Health Community Based Services - Understanding The Qualifications And Requirements Of The Many Available Options

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The national public health insurance coverage for individuals age 65 and over is called Medicaid. Massachusetts has its own public health insurance coverage for residents in the Commonwealth called MassHealth. This program provides many community based services, and it is designed for low to middle income individuals.

Through it, people who meet certain financial and medical eligibility requirements may receive benefits including basic health insurance, prescription drug coverage, hospitalization, ambulance service, and personal care assistance at home. MassHealth also provides the elderly with alternatives to funding their medical care. Four of the major ones are explained below.

1) MassHealth Standard

MassHealth Standard is a program that allows certain individuals the ability to gain access to medial care from doctors, hospitals and pharmacies and certain medical providers who accept MassHealth Payments. It is offered to several categories of individuals including individuals over the age of 65.

MassHealth Standard has financial requirements in order to qualify for the coverage. An individual age 65+, may not have countable assets in excess of $2,000, and a married couple may not have more than $3,000. In determining eligibility, essentially all assets are counted except those that are exempted by law or that are "inaccessible" to the individual. Such examples include assets that have been held for over sixty (60) months in (1) an allowable irrevocable trust; (2) an annuity that has been annuitized, or (3) a brokerage account titled with another as joint tenants with rights of survivorship, such that both owners’ signatures would be required to access the asset. In addition, monthly income limits based on percentages of the Federal Poverty Guidelines are required for eligibility. An individual’s monthly income may not exceed 100% of the Federal Poverty Guidelines. In 2005, this is $776 for individuals and $1,041 married couples. If individuals over age 65 do not meet the eligibility requirements of MassHealth Standard, they may become eligible by reducing their assets or meeting a deductible.

MassHealth Standard provides the following benefits for eligible applicants: inpatient and outpatient hospital services, doctor and clinic visits, pharmacy services, hearing aids, medical equipment and supplies, x-rays and laboratory work, adult foster care, long-term adult day health care in a medical facility (nursing home, hospital, etc.) and transportation services. In addition, if a person is eligible for MassHealth Standard and Medicare Part A and/or B, MassHealth will pay their Medicare premiums, co-payments and deductibles.

2) MassHealth Limited ...

You may read more at the link below.

by: Brett A. Kaufman, Esq.

Healthcare News
July 2005

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