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Legalease
Legalease, Lawyer
Category: Legal
Satisfied Customers: 16298
Experience:  15 years exp all aspects of general law
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I am currently on MassHealth insurance on August 1 2015 I will

Customer Question

I am currently on MassHealth insurance on August 1 2015 I will be receiving Medicare because I receive SSDI and I am under 65. I have some stock and an annuity. The paperwork received I can only have $7000.00. How do I handle the this problem
Submitted: 1 year ago.
Category: Legal
Expert:  Legalease replied 1 year ago.
Hello there --
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I also live and practice in Massachusetts and have an older sister who lives with me who is in the same situation as you are in. She received MassHealth insurance until she was approved for SSD and then after two years of receiving the SSD payments you are required pursuant to federal and MA law to take the Medicare offered by the federal government with your SSD benefits. Unfortunately, the Medicare insurance pays just 80 percent of each claim or appointment or test and you are responsible for the payment of the remaining amount unless you have what is called "supplemental insurance" which will pick up the remaining 20% of the medical bills.
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MassHealth can be used as a supplemental insurance only if you meet their low income guidelines and if you do not meet those guidelines then you will be directed to purchase private supplemental insurance through a company like AARP or Unum insurance. The premium for such supplemental insurance is approximately $150 to $200 per month (with prescription coverage) which is paid directly to the insurance company each month by you. In the event that your income is more than about $1350 per month then you will most likely not qualify for MassHealth to pay for the supplemental portion of the medical bill payments (the 20% that Medicare will not pay) and it will not matter that you have the stocks and annuities anyway.
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However, there is not way around actually reporting these items to MassHealth unless you can transfer them into the name of someone else that you trust so that you are no longer the owner or holder of the assets. And you would have to leave the stocks and annuities in the name of the other person on a going forward basis if you want to continue to receive the MassHealth payments because they are getting very, very strict in this regard and they will not hesitate to pursue you if your income or assets exceeds the amounts that are permissible under MA statutes.
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I know that your thought is that perhaps there is some type of trust that you can transfer these assets to in order to continue to receive the MassHealth benefits -- but what you are thinking of is the Medicare rules for the elderly when they are permitted to put certain assets in trust to continue to receive Medicare benefits through the end of their lives and/or in a nursing home setting. There are no such provisions in MA law that permit you to create a trust or any other instrument to hold these items so that you can continue to receive the MAsshealth benefits as a supplementary insurance to the Medicare.
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I wish I could give you better news on this but I do deal with it all the time for my 58 year old disabled sister who lives with me. She did not qualify for the MassHealth supplement to pay for the 20% because the amount she received each month in SSD and a small long term disability payment was considered to be too high for a single person (and there were no other assets in her case). She now purchases supplemental insurance each month through AARP for $135 per month (you can review the AARP plans by going to their website). Every year we continue to check in with MassHealth for her in case the income guidelines to receive the cost free supplemental care through MAssHealth change.
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Please let me know if you have further questions. I truly wish I could have given you better news on this question but if nothing exists to take care of the matter, then there is not much you can do about it. And the Community Legal Services could have told you all of this -- they most likely did not want to be the one to give you the disappointing news. If you have no further questions, I would ask that you do not shoot the messenger and that you press a positive rating in the ratings section below so that I will be paid for my time assisting you today. I truly am Paid NOTHING unless you press a positive rating below (we do not receive paychecks and are only paid for the answer when you press a positive rating (the middle smile or star or the third or fourth smile or star below). Pressing a positive rating will not cost you any additional money -- it simply acts as the trigger to Just Answer to pay me for my time today.
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I have to step away for a doctor appointment myself for about 2 hours but can pick up any follow up questions that you may have when I return to the website later this afternoon.
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THANK YOU VERY MUCH
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MARY
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Expert:  Legalease replied 1 year ago.
Hello there --
-
I also live and practice in Massachusetts and have an older sister who lives with me who is in the same situation as you are in. She received MassHealth insurance until she was approved for SSD and then after two years of receiving the SSD payments you are required pursuant to federal and MA law to take the Medicare offered by the federal government with your SSD benefits. Unfortunately, the Medicare insurance pays just 80 percent of each claim or appointment or test and you are responsible for the payment of the remaining amount unless you have what is called "supplemental insurance" which will pick up the remaining 20% of the medical bills.
-
MassHealth can be used as a supplemental insurance only if you meet their low income guidelines and if you do not meet those guidelines then you will be directed to purchase private supplemental insurance through a company like AARP or Unum insurance. The premium for such supplemental insurance is approximately $150 to $200 per month (with prescription coverage) which is paid directly to the insurance company each month by you. In the event that your income is more than about $1350 per month then you will most likely not qualify for MassHealth to pay for the supplemental portion of the medical bill payments (the 20% that Medicare will not pay) and it will not matter that you have the stocks and annuities anyway.
-
However, there is not way around actually reporting these items to MassHealth unless you can transfer them into the name of someone else that you trust so that you are no longer the owner or holder of the assets. And you would have to leave the stocks and annuities in the name of the other person on a going forward basis if you want to continue to receive the MassHealth payments because they are getting very, very strict in this regard and they will not hesitate to pursue you if your income or assets exceeds the amounts that are permissible under MA statutes.
-
I know that your thought is that perhaps there is some type of trust that you can transfer these assets to in order to continue to receive the MassHealth benefits -- but what you are thinking of is the Medicare rules for the elderly when they are permitted to put certain assets in trust to continue to receive Medicare benefits through the end of their lives and/or in a nursing home setting. There are no such provisions in MA law that permit you to create a trust or any other instrument to hold these items so that you can continue to receive the MAsshealth benefits as a supplementary insurance to the Medicare.
-
I wish I could give you better news on this but I do deal with it all the time for my 58 year old disabled sister who lives with me. She did not qualify for the MassHealth supplement to pay for the 20% because the amount she received each month in SSD and a small long term disability payment was considered to be too high for a single person (and there were no other assets in her case). She now purchases supplemental insurance each month through AARP for $135 per month (you can review the AARP plans by going to their website). Every year we continue to check in with MassHealth for her in case the income guidelines to receive the cost free supplemental care through MAssHealth change.
-
Please let me know if you have further questions. I truly wish I could have given you better news on this question but if nothing exists to take care of the matter, then there is not much you can do about it. And the Community Legal Services could have told you all of this -- they most likely did not want to be the one to give you the disappointing news. If you have no further questions, I would ask that you do not shoot the messenger and that you press a positive rating in the ratings section below so that I will be paid for my time assisting you today. I truly am Paid NOTHING unless you press a positive rating below (we do not receive paychecks and are only paid for the answer when you press a positive rating (the middle smile or star or the third or fourth smile or star below). Pressing a positive rating will not cost you any additional money -- it simply acts as the trigger to Just Answer to pay me for my time today.
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THANK YOU VERY MUCH
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MARY

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