MassHealth and the Home of a Single Person: Does the House “count” if you go in a nursing home? Can you still give the house away? Is there a Death lien?  Recall in an earlier blog Attorney Thomas Mullen discussed why the home is safe if you are married and one spouse enters a nursing home. But what if a single person enters a nursing home?

The Medicaid regulations for MassHealth and the single person (a widow is a single person) discuss the home as being a countable or non-countable asset. Even if it is a non-countable asset there will still be a living lien and even if there is no living lien, there may be a death lien (estate recovery).  We’re going to discuss each of these three issues in three separate blogs. In this blog we’ll see if the home of a single person will make them ineligible for MassHealth if they enter a nursing home. Said another way is the home of a single person a countable asset?

Please see an experienced elder law attorney like Attorney Tom Mullen if this applies to your loved one.  A countable asset is simply something of value that is included when determining MassHealth eligibility. Just because it doesn’t “count,” however, will not be enough.  The State will either place a lien on it hoping you will sell it–then you will have money which takes you off MassHealth–or they’ll simply wait until you die and place a death lien on it (estate recovery). Each of these two lien scenarios will be discussed in future blogs.

Therefore if you are single and move from your own home to a nursing home you will still be able to obtain Medicaid benefits if one of the following persons lives in the home:

1) A child under age 21. The word is “child,” not a niece, grandchild or stepchild.

2) A legally blind child of any age–can be 60 years old with macular degeneration.

3) A permanently and totally disabled child of any age–perhaps one of our Wounded Warriors.

4) A brother or sister (of the person in the nursing home) who has lived in the home for at least one year immediately prior to the elder’s admission to the nursing home and is a part owner.

5) This one is hard to establish: a child of any age who was living in the home for two years or more immediately before the elder’s admission to the nursing home; and who can prove to MassHealth they cared for their parent sufficiently to keep her out of the nursing home for those two years.

6) A dependent relative. While this can be any relative you have to have listed them as a dependent on your tax return. This one is so rare I’ve never run across it and I’ve been doing  this since 1988!

The next two are extremely technical (as if the ones above were not!   The MassHealth application has a seemingly simple question buried deep in the application: “Does the applicant intend  (italics added) to return home?”  There are two boxes–you check one, “yes” or “no.” At first blush this looks like a simple question:

7) If you check off “no,” you are approved for MassHealth; they place a lien on your property and give you nine months to sell it. The thinking goes: if you only own the house, you can’t cut it into monthly payments to pay the nursing home  bill. So, Medicaid approves you but they place a lien on the house and make you sell it.  Now, here’s the crazy  part. If you check off “yes” you intend (italics added) to return to your home even if it’s really unrealistic you still get approved for  Medicaid; they place a lien on your home but you don’t have to sell it! Sure, they’ll collect on their lien when the family sells the house after the elder’s death, but, as we will see in a later  blog, the lien rate is far less than the private rate at the nursing home.

8) Long Term Care insurance–buy it! If you have long term care insurance you will be approved for Medicaid (assuming you have the right amount of insurance), but–ready for weird?–only if you check off the box “no”, you do not intend to return to your home.

In conclusion we now see that even if you are single, an experienced elderlaw attorney like  Tom Mullen Quincy Attorney may be able to help you obtain MassHealth benefits even if the person seeking those benefits is a single person who owns a home.

In our next discussion on this subject we’ll see if you can transfer this house out of the Elder’s name as you apply for MassHealth.


Thomas R. Mullen
Thomas R. Mullen has been an attorney since 1977 and has devoted his practice exclusively to elderlaw since 1988. He is nationally recognized as one of the foremost experts on Medicaid planning. His additional Practice areas include estate planning and trusts for disabled people, as well as assisting attorneys with Medicaid lien allocations and the Medicare Secondary Payer Act. In the Spring 2013 issue of the National Academy of Elder Law Attorneys (NAELA) Journal, Attorney Thomas R. Mullen of Quincy, Mass. was described by the Academy’s Massachusetts past president and law professor William J.Brisk as being “a prominent and innovative elderlaw attorney.”