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 $28,865/one person and $40,842/two person family.
- Monthly Co-Payments
- $10 - $141 for individuals with incomes that range from $12,849 - $28,865
- $18 - $152 for couples with incomes that range from $17,303 - $40,842
- See specific cost-share schedules below.
Over-Income Scale: (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 Over-Income Scale: 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. For more information call: (800) 243-4636.
Voluntary Co-Payment and Cost Sharing Schedules
Issue Date: 1/15/2020
Effective Date: 3/01/2020
Voluntary Co-Payment:
| Family Size | Annual Gross Income | Voluntary Monthly Co-payment |
|---|---|---|
| 1 | $12,848 or less | $10.00 |
| 2 | $17,302 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 |
|---|---|---|---|
| $12,849 - $15,486 | $10.00 | $17,303 - $21,343 | $18.00 |
| $15,487 - $18,272 | $13.00 | $21,344 - $25,654 | $23.00 |
| $18,273 - $20,182 | $27.00 | $25,655 - $27,824 | $52.00 |
| $20,183 - $21,262 | $39.00 | $27,825 - $29,989 | $78.00 |
| $21,627 - $23,067 | $49.00 | $29,990 - $32,160 | $92.00 |
| $23,068 - $24,505 | $69.00 | $32,161 - $34,333 | $110.00 |
| $24,506 - $25,950 | $90.00 | $34,334 - $36,497 | $120.00 |
| $25,951- $27,386 | $125.00 | $36,498 - $38,6701 | $139.00 |
| $27,387 - $28,865 | $141.00 | $38,671 - $40,842 | $152.00 |
Cost Sharing for Over Income:
| One Person Annual Gross Income | Monthly Co-payment | Two Person Family Annual Gross Income | Monthly Co-payment |
|---|---|---|---|
| $28,866 - $31,276 | 50% | $40,843 - $42,225 | 50% |
| $31,277 - $33,621 | 55% | $42,226 - $44,568 | 55% |
| $33,622 - $35,968 | 60% | $44,569 - $46,918 | 60% |
| $35,969 - $38,313 | 65% | $46,919 - $49,262 | 65% |
| $38,314 - $40,657 | 70% | $49,263 - $51,607 | 70% |
| $40,658 - $43,007 | 75% | $51,608 - $53,952 | 75% |
| $43,008 - $45,348 | 80% | $53,953 - $56,299 | 80% |
| $45,349 - $47,695 | 85% | $56,300 - $58,644 | 85% |
| $47,696 - $50,045 | 90% | $58,645 - $60,988 | 90% |
| $50,046 - $52,388 | 95% | $60,989 - $63,337 | 95% |
| $52,389 and over | 100% | $63,338 and over | 100% |