One Ashburton Place, 5Th Floor

The Commonwealth of Massachusetts

Executive Office of Elder Affairs

One Ashburton Place, 5th Floor

Boston, Massachusetts 02108

Tel: (617) 727-7750

Fax: (617) 727-9368

KARYN E. POLITO

Lieutenant Governor

ALICE F. BONNER

Secretary

PI-18-01

REF: PI-17-02

PROGRAM INSTRUCTION

TO:Aging Service Access Point Executive Directors

FROM:Alice F. Bonner

DATE: February 14, 2018

RE:Revised Cost Share Table for the Home Care Program

Purpose:

This Program Instruction (PI) transmits the Financial Eligibility Guidelines that take effect on March 1, 2018 for the Home Care Program, and sets out the voluntary co-payment, costsharing, and over-income co-payment schedules.

Background:

The U.S. Social Security Administration recently announced a 2 percent Cost of Living Allowance (COLA) increase from calendar year 2017. Accordingly, monthly Social Security andSSI benefits will increase 2 percent in calendar year 2018.

As required under 651 CMR 3.04(4)(b), the Executive Office of Elder Affairs (EOEA) has adjusted the Financial Eligibility Guidelines to incorporate the COLA increase. By increasing these Financial Eligibility Guidelines, EOEA will prevent any unintended displacement of consumers who would otherwise become ineligible due to increases in family income.

Revised Co-payment and Cost Share Schedule:

EOEA will continue to request a voluntary donation from consumers whose income does not exceed the amounts set forth in the Voluntary Copayment section of the Financial Eligibility Guidelines. MassHealth members with any coverage type whose income is at or below 300% of Supplemental Security Income Federal Benefit Rate (SSI FBR) are exempt from all co-payments, including voluntary co-payments. Aging Services Access Points (ASAPS) will continue to have the ability to waive and reduce fees based on hardships that impact the consumer’s ability to pay.

Effective Date:

The effective date of this Program Instruction is March 1, 2018.

Contact:

If you have questions about this PI, please contact Shannon Philbrick, Home Care Program Coordinator at:.

MASSACHUSETTS HOME CARE PROGRAM

VOLUNTARY CO-PAYMENT AND COST SHARING SCHEDULES

Issue Date: 2/14/18

Effective Date: 3/01/18

VOLUNTARY CO-PAYMENT:

Family sizeAnnual Gross IncomeVoluntary Monthly Co-Payment

1$12,302or less $10.00

2$16,566or less $18.00

COST SHARING FOR HOME CARE:

One PersonMonthlyTwo Person Family Monthly

Annual Gross IncomeCo-paymentAnnual Gross Income 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 PersonMonthlyTwo Person Family Monthly

Annual Gross IncomeCo-paymentAnnual Gross Income Co-payment

$27,637 - $29,94550%$39,105 -$40,42850%

$29,946 - $32,19155%$40,429 -$42,67155%

$32,192 - $34,43860%$42,672 -$44,92160%

$34,439 - $36,68365%$44,922 -$47,16565%

$36,684 - $38,92770%$47,166 -$49,41070%

$38,928- $41,17775%$49,411 -$51,65675%

$41,178 - $43,41880%$51,657 -$53,90380%

$43,419 - $45,66585%$53,904 -$56,14885%

$45,666 - $47,91590%$56,149 -$58,39390%

$47,916 - $50,15995%$58,394 -$60,64295%

$50,160and over100%$60,643-and over100%

1

2/12/18 SKP