Cost Share Guidelines for Home Care

Home care services are open to all. Some have specific eligibility requirements related to residency, age and functional needs.

Any older adult or individual with a disability is eligible for a free in-home assessment and information based on community resources and their specific needs. Cost share amounts for supportive services through the Home Care program are determined based on income.

Cost Share Guidelines:

Age & Residence

60 years and older or under 60 with a diagnosis of Alzheimer's disease and in need of respite services. Consumers must be living at home in Massachusetts and not in an institutional setting or Assisted Living Residence.

Financial

MassHealth members are financially eligible. Income guidelines require Annual Gross Income less than $33,659/one person and $47,626/two people.

  • Monthly Co-payments
    • $10 - $141 for individuals with incomes that range from $14,983-$33,659
    • $18 - $152 for couples with incomes that range from $20,177-$47,626
    • See specific cost-share schedules below.

Percent Based Co-payment: (For those with a higher income than those listed above.) 

  • 50% - 100% of the cost of services received monthly, based on a person's individualized care plan.
  • See specific cost-share schedules below.
     
  • Note on Percent Based Co-payment: Each person's care needs are different and can change based on a variety of factors. This can affect the type of services necessary to support care needs and the cost of services. A regional elder care agency, that works in partnership with the State Home Care Program, will work with you to access services based on your care needs and goals. 

Voluntary Co-Payment and Cost Sharing Schedules

Issue Date: 3/27/23                                                                                       

Effective Date: 5/01/23

Voluntary Co-Payment:
Family SizeAnnual Gross IncomeVoluntary Monthly Co-Payment
1$15,460 or less$10.00
2$20,820 or less$14.00
Cost Sharing - Maximum Fixed Monthly Amount Based on Services Received During the Month:
One Person Annual Gross IncomeMonthly Co-paymentTwo Person Family Annual Gross IncomeMonthly Co-payment
$15,461 - $18,634$10.00$20,821 - $25,683$14.00
$18,635 - $21,987$13.00$25,683 - $30,869$18.00
$21,988 - $24,285$27.00$30,870 - $33,481$40.00
$24,286 - $26,022$39.00$33,482 - $36,086$55.00
$26,023 - $27,757$49.00$36,087 - $38,698$68.00
$27,758 - $29,488$69.00$38,699 - $41,312$96.00
$29,489 - $31,225$90.00$41,313 - $43,916$126.00
$31,226- $32,954$125.00$43,917 - $46,531$176.00
$32,955 - $34,733$141.00$46,532 - $49,145$199.00

MassHealth Members whose income is below $33,948 (300% FBR) do not have a co-pay

Cost Sharing - Percent Co-Payment Based on Cost of Services Received During the Month:
One Person Annual Gross IncomeMonthly Co-paymentTwo Person Family Annual Gross IncomeMonthly Co-payment
$34,734 -
$37,634
50%$49,146 -
$50,810
50%
$37,635 -
$40,456
55%$50,811 -
$53,629
55%
$40,457 -
$43,281
60%$53,630 -
$56,456
60%
$43,282 -
$46,102
65%$56,457 -
$59,276
65%
$46,103 -
$48,923
70%$59,277 -
$62,099
70%
$48,924 -
$51,750
75%$62,100 -
$64,920
75%
$51,751 -
$54,567
80%$64,921 -
$67,744
80%
$54,568 -
$57,391
85%$67,745 -
$70,565
85%
$57,392 -
$60,220
90%$70,566 -
$73,387
90%
$60,221 -
$63,038
95%$73,388 -
$76,212
95%
$63,039 -
and over
100%$76,213 and over100%
Call (800) 243-4636 for additional information.

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