2,000 in assets. If you are married, MassHealth only looks at your individual income and assets, not those of your spouse. If you have too much income, you can still qualify for MassHealth Waiver programs by meeting a deductible.
To receive waiver services in Massachusetts, you must also show that you would be institutionalized in a nursing home if you were not receiving waiver services. To do that, you must show either that you need at least one skilled nursing or therapy service daily (such as help with injections, catheters, feeding tubes, or physical or occupational therapy) OR that you need a nursing service at least three times per week, plus two "other" services. Other services can be additional nursing services or assistance with activities of daily living like bathing, dressing, toileting, getting in or out of a bed or chair, walking, or eating.
Massachusetts Frail Elder Waiver
If you meet the above financial and level of care requirements, you may qualify for Massachusetts’s Frail Elder Waiver Program. To qualify, you must be 60 or over, but if you are under age 65 you must be disabled.
When you apply for the Frail Elder Waiver, an assessor from your local Aging Services Access Point (ASAP) will visit your home and decide how much help you need every month and with which tasks. Then MassHealth will pay for the cost of services to meet those needs every month. Services provided under the Frail Elder Waiver include personal care services; housekeeping, chore, and laundry services; home health and skilled nursing; adult day programs; grocery shopping and delivered meals; transportation; respite care; and accessibility adaptations to your home.
Community Choices Waiver Program
If you meet the criteria for the Frail Elder Waiver Program, but you are at imminent risk of being institutionalized in a nursing home unless you receive help, you might qualify for the Community Choices Waiver Program. You must have a serious condition evidenced by one of the following:
a need for 24-hour supervision
a significant cognitive impairment
an inability to manage your medications
frequent incontinence, or
a need for daily assistance with activities of daily living.
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if the person has a relatively small amount of excess income, a special type of trust can be drawn up in order that the applicant can become eligible.
Mass Health also considers one's countable assets. The limits for an individual and couple respectively are $2,000 and $3,000. However, as with the income limits, there is flexibility. When only one spouse of a married couple is applying, the asset limit for the other spouse is $119,220. Their home, if owner-occupied, is considered exempt up to a value of approximately $802,000. There are also other exempt assets such as a vehicle, funeral trusts, and personal valuables. As with other state Medicaid programs, the applicant's financially history has a five-year look back period.
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MassHealth is a public health insurance program for low-to medium-income residents of Massachusetts. The national name of this health insurance program is Medicaid.
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