TO: ASAP Executive Directors
FROM: Eleanor Shea-Delaney
DATE: March 11, 2009
RE: Increased Co-payments for Home Care Program Services

Purpose

This Program Instruction (PI) contains revisions to PI-08-13 regarding the Financial Eligibility Guidelines that took effect on January 1, 2009 for the Home Care Program and set out the voluntary co-payment, cost sharing, and Respite Care cost sharing schedules. This Program Instruction supersedes PI-08-13.

Revised Co-payment and Cost Share Schedule

Elder Affairs is implementing co-payment and cost share increases effective January 1, 2009.

Elder Affairs will continue to request a voluntary donation from elders whose income is at or below the income eligibility guidelines for Medicaid. MassHealth members with any coverage type whose income is at or below 300% of SSI are exempt from all co-payments, including voluntary co-payments. Aging Services Access Points will continue to have the ability to waive and reduce fees based on hardships that impact the client's ability to pay.

Additionally, the U.S. Social Security Administration recently announced a 5.8% Cost of Living Allowance (COLA) increase in monthly Social Security and SSI benefits beginning January 1, 2009. As required under 651 CMR 3.03(3)(a), Elder Affairs has adjusted its Financial Eligibility Guidelines to incorporate this COLA percentage increase and prevent any unintended displacement of clients who would otherwise become ineligible due to increases in family income.

The revised co-payment and cost sharing table is attached. These revised Financial Eligibility Guidelines will soon be accessible at the Elder Affairs' Internet website http://www.mass.gov/elder, indexed under Regulations and Home Care.

Effective Date

The effective date of this Program Instruction is January 1, 2009.

Contact

If you have questions about this PI, please contact Elizabeth Clifford, Home Care Program Coordinator, at Elizabeth.clifford@state.ma.us.

Massachusetts Home Care Program
Voluntary Co-Payment And Cost Sharing Schedules

Issue Date: 12/2/2008
Effective Date: 1/1/2009

Voluntary Co-Payment

Family Size

Annual Gross Income

Voluntary Co-payment

1

$10,923 or less

$9/month

2

$14,645 or less

$17/month

Cost Sharing For Home Care

One Person
Annual Gross Income

Monthly
Co-payment

Two Person Family
Annual Gross Income

Monthly
Co-payment

$10,924 - $13,325

$9

$14,646 - $18,366

$17

$13,326 - $15,723

$12

$18,367 - $22,074

$21

$15,724 - $17,366

$25

$22,075 - $23,943

$48

$17,367 - $18,608

$36

$23,944 - $25,806

$72

$18,609 - $19,848

$45

$25,807 - $27,675

$85

$19,849 - $21,087

$63

$27,676 - $29,543

$101

$21,088 - $22,329

$83

$29,544 - $31,406

$110

$22,330 - $23,567

$115

$31,407 - $33,274

$128

$23,568 - $24,837

$130

$33,275 - $35,144

$140

Cost Sharing For Respite Care

One Person
Annual Gross Income

Monthly
Co-payment

Two Person Family
Annual Gross Income

Monthly
Co-payment

$24,838 - $26,913

50%

$35,145 - $36,333

50%

$26,914 - $28,931

55%

$36,334 - $38,350

55%

$28,932 - $30,951

60%

$38,351 - $40,372

60%

$30,952 - $32,968

65%

$40,373 - $42,388

65%

$32,969 - $34,986

70%

$42,389 - $44,406

70%

$34,987 - $37,007

75%

$44,407 - $46,425

75%

$37,008 - $39,022

80%

$46,426 - $48,444

80%

$39,023 - $41,041

85%

$48,445 - $50,461

85%

$41,042 - $43,062

90%

$50,462 - $52,481

90%

$43,063 - $45,079

95%

$52,482 - $54,501

95%

$45,080 and over

100%

$54,502 and over

100%