What’s new in January 2020?
Medicare Savings Program Expansion eff. Jan 1
More Medicare beneficiaries will now qualify for help paying for Medicare Part B premiums and other costs thanks to higher income and asset limits for the Medicare Savings Program/Buy-In programs. A single individual can now get help if his/her income is under $1,738 per month (165% FPL –up from 135% FPL in 2019) and with countable assets of $15,720 or less (twice the prior asset ceiling)
A new MSP/Buy-In only application form in Eng & SP is posted with other MassHealth forms here: https://www.mass.gov/lists/
To qualify for Health Safety Net and MSP/Buy-In, Medicare beneficiaries will have to apply using the SACA-2 application form.
The Buy-In & Senior Buy-In regulations have also been amended to reflect the new financial thresholds. 130 CMR 519.010 & 519.011.
EOHHS & Elder Affairs are developing outreach materials in multiple languages. Flyers in Eng & SP are posted on masslegalservices.org here. https://www.masslegalservices.
March 1, 2020 the upper income limits will go up slightly to reflect the annual COLA to the federal poverty guidelines.
Social Security and Medicare Cost of Living Adjustments for 2020
The Social Security cost of living adjustments in Title II and SSI benefit rates took effect Jan 1 along with adjustments to Medicare cost-sharing and other amounts. Medicare Part B premiums for most people went up to $144.60 per month. The 2020 amounts are summarized in this SSA publication: https://www.ssa.gov/pubs/EN-
In Massachusetts SSI benefit amounts include both the federal amount and a state supplement. The 2020 SSI payment standards are posted on the MassHealth website here: https://www.mass.gov/doc/ssi-
MassHealth Cost of Living Adjustments for 2020
The Federal Poverty Level COLA usually comes out at the end of January and MassHealth updates its income guidelines based on the FPL on March 1. However, some of the financial standards used by MassHealth are based on other adjustments and updated January 1. These are posted here https://www.mass.gov/service-
Jan 1, 2020 adjustments include the Buy-In asset limits and the upper income limit for PACE and HCBS waivers which is set at 300% of the SSI Federal Benefit Rate. In 2020 the 300% FBR rate will be $2349 per mo for an individual (up from $2313 in 2019).
Also adjusted Jan 1, 2020 are several standards used in determining eligibility for nursing home eligibility including the home equity limit, the community spouse resource maximum, and the maximum monthly needs allowance for a community spouse.
Personal Care Attendant (PCA) Changes Jan 1
MassHealth entered into new contracts with Personal Care Management (PCM) agencies effective Jan 1, 2020. PCMs are responsible for many aspects of the PCA program including making an assessment and requesting authorization for hours of service. Five agencies that provided PCM services in 2019 and prior years were not chosen in 2020 and a 6th did not seek renewal. Approximately 2300 MassHealth members who had been using one of the six non-renewing PCMs were reassigned to new PCMs, but are free to choose any available PCM. In addition One Care and SCO plans were given the option to drop one or more of the non-renewing PCMs from their PCM networks effective Jan 1. The non-renewing PCM agencies are: BayPath Elder Services, Family Services Associates of Greater Fall River, Montachusett Home Care Corp (MHCC), Old Colony Elder Services and Toward Independent Living and Learning (TILL), and PRIDE.
One thing to watch out for is whether a new PCM may recommend fewer hours than the former PCM when there has been no improvement in the member’s condition or circumstances. A reduction in hours like this will probably require legal advocacy just to get a hearing.
Also effective Jan 1, 2020 amended PCA regulations at 130 CMR 422 took effect. See Transmittal Letter 23 (January 2020) which summarizes various updates & clarifications. https://www.mass.gov/lists/
Automatic Voter Registration with Opt Out eff Jan 1
Beginning Jan 1 a 2018 state law takes effect providing that certain Massachusetts residents who do not opt out will be automatically registered to vote when they renew their driver’s license or apply for coverage through MassHealth or the Health Connector.
MassHealth and the Connector have made changes to the online application to allow a head of household who meets the age, residence and US citizenship criteria for voting and does not opt out to have this information forwarded to the Secretary of State in order to be registered to vote. MassHealth and the Connector have supplied a training for assisters & navigators about this new process.