People living at home (children as well as adults) who need more help than family members can give, can get certain long-term-care services to help them live at home. MassHealth offers three special programs that allow certain MassHealth Standard members to get these needed long-term-care services at home.
  • Kaileigh Mulligan Program (Home Care for Disabled Children)
  • PACE (Program of All-Inclusive Care for the Elderly)
  • Home- and Community-Based Services Waiver

Though these special programs are available under MassHealth Standard, each program has its own eligibility rules and application process.

Kaileigh Mulligan Program (Home Care for Disabled Children)

The Kaileigh Mulligan Program allows certain severely disabled children (under age 18) to live at home with their parents and have MassHealth eligibility determined without counting the income and assets of their parents. The child's medical needs must be severe enough to require a level of care equal to that provided in a hospital or pediatric nursing facility.

This program covers payments for a wide range of medical and nursing care, and certain medical equipment and supplies for the child. The cost to MassHealth cannot be greater than what it would cost for the child to live in a hospital setting or nursing facility.

The application process

Generally, referrals are made by the Department of Public Health case managers or by the child's hospital social worker.

OR

Call the MassHealth Enrollment Center at 1-800-408-1253 (TTY: 1-800-231-5698 for people who are deaf, hard of hearing, or speech disabled) for a Senior Medical Benefit Request (SMBR) and more information about this program.

PACE (Program of All-Inclusive Care for the Elderly)

PACE allows certain frail people (aged 55 and older) who need help with daily personal care, and have a medical condition that needs regular attention, to live at home and remain as healthy and independent as possible. The need for a level of care must be equal to that provided in a nursing facility.

A person on PACE gets all services through a PACE-authorized health center, which offers a wide range of medical and personal-care services.

You must live in a PACE service area.

The application process

Generally, referrals are made by the person's medical provider.

OR

Call the MassHealth Enrollment Center at 1-800-408-1253 (TTY: 1-800-231-5698 for people who are deaf, hard of hearing, or speech disabled) for a Senior Medical Benefit Request (SMBR) and more information about this program.

Home- and Community-Based Services Waiver

The Home- and Community-Based Services Waiver allows certain frail people (aged 60 and older) to live at home and get MassHealth Standard.

This program allows the person needing the at-home services, if married and living with his or her spouse, to have MassHealth eligibility determined without counting the income and assets of the other spouse.

An agency of the Massachusetts Executive Office of Elder Affairs (EOEA) reviews the medical need for long-term-care services.

The application process

Generally, referrals are made by the person's medical provider or by a case manager.

OR

Call a MassHealth Enrollment Center at 1-888-665-9993 (TTY: 1-888-665-9997 for people who are deaf, hard of hearing, or speech disabled) for a Senior Medical Benefit Request (SMBR) and more information about this program.

 


This information is provided by MassHealth.