In order to understand what options are available to your loved one, our process begins with a detailed and thorough assessment of your loved one’s current legal and financial circumstances. Through a detailed analysis of his or her income, assets, current legal documents, and recent financial activity we will determine what options may be available in helping cover the cost of care. During our Assessment consultation we’ll discuss family goals and concerns and review the dangers, opportunities and strengths that exist as we move forward.

After the completion of our Assessment consultation, our attorneys will analyze the information you provided and determine which options are available to assist you with the cost of care and prepare an extensive summary letter of our findings for you. We will then meet and discuss each one and together develop a plan that is best for you, given your loved one’s financial situation and family goals and concerns.

Based upon the solution we both determine is appropriate for your family, the next step is to work together to implement the plan. To the extent that any assistance is needed with a facility, care provider or insurance company, we help you coordinate everything with them. If the plan includes obtaining eligibility for government benefits (i.e. MassHealth), we will take the lead in directing each step in gaining that eligibility as quickly as possible.

In many cases, an application for Long-Term Care MassHealth is a critical part of the solution. Our office will handle this complex and challenging process for you. It starts with the preparation and filing of the application. We will handle all correspondence with the MassHealth caseworker and will monitor your case, keeping you informed of the status throughout each step of the process.

Working through the MassHealth application process is complicated and time-consuming. No matter how well-organized and thorough an application is when first submitted, there are always roadblocks to work through before an approval is obtained. In working with MassHealth and its caseworkers, it is very common for caseworkers to make further inquiries into the financial circumstances of the applicant. This process can be as basic as a request for additional documents or can involve more extensive inquiries where a caseworker will deny an application. We work through and address these roadblocks. If a denial letter is issued by MassHealth, we will review and analyze the letter and evaluate how to proceed. Often times a denial is issued by a caseworker, but can be easily rectified. However, if the denial is the result of a more significant issue, an appeal may need to be filed.

At this stage in our process we have pushed through the application and have received our answer from MassHealth. We will review the approval letter issued by MassHealth, double check any income-based calculations for accuracy and then review the approval letter with you. In the case of a loved one in a nursing home, we will make sure that the nursing home receives the letter and that they understand any monthly patient paid contributions to be paid by the resident.

Getting the MassHealth approval letter is never the final step. There are often adjustments to asset ownership that need to take place after the approval is received and logistics surrounding patient paid amounts for nursing home residents. We also need to review how to keep assets and income structured properly to ensure continuing access to MassHealth benefits each year. In addition, at this point it is critical that we update estate planning documents, especially in situations where there is a spouse living at home.