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MassHealth Eligibility for Adult Day Health Participants

Adult Day Health programs are a lesser known alternative to providing care to an aging or disabled family member. These programs offer a win/win situation for everyone in the family-from the client or member who attends the program to the family member who has primary responsibility as caregiver. Adult day Health programs afford the participant the opportunity for socialization, companionship, daily activities, exercise, nutrition, emotional support, nursing, and personal care, in addition to so much more. It also permits much-needed respite for the caregiver, providing a break from the physical, psychological and emotional demands of providing care at home.

Nationwide, the average cost to attend an adult day health center is approximately $65.00 per day. This of course depends on the level of care provided, as well as other factors such as meals, transportation and additional needs of each particular participant. In Massachusetts, however, Medicaid or MassHealth provides a unique opportunity to its members for participating in an adult day health program. As most people know, in order to shelter assets from the cost of the long-term care, a five (5) year look back period applies; meaning that someone would need to transfer assets out of his or her name more than five (5) years prior to needing care in a skilled nursing facility. By comparison, financial eligibility for a Community MassHealth program, such as an adult day health center, does not encompass a five (5) year look back period. This means that an individual could essentially be eligible overnight after making the requisite transfers. In order to be financially eligible for a Community MassHealth program, such as participation in an adult day health program, a MassHealth member is allowed to retain $2,000.00 or less in countable assets (principal residence and one motor vehicle are considered non-countable assets). This allows a great opportunity for individuals to receive the care that they need in the community, as well as attempt to shelter and transfer to future generations assets which they have accumulated over the course of their lives.

For more information on adult day health programs, please visit my website (www.daviaulaw.com), e-mail me ([email protected]), or call my office (508-797-3010). Also, visit my estate planning blog at http://worcesterestateplanning.blogspot.com/.

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