Page Reviewed / Updated - Dec. 2018
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 medications, 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 seven: Del Norte, Nevada, Plumas, San Benito, San Luis Obispo, Sierra, and Sutter counties. However, availability of the waiver 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 48 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.
2019 Medi-Cal Income Limits
Despite seemingly rigid income guidelines, there is some flexibility to the income requirement. Individuals with countable monthly income of less than $1,242 per month are eligible. Couples can have monthly income up to $1,682. 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.
2019 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 limit on one’s home for exemption purposes, California is an exception and does not have an equity limit. This means, regardless of the 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 abovementioned asset limits, and even those who have some questions 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 offers Medi-Cal recipients with personal care services in their home or in the home of a family or friend.
To receive services under MSSP 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 here. Alternatively, one cal 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. For a list of the county-specific social service organizations, please review the contacts available here.