Tailored Supports for Older Adults (TSOA) and Medicaid Alternative Care (MAC) programs

The Tailored Supports for Older Adults (TSOA) and Medicaid Alternative Care (MAC) programs provide services for unpaid caregivers who are taking care of someone who is 55 years old or older. 

• TSOA is for people who aren’t eligible for Medicaid.
• MAC is for people who are eligible for Medicaid but have chosen not to participate in a Medicaid program.

You can apply online or go to your local DSHS office. You can ask DSHS for help applying for the program.

You’re eligible for TSOA if your income is $3,868/month or less.

The resource limit is $77,052 if you’re single and $145,353 if you’re married.

Some resources, like your house, car, and personal items don’t get counted for the resource limit.

You’re eligible for MAC if you’re eligible for “categorically needy” Medicaid or “alternative benefit plan” Medicaid. Generally, your income must be at or below 138% of the federal poverty level, which is $1,799.75/month if you’re single and $2,432.25/month if you’re married. You might qualify with higher income if you have certain disabilities.

If you’re already eligible for a Medicaid (“Apple Health”) program that doesn’t have a resource limit, there’s no resource limit.

Otherwise, the resource limit is $2,000 if you’re single and $3,000 if you’re married. 

Some resources, like your house, car, and personal items don’t get counted for the resource limit.

Once DSHS decides you’re financially eligible for TSOA or MAC, a specialist will interview you and your unpaid caregiver to find out what kind of help you need.

Coverage for both programs can start after a quick eligibility screening with DSHS. For TSOA, you might also have to go through an application process. But if it turns out you’re not eligible for TSOA, you don’t have to pay anything back. There’s no retroactive coverage for TSOA or MAC.

There are different levels (or “steps”) of services for TSOA and MAC depending on what you and your unpaid caregiver need. Services can include, but aren’t limited to, these:

• Caregiver support groups
• Caregiver training and consultation
• Dietician consultation
• Fall prevention workshops
• Long-term care planning assistance
• Short and long-term respite care
• Home safety evaluation
• Transportation assistance
• Adult day health
• Medical equipment and supplies
• Personal emergency response system
• Minor home modifications
• Meals and housework 

Yes. But be careful! If you’re only getting TSOA or MAC, you can transfer your resources without penalty. But your ability to transfer resources may be limited for other programs you need now or in the future.

No. But other Medicaid services involve “estate recovery.”