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The cost of home care in Massachusetts is $5,911 per month, according to the 2021 Genworth Cost of Care Survey. In-home care provides personal care services for seniors, including help with daily living activities, while home health care offers these same services but with added medical attention, such as medication administration, wound or post-surgery care and health monitoring for seniors with long-term chronic illnesses.
Massachusetts’s home care costs are relatively close to prices in surrounding states. In Rhode Island, in-home care is slightly less at $5,720 per month, while home health care costs a little more at $5,958 per month. Connecticut, Rhode Island and Vermont have more affordable home care costs; however, New Hampshire seniors pay slightly more than Massachusetts seniors at $6,006 monthly for in-home care and $6,197 for home health care. When compared with the monthly national median, Massachusetts’s home care fees are close to $1,000 more.
|Home Health Care
When it comes to long-term senior care costs in Massachusetts, in-home care and home health care are more affordable than residential care options, such as assisted living, which costs $6,500 monthly and nursing home care at $12,623 per month. Those who don’t need round-the-clock support may want to consider adult day care, which provides out-of-home services for seniors at a more affordable monthly price of $1,587.
MassHealth, Massachusetts’s Medicaid system, offers several programs to help seniors cover the cost of home care. These programs include the Frail Elder Waiver, the Home Care Services for Elders waiver, Home Care Services waiver, Senior Care Options and Program for All-Inclusive Care for the Elderly.
Massachusetts has four waiver programs that cover costs for seniors who live independently while receiving home care services.
|How it Works
|Frail Elder Waiver
|The Frail Elder Waiver provides seniors aged 60 and older with improved access to long-term care. This entitlement program requires participants to be Medicaid eligible and need a nursing care level but prefer to live at home safely. The waiver provides an array of services, including home-based wandering response systems, home care services, personal care, home delivery for foods and medications and companion care.
|Home Care Services
|MassHealth may connect those in need with in-home care services, including grocery shopping help or home-delivered meals, companion services, chore services and personal care. Seniors should contact LifePath at (800) 243-4636 to learn more about taking advantage of the services available to them.
|Senior Care Options (SCO)
|For seniors aged 65 and older who are living at home in an eligible area, SCO can provide the same services typically offered by Medicare or MassHealth at a reduced cost. Medicare and Medicaid administer this coordinated care program jointly and offer benefits such as no copays or six-month deductible periods.
|Program for All-Inclusive Care for the Elderly (PACE)
|Contact your local PACE organization
|Those who live in a PACE service area can access this all-inclusive managed care plan administered by Medicare and MassHealth. The program is available to those 55 and older. It provides everything from primary and hospital care to home-delivered meals, companion care, personal care and home health care services for those who need them.
You must meet specific income guidelines to qualify for MassHealth coverage. For a single person, annual income may not exceed $18,075, and countable assets can’t be more than $2,000 in value. For two-person households, Medicaid limits their income to $24,353 per year and their assets to $3,000.
Further to the financial requirements stipulated by MassHealth, seniors must also be:
To apply for Medicaid in Massachusetts, you can call (800) 841-2900 or (800) 497-4648 for TTY service. Alternatively, you can apply online via the Massachusetts Health Connector or print and mail your application to:
Health Insurance Processing Center
P.O. Box 4405
Taunton, MA 02780-0419
What Information You Will Need
Before applying, you should be prepared to provide:
How to Get Help Applying for Medicaid
In Massachusetts, several resources are available to help seniors process their Medicaid applications.
|Medicaid Planning Assistance
|Medicaid Planning Assistance provides an up-to-date, detailed breakdown of all income and asset limitations for Medicaid programs in the state, as well as clarification on topics such as income, assets and the application process.
|MassHealth Disability Special Accommodations Ombudsman
|The Special Disability Ombudsman offers extra assistance for disabled state residents, guiding them through the application process and providing representation where needed.
|MassHealth Customer Service
|MassHealth Customer Service is available to answer questions about the application process, eligibility requirements and MassHealth’s covered services.
Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.
Below is an overview of some of the services typically covered by Medicare for those who are eligible:
As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.
Read our guide to Medicare and Home Care Coverage for more information.
While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.
There are several resources in Massachusetts designed to help seniors who live at home enjoy a better quality of life, even with a modest income.
|Low-Income Weatherization Assistance Program (WAP)
|Massachusetts’s Low-Income Weatherization Assistance Program offers home efficiency upgrades for eligible homeowners in the state. The program is only open to those who earn an income totaling 60% of the estimated state median or less. Weatherization activities the program may offer include insulation upgrades, air sealing and furnace repairs or replacements.
|Boston, Worcester, Haverhill
|Rebuilding Together is a nonprofit organization that works with community volunteers to provide home repairs and build home modifications for elderly and disabled residents.
|MassHousing is a state agency that works with homeowners and potential home buyers to provide funding for home modifications and other necessary renovations, as well as down payments for those looking to secure a safe place to live.
|Massachusetts Assistive Technology Loan Program
|This state program offers low-interest loans to seniors and residents who have disabilities. You can only use loans to conduct home modifications, purchase assistive technology or fund other investments to improve your independence.
|Elder Protective Services
|Elder Protective Services investigates complaints of physical, sexual and emotional abuse against seniors, as well as complaints of caretaker neglect, self-neglect and financial exploitation. It caters specifically to the needs of those over 60 years of age.
In Massachusetts, the Centers for Medicare & Medicaid Services (CMS) required all in-home care and home health care workers to be fully vaccinated against COVID-19 no later than February 28, 2022. It has enforced this requirement, effective January 28, 2022. While the regulation requires two rounds of vaccine, all health care workers should follow the recommendations of the Centers for Disease Control (CDC).
These guidelines are up-to-date as of April 2022; however, they are subject to change, so it’s important to continually check for revised recommendations from local government agencies. Home care agencies may also have additional recommendations or rules in place for their workers, which you can obtain by contacting the agencies directly.
Massachusetts does not regulate home care providers at the state level; however, those providing food or health services must abide by the Massachusetts Department of Public Health’s health care and food service regulations.
|What Types of Care Can Be Provided?
|Since there aren’t regulations surrounding home care in the state, agencies can provide any necessary scope of services, provided they’re reasonable and safe. Home health care agencies must provide a qualified health care practitioner, such as a physician, nurse or trained home health aide, to conduct any medical services.
|Are Care Plans Required?
|There are no care plan requirements in place for home care agencies in Massachusetts; however, most agencies follow the standard practice of providing new clients with a comprehensive service plan that includes details about their needs, mental and physical condition, medications and other preferences.
|Can Home Care Providers Assist with Medication Management?
|There are no regulations regarding medication management in Massachusetts.
|Are There Special Requirements for Screening Home Care Aides?
|While screening requirements aren’t in place, most home care agencies ensure that their caregivers and other staff members undergo criminal background checks prior to working with clients.
|Are Home Care Aides Required to Undergo Special Training?
|There are no special training regulations for home care workers in Massachusetts.
|Does Medicaid Cover Home Care in New York?
|In Massachusetts, there are several Medicaid programs offered that cover the costs of home care services for seniors living here. These programs include the Frail Elder Waiver, Home Care Services for Elders, Senior Care options and the Program for All-Inclusive Care for the Elderly (PACE).
|How Do I Report Abuse of Myself or a Loved One?
|Those who have concerns about the welfare of a senior receiving home care or another type of long-term care can contact the Long-Term Care Ombudsman. This program investigates and resolves complaints of neglect, abuse and exploitation of seniors living in long-term care situations.
You can contact the Long-Term Care Ombudsman by calling (617) 727-7750.
Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.