Ben had been in an assisted living facility for several years and doing well there. His family felt fortunate. Although Ben didn’t have much in the way of assets he did have income from Social Security and a pension, totaling $5,000. He also had a long-term care insurance policy that was paying $2,500 a month. His daughter, Caroline, called me, however, because now Dad needed nursing home care. She figured she needed to apply for MassHealth. That’s when I explained to her that Ben couldn’t get MassHealth, even if he has not even a dollar to his name.
Caroline corrected me. “Dad only has $500 in the bank. His income doesn’t count towards the $2000 asset limit”, she said. That’s true but the assets aren’t Ben’s problem. He has too much income. You see, if his income exceeds the MassHealth reimbursement rate, that rate which MassHealth pays the nursing home for its’ MassHealth residents, then he won’t qualify. (Actually, MassHealth requires the resident to give his income to the nursing facility and then it will pay the difference up to the reimbursement rate.) And the long-term care insurance, which will pay out for another 3 years, counts towards income.
“But, the nursing home we looked at said their private pay rate is $11,000 per month”, Caroline told me. “He only has $8,500. What are we going to do?” I asked her if Ben was a veteran. He was, of World War II. There is a wonderful program available to wartime veterans and their surviving spouses, which can provide additional income in the form of a pension.
I told Caroline that Ben could obtain a pension of $1,700 per month. That would bring his income up to $10,200 per month, close to the $11,000 she was quoted. We could either negotiate with that facility or find another one that would accept her dad’s income on a private pay basis. That would get her through 3 years, until the insurance policy is tapped out. And what then? Ben’s income would most likely be below the MassHealth reimbursement rate at that point and we could then qualify him for MassHealth.
I could hear the relief in Caroline’s voice. “This is all so complicated. I am so lucky I found you. I could never have figured this all out myself. ” I understood completely. It’s so difficult to navigate through the long-term care system without a knowledgeable guide.
For more information on how Veteran’s Benefits can help you or your loved one please visit www.WartimeVeteran.com/sullivan. We also invite you to attend one of our FREE educational workshops. You can register by CLICKING HERE or by calling (800) 964-4295 (24/7). Discover how if you or a member of your family is an honorably discharged veteran who served at least one day during a period of wartime, you may qualify for Benefits under the VA Aid and Attendance Pension Program.