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Medicaid Planning & Nursing Home Planning

Greater Boston Massachusetts Medicaid, Nursing Home, and Elder Law Planning

Medicaid, MassHealth, Nursing Home Planning, Mass Health Eligibility, Medicaid Planning- for Boston, Wellesley, Metrowest, and Communities throughout Massachusetts

Crisis Planning: For a loved one who is in or going to a nursing home soon.

It’s never too late to protect your spouse, your home and your lifesavings!

At Dennis Sullivan & Associates, we offer a unique process to help you develop actionable strategies to protect your spouse, your home, and your life savings so you will not improvrish your spouse and leave your family without a dime. The consultation has three parts:

1. Information Collection. When you call us, an attorney or paralegal will ask questions about your situation. If we think we can help you, we will send you a detailed questionnaire to help us analyze how Medicaid rules will apply to your situation.

2. Strategy meeting. Next, we will meet with you to create a personalized plan to help you and your family. You may have family members or others participate in the meeting. We will also give you a written plan that summarizes the pertinent parts of Medicaid law and identifies the actions you should take next.

3. Implementing the Plan. For most clients, implementing the Asset Protection plan will require the assistance of an attorney. There may be a deed or other legal documents to prepare. We will work with you, your family and your financial advisor to take the steps needed to qualify for Medicaid and protect your life savings.

If you, or someone you love is in crisis, please call our office at (781) 237-2815 to see how Dennis Sullivan & Associates can help you.

Why is it so important to plan ahead?

With nursing home costs averaging $400-$500 a day in Massachusetts, and rapidly rising (see the schedule of projected increases in the cost of nursing home care), it is vital to plan ahead in order to protect your home and other assets. New Medicaid laws strictly limit the available assets and income that a spouse can keep if the other spouse is in a nursing home. They will even put a lien on the home. The limitations are even more severe for a widow or unmarried person. If you wait until you or someone you love is already in a nursing home to determine your options, you WILL significantly decrease the likelihood of retaining your assets.In order to protect your life savings, legacy and lifestyle you must obtain education and plan in advance.

Medicaid and Elder Law FAQs

What is Medicaid

What Is Medicaid?

Medicaid is a joint state and federal program, which will pay the costs of a nursing home. It is intended to assist those who do not have the means in which to pay the outrageous costs of nursing home care. The guidelines of which an individual qualifies for Medicaid changes frequently. The best way to be aware of these changes is through education and help from qualified professionals, like the attorneys of The Estate Planning and Asset Protection Law Center, to update you on the guidelines of qualification.


The Problem with Medicare

Problems with Medicare

Medicare covers up to 100 days of “skilled” nursing care per illness. The conditions and definitions for obtaining Medicare coverage is quite stringent, leaving most with less than 100 days of coverage.

Should I Transfer My Assets?

Transferring assets has a direct affect on whether or not you will be able to qualify for Medicaid and when. The newest Medicaid law changes (called the “Deficit Reducation Act of 2005”) has increased the look-back period of transferring assets from 3 years to 5 years. Most transfers within this time period are subject to a disqualification period, which does not begin to run until you have spent down to the qualifying level. Due to these new laws, making transfers before this 5-year period has expired is a sure way to lose most, if not all, of your assets. It is even more critical if a spouse is at home while the other is in a nursing home. How will the spouse that is at home be able to support themselves if all your money is gone?

Mrs. Smith had savings of $100,000. The average private-pay nursing home rate in her state is $10,000 a month. Mrs. Smith transferred $50,000 to her son to help him buy a home in 2006. Mrs. Smith became very ill and entered a nursing home facility in 2007. Mrs. Smith is not eligible for Medicaid until her assets do not exceed $2,000. With her $50,000 it only takes 5 months for her to be completely broke. At this point, she should be qualified for Medicaid. However, because she transferred the $50,000 to her son before the 5-year lookback period had expired, she received a 5 month penalty before she can qualify for Medicaid. This 5 month period would already have expired under the old laws, but due to the DRA, the penalty period does not begin to run until she has spent down her assets to the qualifying level of $2000. As you can see, there is a problem here. She has to wait 5 months before being on Medicaid, which is $50,000 worth of fees due to the nursing home. If her family does not pay this she may not be able to stay in the facility.

Planning ahead for these situations would have eliminated this problem, as well as saved a substantial amount of money for the family. Through our workshop you will learn everything you need to know to protect your family if a loved one requires nursing home care.

Learn more about Eligible and Ineligible Transfers, and Protecting Your Home and Assets from Nursing Home Costs

Medicaid Trust Planning

Medicaid Trust Planning

Transferring assets is not always the best option in planning for Medicaid for many reasons discussed above. The fact that transferring assets requires that you give them away and most people are not comfortable with this option. A standard Revocable Trust is perfect for keeping control and avoiding probate and savings taxes, but it does not protect your home and assets from nursing home costs. Because a Revocable Trust can be changed or rescinded by the person who created it, Medicaid considers any assets owned by these trusts countable assets when determining your qualification.

Fortunately, there are options available to protect your home and other assets  so that Medicaid can no longer count these assets as part of your estate.

Medicaid Application

What can I spend my money on before applying for Medicaid without becoming ineligible?

There are a few ways you can spend assets if you are over the limits of Medicaid eligibility.
These include:
·    Paying off a Mortgage
·    Home Repairs
·    Replacing an old Automobile
·    Updating Home Furnishings
·    Paying For More Care At Home

Again, due to the fact that the penalty periods incurred by Medicaid for an ineligible transfer, any spend-down attempt should be done with the consultation and advice of a qualified professional.

Applying for Medicaid
The last step in your pursuit of qualifying for Medicaid is the Medicaid application. It is essential that, even if you did not plan ahead, you seek the advice of an attorney or other qualified professional before applying for Medicaid. A spend-down plan can be implemented to save you as much money as possible.

Planning with Annuities

Annuities can be ideal planning tools for spouses of nursing home residents. For single individuals, they are less useful. An immediate annuity, in its simplest form, is a contract with an insurance company under which the consumer pays a certain amount of money to the company and the company sends the consumer a monthly check for the rest of his or her life. In most states the purchase of an annuity is not considered to be a transfer for purposes of eligibility for Medicaid, but is instead the purchase of an investment. It transforms otherwise countable assets into a non-countable income stream. As long as the income is in the name of the community spouse, it’s not a problem.

In order for the annuity purchase not to be considered a transfer, it must meet three basic requirements: (1) It must be irrevocable–you cannot have the right to take the funds out of the annuity except through the monthly payments. (2) You must receive back at least what you paid into the annuity during your actuarial life expectancy. For instance, if you have an actuarial life expectancy of 10 years, and you pay $60,000 for an annuity, you must receive annuity payments of at least $500 a month ($500 x 12 x 10 = $60,000). (3) If you purchase an annuity with a term certain, it must be shorter than your actuarial life expectancy. (4) Under the DRA, the state must be named the remainder beneficiary up to the amount of Medicaid paid on the annuitant’s behalf.


Increasing Cost of Care

At the Estate Planning and Asset Protection Law Center, we help people protect homes and other assets from increasing health and nursing home costs.

As the costs of nursing homes (already averaging between $10,000 and $12,000 a month in Massachusetts) continue to rise, the risk of loss of your lifesavings and reduction in lifestyle as well as the loss of your legacy becomes greater and greater.

A nursing home stay of five years at $300 per day can cost an average family $605,000 in today’s values, but adjusted for inflation, that amount will grow significantly. Five years from now that same 5-year stay will cost $735,000 and ten years from now it will be $939,000. Click below to see the growth of costs from year to year with an inflation rate of 5%.

Taking steps now can protect your lifestyle and legacy from these potentially devastating costs.

What Our Clients Experience

  • C.C. Dedham, MA

    My daughter was acquainted with Greta Atchinson, so when I had a need I naturally went to them. Both Greta and Dennis Sullivan have treated me wonderfully well! I’ve been very satisfied with the trust they did for me. Greta and Dennis were polite, caring and compassionate. They were very well prepared and helpful. I never felt rushed. I knew I needed to do something but didn’t know what. It was a great decision to go there. They were of tremendous help! Plus as a member of their Lifetime Protection Program I know they’re looking after me, plus whenever I have a question I can call them. I would absolutely recommend their services.

  • Mary McKernan, Needham, MA

    I’m extremely satisfied with the work that was done for my husband and me. Greta and the entire staff are always very helpful and nice. I’d initially found out about the Dennis Sullivan law firm when I was getting ready to retire and received a flyer from the state of Massachusetts that had various information on it. They are great people to know! We go in once a year now for a check-up that they provide. This keeps us very well informed about any developments, plus they answer all of my questions. The Sullivan group gets my highest recommendation!

  • C.B. Wellesley, MA

    We’re very pleased with the estate planning work that was done for us. My husband and I were very comfortable using their services. We originally went to one of their seminars, liked what we heard, and then came in for a consultation. I would definitely recommend going to see the people at Sullivan and Associates!

  • Mike McInerney, Framingham MA

    These people get things done! They got results in a number of different areas for me, such as estate planning, plus they’re still working with me and the state of Massachusetts in some matters involving my late wife. I first became acquainted with the Estate and Asset Protection Law Center of Dennis Sullivan & Associates a few years back. I’d seen an ad in the newspaper and went to one of Dennis’ free seminars, and then booked a consultation with him. He is very informative! Everyone there is very friendly, knowledgeable, and helpful. They are very accommodating people who get things well taken care of. I highly recommend their services!

  • J.S., Boston, MA

    I’m pleased to say they are my law firm! They’ve been very helpful to me over the years. I especially like the fact that they do a yearly check on all of my legal documents. This is a very viable service because things can change over time, and it’s good to know that I’m always current. This is very important, and I appreciate that they do this. These people do good work; they do things right!

  • H.S. Concord, MA

    Everything has gone fine. We first became familiar with the Sullivan Law Firm when we attended one of their seminars, and then made an appointment to come in for a consultation. We’ve been clients ever since. I appreciate that they continue to do a yearly review for us and advise us if we need to make any changes. As the saying goes, it’s good to have your ducks in a row! Everyone there has treated us wonderful. They are a very good group of people.

  • Noel Thyson, Winchester, MA

    I’m very satisfied with what the legal staff has done for me. Interestingly, an attorney I was using for another matter wound up recommending the Estate Planning and Asset Protection Law Center of Dennis Sullivan & Associates. I like the fact that they provide you with useful information, and quick answers. They treat you with dignity and respect. I highly recommend you go see them.

  • Matt DePalo, CPA., Natick

    The experience has been excellent. I am extremely satisfied with the Lifetime Protection Program.

  • I.C., Framingham

    The team at Dennis Sullivan & Associates is very helpful and knowledgeable. Everyone is pleasant and easy to do business with. I don't feel uncomfortable coming in. I interviewed four other attorneys...I'd rather come to you.

  • E.L., Lynn

    Thank you, Dennis, for your expert and caring assistance you have shown to me and my family. It was a trying and confusing process that needed a pro to guide us.

  • C.&J. K., Hopedale

    Thank you for all your hard work and dedication. We appreciate the promptness with which you handled our difficult situation.

  • B.S., Wayland

    We have told friends of our experience with Dennis Sullivan & Associates. We feel it has been very positive and beneficial.

  • Andy St. James, Holliston

    Dennis provided strong direction and guidance in developing and implementing a lifetime protection plan.

  • D.M. Framingham, MA

    We were very comfortable working with you and thank you for your patience in educating us about a process which frankly was quite foreign to us. We are pleased with the outcome and are pleased to recommend you to friends.

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