Massachusetts pays for in-home care for qualified individuals through MassHealth, the state’s Medicaid program. While MassHealth doesn’t pay for nonmedical in-home care under its regular program, it has several waivers that expand services to fund this type of care. To qualify for services, individuals must meet eligibility guidelines related to their financial needs and functional abilities.

What Medicaid Waivers Pay for In-Home Care?

There are three Medicaid waivers that pay for in-home care for qualified individuals, including the Frail Elder Waiver, the Personal Care Attendant Program and the Adult Foster Care program. Eligibility criteria varies across these programs; individuals generally need to be considered low-income and they must need help with daily living activities. Depending on the program, they may live in their own home or with a family caregiver.

The Frail Elder Waiver provides in-home support, including home modifications, personal care services and home-delivered meals to those who qualify for nursing home-level care but want to remain in their homes. Enrollment for this program is capped, so qualified individuals may be placed on a waiting list until services are available. The Personal Care Attendant Program pays for in-home care for a set number of hours per month and lets participants hire the caregiver of their choice. The Adult Foster Care Program lets older adults live with a family caregiver and provides payments to help cover the cost of the individual’s care.

Other Options for Paying for In-Home Care

In addition to these Medicaid programs, Massachusetts may cover in-home care through the Senior Care Options Program and PACE. SCO is a health plan for those dually eligible for Medicare and Medicaid. It combines health and social services under one plan and pays for services such as housekeeping, personal care, respite care and nonemergency medical transportation. PACE is similar in that it’s for those enrolled in Medicare and Medicaid. It also covers the same scope of services, along with home-delivered meals, recreational activities and family caregiver support. Neither program is available statewide but instead has designated service areas. Only those living within the service areas are eligible for assistance.