Disability Dilemma

People assume that it's easy to apply for MassHealth, just show you are broke and you get approved. It is NOT that simple. We are all people who have lived our lives as people. People who have families, jobs, responsibilities. No one thinks they are going to end their days in a Nursing Home.

MassHealth likes to believe everyone knows they are eventually entering a nursing home and they should save every penny to pay for their own care. That makes sense, but what if you have disabled children (child does not mean under 18, but child of the person entering nursing home) you have been financially supporting your whole life? What will they do when your assets have been depleted and all your income is going towards your care? Maybe you have a spouse who is still healthy and living within the community. Maybe you had a friend, child, family member who sacrificed their time, energy and life to help care for you and keep your dream alive of never entering a nursing home. People have gray in their lives.

If you have lived your life with any gray in it please contact us. We study the regulations and understand them. Below is an example of a family, who did everything right per regulation and was still put through the ringer to get approved.

Per MassHealth regulations you can transfer assets to a disabled child free and clear of any penalties. You must prove their disability and prove they are your child. Typically, if a person is under 65 and on Medicare they have already been deemed disabled. I had a situation where the child was deemed disabled through the VA only, as they were already over 65 and receiving Medicare.

MassHealth made the determination that the individual can only be deemed disabled by Social Security or MassHealth. The MassHealth's definition of disabled is "having a permanent and total disability." The VA is a federal government whom had deemed this individual as permanently and totally disabled due to their time in the war.

They were over 65, therefore, Social Security would not deem them disabled. They lived in another state which meant we could not apply for disability through the MassHealth disability unit.

We had to go to an appeal to explain why this individual should be viewed as a disabled child. We won and protected the coverage of our client. We had submitted all the appropriate documents on this case within 45 days of our request date October 2017. It took us 24 months October 2019 before we got our approval from MassHealth.