Call (800) 243-4636 for additional details.
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 $27,636/single and $39,104/couple.
- Monthly Co-Payments
- $10 - $141 for individuals with incomes that range from $12,303 - $27,636
- $18 - $152 for couples with incomes that range from $16,567 - $39,104
- Over-Income Scale
- 50% - 100% of cost of services
Voluntary Co-Payment and Cost Sharing Schedules
Issue Date: 2/14/2018
Effective Date: 3/01/2018
Voluntary Co-Payment:
| Family Size | Annual Gross Income | Voluntary Monthly Co-payment |
|---|---|---|
| 1 | $12,302 or less | $10.00 |
| 2 | $16,566 or less | $18.00 |
Cost Sharing for Home Care:
| One Person Annual Gross Income | Monthly Co-payment | Two Person Family Annual Gross Income | Monthly Co-payment |
|---|---|---|---|
| $12,303 - $14,827 | $10.00 | $16,567 - $20,435 | $18.00 |
| $14,828 - $17,494 | $13.00 | $20,436 - $24,562 | $23.00 |
| $17,495 - $19,323 | $27.00 | $24,563 - $26,640 | $52.00 |
| $19,324 - $20,705 | $39.00 | $26,641 - $28,713 | $78.00 |
| $20,706 - $22,086 | $49.00 | $28,714 - $30,792 | $92.00 |
| $22,087 - $23,462 | $69.00 | $30,793 - $32,872 | $110.00 |
| $23,463 - $24,845 | $90.00 | $32,873 - $34,944 | $120.00 |
| $24,846 - $26,221 | $125.00 | $34,945 - $37,024 | $139.00 |
| $26,222 - $27,636 | $141.00 | $37,025 - $39,104 | $152.00 |
Cost Sharing for Over Income:
| One Person Annual Gross Income | Monthly Co-payment | Two Person Family Annual Gross Income | Monthly Co-payment |
|---|---|---|---|
| $27,637 - $29,945 | 50% | $39,105 - $40,428 | 50% |
| $29,946 - $32,191 | 55% | $40,429 - $42,671 | 55% |
| $32,192 - $34,438 | 60% | $42,672 - $44,921 | 60% |
| $34,439 - $36,683 | 65% | $44,922 - $47,165 | 65% |
| $36,684 - $38,927 | 70% | $47,166 - $49,410 | 70% |
| $38,928 - $41,177 | 75% | $49,411 - $51,656 | 75% |
| $41,178 - $43,418 | 80% | $51,657 - $53,903 | 80% |
| $43,419 - $45,665 | 85% | $53,904 - $56,148 | 85% |
| $45,666 - $47,915 | 90% | $56,149 - $58,393 | 90% |
| $47,916 - $50,159 | 95% | $58,394 - $60,642 | 95% |
| $50,160 and over | 100% | $60,643 and over | 100% |