Holly T. Freiner v. Secretary of the Executive Branch of Health and Human Serivces

Boston, Massachusetts family law lawyer represented the Plaintiff who sued seeking Medicaid benefits.

This case arose at the intersection of Medicaid and marriage. The Medicaid program must preserve its limited resources to pay benefits only for those who are unable to afford care on their own. Consistent with that directive, the financial resources available to an applicant for Medicaid long-term benefits must fall below a threshold amount in order for the applicant to be eligible. When an applicant for long-term care benefits is married, determining eligibility requires a delicate balance. On the one hand, the Medicaid program seeks to ensure that a financially secure couple cannot shift the burden of paying for the care of a married applicant (institutionalized spouse) onto Medicaid by sheltering assets under the name of the applicant's spouse (community spouse) in order to make the institutionalized spouse appear impoverished "enough" to meet the eligibility requirements for Medicaid benefits. On the other hand, the Medicaid program aims to avoid effectively impoverishing the community spouse by forcing the community spouse to spend virtually all the couple's assets before the institutionalized spouse can obtain benefits.



Freiner v. Sec'y of the Exec. Office of Health & Human Servs., SJC-13514 (Mass. Jun 14, 2024)

Affirmed.