Currently, there are three identical bills pending in the Massachusetts legislature on nursing facility and long term care. These bills are as follows: House Bill No. 1069 (HB 1069) which has been presented by Christopher G. Fallon on the petition of 19 house members; Senate Bill No. 309 which has been presented by Harriette L. Chandler on her own petition; and Senate Bill No. 572 which has been presented by Robert A. O'Leary on the petition of 6 senate members.
The law as it exists currently in the Commonwealth of Massachusetts states you must have two (2) years of long term care insurance coverage on your policy when you enter a Nursing Home. In essence, under the current law, if an individual’s long term care insurance policy provided home care benefits, and those benefits were accessed, it could be that the exemption currently provided in the Code of Massachusetts Regulations from Estate Recovery for receipt of MassHealth could be jeopardized. Let me give you an example: Let us assume Sally had 3 years coverage under a long term care insurance policy. Let us further assume that policy not only provided benefits in the event Sally were to go into a nursing home, but also provided benefits to Sally in the event she needed home care services so she was able to remain in her home. Under the current scheme, if Sally accessed her long term care insurance for home care and she had less than two (2) years of coverage at $125.00 a day at the time she entered a nursing home, she would lose the exemption against Estate Recovery as currently provided by regulation.
The currently proposed revisions to the Massachusetts law state that you need two (2) years of coverage at $125.00 a day when you purchase your long term care insurance, and not at the time you enter a Nursing Home. This bill would allow a policyholder to protect their home from the Medicaid lien as long as they buy $125/day for 2 years, even if they use up all of their policy coverage at home before entering the Nursing Home and qualifying for Medicaid.
House Bill No. 1069 (HB 1069) which has been presented by Christopher G. Fallon and Senate Bill No. 572 which has been presented by Robert A. O'Leary are in the Health Care Financing Committee. Senate Bill No. 309 which has been presented by Harriette L. Chandler is in the Elder Affairs Committee.
Hopefully the Massachusetts legislature will see the wisdom that it is far more cost effective to provide care at home (rather than in a long term care facility) and will stop penalizing Massachusetts citizens who try to stay in their homes for as long as possible by accessing their long term care insurance coverage. SUPPORT THESE BILLS!
Attorney Kaltsas practices law at Elder & Disability Law Advocates in Worcester and Framingham, Massachusetts
and hosts WTAG’s Saturday morning talk show ”The Senior Focus” at 11:00 AM.
”The Senior Focus” can be heard on True Talk Radio -- 580 AM or 94.9 FM
Please feel free to call Attorney Kaltsas in Worcester at 508-755-6525 or Framingham at 508-620-4525.
Or listen to The Senior Focus and call your comments or questions into the show at 508-755-0058.
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