What do you know about MassHealth, and why should you care? Lincoln residents of all ages are invited to a special program at Bemis Hall on Monday, April 29 at 7 p.m. to learn more about MassHealth (Massachusetts’ Medicaid program). You might not think you need the information, but that could change if you have an unforeseen financial crisis or need to be in a nursing home for an extended period.
The Lincoln Council in Aging program will feature Don Milan, Elizabeth Killeen and Arthur Budnik, all of Minuteman Senior Services’ SHINE health benefits counseling program, explaining what MassHealth currently covers, who’s eligible, how it coordinates with Medicare, and more. Carolyn Bottum, director of the COA, interviewed Milan, who is Lincoln’s SHINE counselor.
Q: Should Lincoln residents have MassHealth on their radar screen?
Many people perceive Lincoln as having only residents with relatively high incomes. This, in fact, is not the case. There are Lincolnites, young and old, who are economically struggling and need assistance in various forms, and who are or possibly could be enrolled in various MassHealth programs that could greatly benefit them.
In addition, many people who go into a nursing home for a period longer than a couple of years end up on MassHealth to pay the average $120,000 a year that nursing home care costs in Massachusetts. It’s good to know about what your options are before a crisis occurs and how to apply for MassHealth should that time come.
Q: Should younger people as well as seniors come?
The short answer is an emphatic yes. Much of what will be discussed will pertain to younger people as well as older people. Also, anyone who is a family member or caregiver of someone who may need to enter a nursing home will benefit from having this information.
Q: Most people think of MassHealth as being a way only for people with low incomes to get either health insurance or to pay for nursing home care . Why should a resident who doesn’t think he or she will ever be income eligible or will need MassHealth come to the program?
News sources have consistently reported that increasingly large numbers of people are struggling to make ends meet. Such as: older people on fixed incomes; people in their late 50’s or older who are laid off and can’t find reemployment; adults under age 65 classified as “disabled”; children of older parents becoming involved in handling health-care related circumstances, and others. These situations with their resulting financial consequences might be helped by various MassHealth programs affording varying assistance levels depending on income and asset levels. There are various degrees of assistance depending upon income, assets and employability.
Q: Have you been doing more counseling with younger people regarding MassHealth assistance recently?
SHINE counselors in all towns have had more younger people inquiring about eligibility for MassHealth as well as other assistance and Lincoln is no different.
Q: Who determines whether a person is eligible to receive MassHealth benefits?
It’s important to understand that SHINE counselors do not determine the eligibility of a person to receive MassHealth benefits. Only MassHealth makes that determination. The only way to initiate the process of getting a determination is by filing an application to MassHealth.
SHINE counselors are trained to do an initial rough screening for eligibility and assist in the application, but only by applying does an individual get an official determination. And I should note, that in some cases, because of particular circumstances, MassHealth finds ways to assist via one program or another, or suggests steps to take to become eligible.
Q: What are some of the common concerns or questions from Lincoln residents that you’ve been hearing where MassHealth might be of help?
MassHealth has programs that may benefit younger as well as older people who:
- are involved with care-giving of older parents or friends.
- are classified as being disabled.
- are younger employed people whose employers do not offer health insurance options.
- are single or married parents who cannot get health insurance coverage for their children., etc.
- qualify for Medicare, but need premium assistance for Part B and/or Part D.
Q: Tell us a little about the SHINE program. About how many residents did you serve in the past year?
In calendar year 2012, not counting one month I was away, I estimate I handled between 130-140 requests for help including personal counseling as well as training, constant updating, administrative requirements, and presentations. I volunteered about 238 hours.
Q: What are some typical questions people have about Medicare or other insurance besides MassHealth, or common problems people bring to you?
- General questions like “I’m turning 65, laid off or retiring—what do I do about Medicare and supplemental health insurance?” and “What about long-term care insurance?”
- Specific questions about Medicare coverage, include lab tests, physical therapy, mental health care, examinations, hospital stays, diabetes, prescription, ambulance, and appeals from decisions;
- Billing questions
- Questions about coverage for a skilled nursing medical home or facility care
- Low-income assistance
- “I’m a veteran—what’s best for me?”
- “I didn’t sign up for Medicare on time. What should I do?”
- “My employer offers a retirement health plan. How does it compare?”
Q: How can people make an appointment to see you?
Call the Lincoln COA at 781-259-8811 and ask for a SHINE appointment.
Q: Tell us a little about Minuteman Senior Services and SHINE.
Minuteman Senior Services provides a variety of services that help seniors and people with disabilities live in the setting of their choice. SHINE provides free health insurance counseling, including concerns about both Medicare and MassHealth for seniors and Medicare beneficiaries of all ages, through Minuteman Senior Services and the COA. For information, call 888-222-6171 or visit www.minutemansenior.org.