Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street Boston, MA 02111 www.mass.gov/dma

MassHealth Eligibility Letter 99 January 1, 2003

TO:	Division Staff
FROM:     Wendy E. Warring, Commissioner
RE:	2003 RSDI Cost-of-Living Adjustment (COLA) for Community and Long-Term-
Care MassHealth Cases
The following cost-of-living adjustments are effective January 1, 2003.
•	Retirement/Survivors/Disability Insurance (RSDI) benefits increased by 1.4%.
•	The maximum monthly maintenance needs allowance increased from $2,232 to $2,267.
•	The maximum amount of assets that can be kept by an institutionalized individual's spouse increased from $89,280 to $90,660.
•	The basic Medicare Part B premium increased from $54 to $58.70 per month.
These regulations are issued as emergency regulations, effective January 1, 2003.
MANUAL UPKEEP
Insert	Remove	Trans. By
519.003 (2 of 2)	519.003 (2 of 2)	E.L. 89

520.026 (1 of 5)

520.026 (1 of 5)	E.L. 94

130 CMR: DIVISION OF MEDICAL ASSISTANCE
Trans. by E.L. 99

Rev. 01/01/03

MASSHEALTH COVERAGE TYPES

Chapter     519
(2 of 2)    Page	519.003

(B) SSI Payment Standards. The RSDI amount, as described in 130 CMR 519.003(A)(3), and any other countable-income amount, as defined in 130 CMR 520.009, of the individual or couple is compared to the SSI payment standards to determine Pickle eligibility.

MASSACHUSETTS SSI PAYMENT STANDARDS	
			LIVING ARRANGEMENT CATEGORY		
		A	B	C	E	G	
Individual		Full Cost of
Living
Expenses	Shared
Living
Expenses	Household
of
Another	Licensed Rest Home	Assisted Living	
Aged		$680.82	591.26	472.36	845.00	1,006.00	
Disabled		666.39	582.40	455.58	845.00	1,006.00	
Blind		701.74	701.74	701.74	701.74	1,006.00	
Member of a Couple						
Aged		$515.36	515.36	384.24	845.00	755.00	
Disabled		504.53	504.53	373.43	845.00	755.00	
Blind		701.74	701.74	701.74	701.74	755.00	
NOTE: The personal-needs allowance in licensed rest homes is $60. The personal-needs allowance in nursing facilities and chronic-disease hospitals is $65.	
(C) Financial Standards Not Met. Individuals whose income, assets, or both exceed the standards
in 130 CMR 519.003 may establish eligibility by reducing assets in accordance with
130 CMR 520.004, meeting a deductible as described in 130 CMR 520.028 et seq., or both.

130 CMR: DIVISION OF MEDICAL ASSISTANCE
Trans. by E.L. 99
MASSHEALTH
FINANCIAL ELIGIBILITY	Chapter     520
Rev. 01/01/03	(1 of 5)    Page	520.026
(1)	The Division determines the MMMNA by adding the following amounts:
(a)	$1,493 (the federal standard maintenance allowance); and
(b)	an excess shelter allowance determined by calculating the difference between the standard shelter expense of $448 and the shelter expenses for the community spouse's principal residence, including:
(i) the actual expenses for rent, mortgage (including interest and principal), property taxes and insurance, and any required maintenance charge for a condominium or cooperative; and
(ii) the applicable standard deduction under the Food Stamp Program for utility expenses. If heat is included in the rent or condominium fee, this amount is $237. If heat is not included in the rent or condominium fee, this amount is $391.
(2)	The maximum-monthly-maintenance-needs allowance is $2,267 per month, unless:
(a)	it has been increased as the result of a fair-hearing decision based on exceptional circumstances in accordance with 130 CMR 520.017(D). The amount determined as a result of a fair hearing must be used when it exceeds the MMMNA calculated according to 130 CMR 520.026(B)(1) or it exceeds a court order for the support of the community spouse; or
(b)	the institutionalized individual is subject to a court order for the support of the community spouse. The court-ordered amount of support must be used as the spousal-maintenance needs deduction when it exceeds the MMMNA calculated according to 130 CMR 520.026(B)(1) or it exceeds the amount resulting from a fair hearing.
(C) Deductions for Family-Maintenance Needs.
(1) The Division allows a deduction from the income of a long-term-care resident to provide for the maintenance needs of the following family members if they live with the community spouse:
(a)	a minor child — a child under age 21 of either member of the couple;
(b)	a dependent child — a child over age 21 who is claimed as a dependent by either
spouse for income-tax purposes under the Internal Revenue Code;