Page Reviewed / Updated - October 19, 2020
The Multipurpose Senior Services Program (MSSP) waiver is designed to help California seniors who are at risk of nursing facility placement, and who can and wish to remain living in their homes or in the community. The program achieves this objective by arranging assistance and managing a broad set of services, including adult day care, home modifications, and care management services. Please note, medical care is not covered under this waiver. In particular, this waiver is an important lifeline for seniors who are ready to return home after a stay in the hospital or nursing home for rehabilitation.This program is not available statewide, but is available in all counties except the following twelve:
However, this waiver program will be available in San Mateo effective January 2021. Please note that availability of the program does not mean automatic enrollment. In some counties, there may be waiting lists. The program is structured to allow for approximately 12,000 concurrent participants.
The MSSP Waiver has age, geographic, functional and financial eligibility requirements. Applicants must be at least 65 years of age and live in (or willing to move to) one of the 46 California counties where the waiver is available. Functionally, applicants must require the level of care typically provided in a nursing home. The financial requirements for the waiver are the same as the financial requirements for aging assistance programs under Medi-Cal.
April 2020 – July 2020 Medi-Cal Income Limits
Individuals with countable monthly income of less than $1,294 per month are eligible. Couples can have monthly income up to $1,747.
August 2020 – March 2021 Medi-Cal Income Limits
Generally, the income limits change annually in April. However, 2020 is unique in that the income limits increase a second time. Starting in August, the income limit for a single applicant will be $1,467 / month. For a married couple, the income limit will be $1,983.
Despite seemingly rigid income guidelines, there is some flexibility to the income requirement. Persons with income exceeding these amounts, but who have high medical or care expenses may still be eligible through the spend-down program in which they are required to pay a share-of-cost. Typically, share of costs enrollees can retain about $600 per month as an individual and $934 as a married couple for personal needs.
Individuals who are close to the income limit may be able to reduce their countable income by deducting the cost of supplemental health insurance. Given the complexity of the income rules for California residents, if you are concerned about how to qualify, consult with a Medi-Cal planning professional.
2020 Medi-Cal Asset Limits
A single applicant for Medi-Cal has an asset limit of $2,000. A married couple has an asset limit of $3,000, but only if both spouses are applying at the same time.
When determining the value of the applicant's assets, many resources, including one's home, household items, and vehicle are not counted. While most states have an equity interest limit on one’s home for exemption purposes, California is an exception and does not have an equity interest limit. This means, regardless of the equity value of one’s home, it is not counted towards Medicaid’s asset limit. In addition, under certain circumstances, Medi-Cal exempts the value of assets in a 401K account, and traditional or Roth individual retirement accounts (IRAs). Persons who have questions about how to navigate the retirement account exemption should contact a Medi-Cal specialist or their financial planner.
As with the income limits, persons who exceed the above-mentioned asset limits, and those who have questions as to whether they exceed the limits, should consider professional assistance for benefits planning to ensure they qualify.
The state of California intends this program to help individuals remain living at home. Therefore, the benefits of MSSP are selected to help them reach this goal. Program staff assesses participants upon acceptance into the program to make a final determination of benefits. They can include any of the following:
Seniors are permitted to use both the Multipurpose Senior Services Program and the In-Home Supportive Services (IHSS) at the same time. IHSS provides Medi-Cal recipients with personal care services in their home or in the home of a family or friend.
For additional information about MSSP, click here. To receive services under this program is a two-staged process. First, one must be eligible for Medi-Cal (Medicaid) and then he/she must obtain a slot for services under the MSSP Waiver. Services are not entitlements and waiting lists can exist. One can learn more, begin the application process, or request to be put on a waiting list by contacting their local Area Agency on Aging (AAA) office. Alternatively, one can call 1-800-510-2020.
Nearly 40 community health nonprofit organizations administer MSSP at the local level throughout the state. Once a senior is Medi-Cal enrolled, he/she can be referred to their local community service provider. To find a county-specific MSSP provider, one should contact their local AAA office here.