How to Qualify for MassHealth in Worcester, Massachusetts

Whether you’re planning ahead for yourself or helping a loved one prepare, the cost of long-term care in Massachusetts can raise serious concerns. Nursing homes, assisted living, and even in-home care can quickly drain savings built over a lifetime. Without a clear plan, you risk losing control over the decisions that matter most.

MassHealth, Massachusetts’ Medicaid program, can help cover long-term care costs, but only if you meet strict income and asset limits. While MassHealth covers a wide range of medical services, the rules for long-term care are more complex and the consequences of mistakes more costly.

At The Law Office of Polly Tatum, we focus on helping families protect what they’ve built while planning for future care needs. Here’s what you need to know about how to qualify for MassHealth and why early planning makes a difference.

What Does MassHealth Cover?

When we talk about qualifying for MassHealth, it’s important to clarify what you’re actually qualifying for. MassHealth offers many types of benefits, but long-term care is where most families face high costs and the most complicated rules.

Depending on your needs and situation, MassHealth may provide:

• In-home care through Home and Community-Based Services (HCBS) or the Personal Care Attendant (PCA) program
• Partial assistance with assisted living services under Group Adult Foster Care (GAFC)
• Full coverage for nursing home care if both financial and clinical requirements are met

Each of these programs has different rules and application processes. The rest of this blog focuses on how to qualify for long-term care coverage, since that’s where planning mistakes tend to have the biggest impact.

Who Can Apply?

Before the state reviews your finances or your care needs, you must meet basic non-financial requirements. To apply for long-term care through MassHealth, you must be:

• a Massachusetts resident
• a U.S. citizen or qualified non-citizen
• age 65 or older or require long-term care due to a medical condition

Once these initial requirements are met, the financial review begins, and that’s where many families run into problems.

Income and Asset Limits for 2025

To qualify for long-term care coverage under MassHealth, you must fall within the program’s income and asset limits. These thresholds change annually and are different depending on whether you’re applying as a single person or part of a married couple.

As of July 2025, to qualify for MassHealth long-term care:

• Monthly income must be $2,901 or less. If your income is higher, a Qualified Income Trust (QIT) can be used to deposit the excess.
• Countable assets must be below $2,000 for a single applicant.

Certain assets are not counted, including:

• One vehicle
• Personal belongings
• An irrevocable prepaid funeral plan
• Your primary residence, if you intend to return or if a spouse, minor, or disabled child lives there (home equity must be under $1,097,000 in 2025 if none of those apply)

For married couples:

• The Community Spouse Resource Allowance (CSRA) is up to $157,920
• The Minimum Monthly Maintenance Needs Allowance (MMMNA) (effective 7/1/25 – 6/30/26) is $2,643.75
• The community spouse’s income is not counted toward the applicant’s eligibility

These limits are adjusted annually.

Why Advance Planning Matters

Even if your income or assets meet the current limits, you could still be disqualified if you transferred assets in the last five years. That’s because MassHealth has a five-year look-back period. Any gifts or transfers made for less than fair market value can result in a penalty period during which MassHealth will not pay for your care.

This is where strategic planning comes in. With the right legal guidance, you may be able to:

• Transfer or shelter assets appropriately
• Use irrevocable trusts to protect your home or savings
• Structure care contracts or annuities to preserve eligibility

These steps require careful timing and documentation. A Medicaid Planning lawyer can help you avoid costly errors that could delay your eligibility or result in unnecessary loss of assets.

Medicaid Planning That Protects What You’ve Built

Qualifying for MassHealth is about more than just numbers. It’s about protecting your home, your spouse, and your future care options. That’s why we don’t just focus on eligibility. At The Law Office of Polly Tatum, we create custom strategies that reflect your family’s goals and financial reality.

With a well-crafted plan, you can:

• Avoid draining your savings to pay for nursing home care
• Keep your spouse from being left without resources
• Decide how and where you want to receive care
• Address immediate needs or prepare for what’s ahead
• Minimize the impact of estate recovery after death

Whether you’re planning years ahead or responding to a sudden health crisis, we help you take the right next step without guesswork or surprises.

The Medicaid Application Process

Once you have a strategy in place, the next step is applying correctly and providing the right documentation.

Here’s what the process typically involves:

• Completing the SACA-2 form (Senior Application for Health Coverage and Assistance)
• Providing five years of financial records, including bank accounts, retirement assets, real estate, and any large transfers
• Submitting supplemental forms based on the type of care you need

Applications are reviewed by the MassHealth Enrollment Center, and it can take 45 to 90 days to receive a decision. You can apply online, by mail, or in person.

If you’re approved, coverage may be retroactive for up to three months, as long as you met the eligibility rules during that time. Some programs, such as HCBS, may also require a home visit or interview.

Don’t Wait Until Long-Term Care Becomes a Crisis

The choices you make today will determine what you’re able to protect tomorrow—your savings, your home, and your ability to decide how and where you receive care. At The Law Office of Polly Tatum, we help Worcester families qualify for MassHealth without draining everything they’ve worked for.

With over 24 years of experience, Attorney Polly Tatum brings the knowledge, compassion, and clarity you need to move forward with confidence. You’ll get clear answers, a customized legal strategy, and fixed pricing, whether you’re planning ahead or dealing with an urgent care situation.

Your online search for a “Medicaid Planning attorney” or “Medicaid lawyers near me” brought you here, and you’re in the right place. Call (508) 795-1557(508) 795-1557 or fill out our confidential online form to schedule your Strategy Session. Virtual and in-person appointments are available.

Looking for additional guidance before you commit to a plan? Visit our events page to see upcoming workshops and webinars hosted by Attorney Polly Tatum.

At the Law Office of Polly Tatum, we’ll help you PROTECT WHAT MATTERS MOST!

Copyright © 2025. The Law Office of Polly Tatum. All rights reserved.

The information in this blog post (“post”) is provided for general informational purposes only and may not reflect the current law in your jurisdiction. No information in this post should be construed as legal advice from the individual author or the law firm, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting based on any information included in or accessible through this post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country, or other appropriate licensing jurisdiction.

The Law Office of Polly Tatum
19 Cedar Street
Worcester, MA 01609
(508) 795-1557(508) 795-1557
https://www.lawofficeofpollytatum.com/