Complex MassHealth Application


A mother created an irrevocable trust with the purpose of 5-year lookback/MassHealth planning.  Unfortunately, her health took a turn a year after the trust was created and she went into a nursing home.  By the time the son came to us for a MassHealth long-term care application, she had been private paying the nursing home for 2 years, and her assets, which included an inheritance from a recently deceased sibling, were quickly dwindling.  We quickly, but carefully, crafted a spenddown plan whereby the son and the other beneficiaries would unwind the irrevocable trust and create a single premium immediate annuity (SPIA) to generate an income stream for mom and stretch out the availability of her assets.

The mom also owned a home, which is a countable asset for purposes of MassHealth.  While we worked on unwinding the trust, the real estate branch of our firm sold the house for an amount above market value.  We placed the sale proceeds in a SPIA and pooled trust and mom was deemed eligible for long-term care coverage within a reasonable timeframe.  Our years of experience in the complicated MassHealth regulations related to spending down, together with meticulous planning and family cooperation, provided mom with MassHealth long-term care coverage and an opportunity to stop the flow of a lifetime of savings from being quickly depleted by private pay nursing home expenses.

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