Who can apply for HCBS waivers in Massachusetts?

On Behalf of | Oct 17, 2024 | MassHealth

If your family relies on MassHealth programs, you might have heard about Home and Community Based Services (HCBS) waivers. These programs aim to support those who prefer to receive long-term health care services in their home rather than in an institutional setting.

But who can apply for these waivers in Massachusetts? In this blog, we’ll explain the essentials in simple terms, helping you understand if your loved one qualifies and how to get started.

Does your loved one qualify for an HCBS waiver?

Individuals must meet specific clinical and financial eligibility criteria to qualify and benefit from the HCBS Waiver program. Here’s a breakdown of the five requirements:

  1. Facility level of care (LOC): Applicants must show they need the kind of care usually provided in a facility, proving that they meet the state’s rules for receiving this type of service.
  2. Ongoing need for support: Applicants must have an ongoing need for waiver services and receive these services at least once a month.
  3. Community safety: Applicants must be able to receive services in the community in which they reside.
  4. Income and asset limits:  The applicant’s income must be less than the income limit of $2,829 per month this year. Their total asset value must also be less than $2,000.
  5. Spousal asset limit: In 2024, the asset limit for the applicant’s spouse is $154,140.

In Massachusetts, there are 10 waivers that support different target groups. These include people aged 60 and older, patients with intellectual disabilities and people with brain injury. Unfortunately, each waiver has a maximum number of participants it can serve annually, meaning not all eligible applicants may receive services.

The importance of community integration

By joining the HCBS Waiver program, people can get special services that regular Medicaid doesn’t usually offer. This program helps patients live safely in their homes and communities while becoming more independent. If you have any questions about this, consider talking to a legal professional.