MassHealth is the state of Massachusetts' public health insurance program that combines Medicaid with the Children's Health Insurance program, also called CHIP. MassHealth insures eligible low- to medium-income residents of the state. Massachusetts pays half the cost of MassHealth and the federal government pays half. MassHealth provides several programs to meet the special needs of the elderly. Geriatric specialists and individualized plans of care are standard component of MassHealth's programs for the elderly.
PACE
The Program of All-inclusive Care for the Elderly, or PACE, is the MassHealth program for Massachusetts' residents age 55 and older. PACE combines Medicare and Medicaid in a managed-care program that provides a variety of services to MassHealth members who meet PACE eligibility, Eligibility includes residency in a PACE service area and enrollment in MassHealth Standard. PACE enrollees agree to receive all medical care, except for emergency care, from PACE providers. As an enrollee, you also agree to participate with your medical team in developing your personal plan of care. Residents of certain facilities, such as those for the developmentally disabled and nursing facilities, are ineligible for PACE.
Adult Family Care
Adult family care, also called adult foster care, is a MassHealth program for elderly adults who are too frail to live alone. Elderly participants live with paid caregivers, who may be family or non-family and who are trained to provide care for the frail elderly. You qualify for group adult foster care if you do not require around-the-clock care and you require assistance with at least one daily personal care task, such as dressing. The program provides personal care, meals and 24-hour supervision. PACE assigns social workers and nurses to provide ongoing training and support for caregivers.
Group Adult Foster Care
MassHealth's group adult foster care, or GAFC, pays for eligible elderly members' medication management and personal care if the member lives in approved housing, which includes assisted-living residences. The program does not pay housing costs. You are eligible for the program if you need assistance with at least one personal care task, are 22 years of age or older and live in a facility that participates in the GAFC program. Services include daily monitoring of your needs, daily help with personal care, medication management and more extensive daily services if approved.
Senior Care Options
Senior Care Options, or SCO, is a voluntary MassHealth program for low-income seniors who are 65 years of age and older, live in the program's service area and are eligible to enroll in MassHealth Standard. People with end-stage renal disease are ineligible for the SCO program. The SCO program assigns a health care team to design a plan of care for members, including geriatric specialists. Seniors are eligible for SCO regardless of their living arrangement.
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