I often hear from family members that the social worker at the nursing home facility or a family member themselves have offered to handle the MassHealth application process. This generally is not a good idea. MassHealth has a maze of complex rules and regulations that are almost impossible to understand and navigate –even for attorneys, unless they specialize in this field.
Many people are reluctant to consult attorneys with respect to eligibility for Masshealth benefits because of the cost. Yes, nursing homes and hospital discharge planners often provide application assistance at no charge or reduced fees. In some instances, there may be no risk in using these services but you should consult with an Elder Law attorney ahead of time.
The nursing home has a vested interest in keeping someone on “private pay” as long as possible since their private-pay rates are significantly higher per month than they receive in MassHealth reimbursement. It is not in their best interest to move someone to MassHealth. Every month that a resident pays privately rather than receives MassHealth coverage is additional money going to the nursing home and less preserved for the applicant’s spouse and/or family.
Even if these individuals have the best of intentions, the MassHealth process is often a daunting task. Most of the time, these individuals are not well-versed or educated in the specific eligibility requirements and advantageous planning opportunities available under MassHealth. Incomplete or improper advice, an untimely filing of a MassHealth application or payment of an impermissible expenditure can cause significant delay and often times severe penalties. Also, these individuals do not have the knowledge, skills or ability, much less a law license required to draft trusts, devise appropriate estate plans and stand by to advocate for you (in court if necessary) should the need arise.
If mistakes are made due to unfamiliarity with government regulations you may compromise or lose your ability to qualify for benefits. Rectifying the situation, if possible, may cost more in legal fees than would have been the case with a properly executed plan. By hiring an elder law attorney to assist with the MassHealth application process, you will ensure that there are no lost opportunities in last minute planning strategies and obtain the overall best outcome for you, your spouse or your family member.
The bottom line is that the cost for legal services is an investment since Elder Law attorneys can save clients and their family members more than the amount of the legal fees. It’s your savings, your spouse’s support and your children’s inheritance that may be jeopardized without the help of an Elder Law attorney.
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