Audrey M. Heidt

Elder law is a specialized practice area dedicated to representing elders and their families. I practice exclusively in the arena of elder law, including long term care planning and estate planning, Medicaid applications, guardianships, probate proceedings, and reverse mortgage representation.

Medicaid and MassHealth

Medicaid is a federal benefits program. In Massachusetts, Medicaid is administered and regulated by a state agency called MassHealth. MassHealth provides long term care benefits to Massachusetts residents, including nursing home benefits. The program has strict income and asset limitations, and complex governing regulations. Often, an elder must reduce his or her assets to less than $2,000 (not including a principal residence) before he or she will become eligible for long term care benefits.

It is difficult for everyone when a family member requires long term care or care in a nursing facility. While nursing facilities may offer to help families process the MassHealth application, most nursing facilities receive a higher rate of pay when families pay privately. As a result, nursing homes have a conflict of interest when it comes to helping applicants preserve assets. The manner in which a MassHealth application is completed and filed may have a significant impact on the applicant's resulting benefits and expected quality of life. I believe applicants should retain counsel or other independent assistance to help prepare and file MassHealth applications. If an applicant is denied benefits, counsel can help the applicant prepare for a fair hearing and represent his or her interests during the hearing.

Long Term Care Planning

The average cost of nursing home care in Massachusetts today is $11,000 per month. As a result, even elders with substantial assets may find themselves destitute after a few years of nursing care. Today’s elders are outliving their retirement plans and are left with few options when long term care is required. Advanced planning may reduce the financial devastation caused by long term care expenses, and should be considered when drafting your estate plan. Some available planning options include long term care insurance, testamentary trusts, irrevocable income only trusts, and life estates.