You may have to make a monthly payment to the long-term-care facility. This is called your patient-paid amount. (Your spouse living at home does not have to pay toward the cost of your care.) Your patient-paid amount is determined using the following income deductions:
  • personal needs allowance;
  • spousal maintenance needs allowance;
  • family maintenance needs allowance;
  • home maintenance allowance; and
  • medical expense allowance.

Asset rules

MassHealth looks at the current value of any assets owned by you and your spouse and compares them to the limits in the Assets Rules section under "Amount you and your spouse can keep" (see below).

Countable assets include the value of bank accounts, certificates of deposit, mutual funds, stocks and bonds, as well as the value of real property other than your home. You may be required to name the Commonwealth of Massachusetts as a remainder beneficiary of an annuity purchased on or after February 8, 2006.

Noncountable assets include the home if you live in it and it is located in Massachusetts, one vehicle per household, and an irrevocable burial trust or prepaid burial contract set up in reasonable amount for future payment of funeral and burial expenses.

Amount you and your spouse can keep

You may keep $2,000.

Your spouse at home may keep up to a certain amount, which changes every January. This amount may also be increased as a result of an appeal. (See the MassHealth regulations at 130 CMR 520.016.) MassHealth must follow special rules when determining how much the spouse at home may keep.

Note: Your spouse at home has the right to ask for a fair hearing to determine if he or she can keep more of your combined assets.

How we count the home as an asset

If you move out of your home to live in a medical institution, MassHealth decides if your former home is a countable asset because it is no longer your principal residence.

Your home is not countable if you have moved into a medical institution and:

  • your spouse lives in your home or certain other relatives who meet specific rules live in your home;
  • you intend to return home; or
  • you have long-term-care insurance that meets certain rules.

Note: If you applied for benefits on or after January 1, 2006 and the equity interest in your principal place of residence is over $750,000, you may be ineligible for payment of long-term-care services.

Transfers of income and assets

If either you or your spouse gave away or transferred assets or income for less than what they were worth, MassHealth may not be able to pay for your nursing-facility services (or for services equal to those provide in a nursing facility) for a certain period of time.

If you got MassHealth and you transferred property for less than what is was worth, MassHealth may take legal action to set aside the transfer. (This means that a court may decide that you still legally own the property.)

Liens on property, including the home

MassHealth will place a real estate lien on any property in which you have a legal interest, unless the property is your former home and certain persons are living in the property.

A lien is placed only after MassHealth decides that it is not likely that you will return home from the long-term-care facility, and sends a notice that it intends to place a lien. If you are discharged from the facility and return home, MassHealth will remove its lien. If you sell the property during your lifetime, MassHealth has the right to get back from your share of the proceeds any money it paid for all services you got from MassHealth on or after April 1, 1995. We will count any remaining proceeds when deciding if you can still get MassHealth.

In certain cases, MassHealth may decide not to use its lien during a person's lifetime to get paid back for long-term-care services.


This information is provided by MassHealth.