Massachusetts can be a welcoming state for seniors who live on their own and wish to remain independent. Even seniors with limited incomes can thrive in the Bay State with help from dozens of programs that are open to them. The Massachusetts Nutrition Program, for example, operates at least 400 sites around the state to provide seniors with free food and nutrition counseling. The Massachusetts Department of Revenue operates senior and low-income tax clinics, which can help seniors with state and federal tax issues. There are also hundreds of senior centers in Massachusetts to look after the specific needs of local seniors.

These programs are among the many reasons Massachusetts is a popular place for seniors to settle. At least 16.5% of the state’s 7 million residents are seniors aged 65 and over, with that number set to increase through 2030. The general cost of living in Massachusetts can be high, compared with most other states. In-home care in the state, for example, costs seniors an average of $5,186 a month, which is well above the national average cost of $4,290 for similar assistance.

This guide is written for seniors and their loved ones in the state of Massachusetts. Its purpose is to inform seniors and their families about the likely costs they face for in-home care, what resources are available to help them and to answer common questions about senior living in Massachusetts.

The Cost of In-Home Care in Massachusetts

In-Home Care Costs in Nearby States

In-home care in Massachusetts costs an average of $5,186 a month, according to the 2019 Genworth Cost of Care Survey. This is $896 more each month than the national average cost of $4,290. The cost of care in Massachusetts is high by national averages, but it is generally competitive with costs in other nearby states. Rhode Island and New Hampshire, for example, cost $5,148 and $5,243 a month, respectively. These are both within about $50 a month of the Massachusetts average. One exception to these costs is Connecticut, where in-home care costs an average of $4,195 a month. This is not just less than the average cost in Massachusetts, it is also $95 a month under the national average.

$5186

Massachusetts

$4290

United States Average

$4195

Connecticut

$5148

Rhode Island

$5243

New Hampshire

$5196

Vermont

Cost of Other Types of Care in Massachusetts

Home care in Massachusetts is similar in cost to several other types of senior care. The $5,186 a month home care costs in the state is within $60 a month of the cost of home health services. Assisted living costs are a few hundred dollars more, though adult day care is significantly less expensive, at just $1,473. Skilled nursing care is one of the most expensive options for senior living in Massachusetts, with a semi-private room averaging $12,473 a month.

$5186

In-Home Care

$5243

Home Health Care

$1473

Adult Day Care

$5640

Assisted Living Facility

$12473

Nursing Home Care

The Cost of In-Home Care in Massachusetts’ Top Cities

Prices for home care vary by hundreds of dollars a month in Massachusetts, depending on the city being surveyed. Barnstable, one of the small towns of Cape Cod, is the most expensive city in the state for home care, at $5,911 a month. The capital city, Boston, is almost $500 a month less than that, at $5,434 a month for home care. Costs are lower still in Worcester, Springfield and Pittsfield, where costs are just $4,767, $4,767 and $4,757 a month, respectively.

$5434

Boston

$4767

Worcester

$5911

Barnstable

$4767

Springfield

$4757

Pittsfield

Financial Assistance for In-Home Care in Massachusetts

Home and Community Based Services Waiver (HCBS)

The Massachusetts Executive Office of Health and Human Services administers a Home and Community Based Waiver (HCBS) program to support seniors and their loved ones who need in-home care with any of five MassHealth waivers. The waivers pay the cost for in-home caregiver assistance directly, in a beneficiary-directed program that empowers seniors to pay their own caregivers’ wages. Other services can include relocation assistance and medical support for seniors with specific medical conditions.

Who Is Eligible?
HCBS waivers are available to all Massachusetts seniors aged 65 and over who have a medical need for residential care. Beneficiaries must waive their right to placement in a senior living facility and meet MassHealth income and asset limitations.

How to Apply
Applicants who meet the program criteria can print and fill out the Department of Developmental Services application here. Applications can be requested by telephone at (888) 367-4435. Completed applications may be mailed to:

Department of Developmental Services
Waiver Management Unit
500 Harrison Avenue
Boston, MA 02118

Massachusetts MFP Community Living (MFP-CL)

The Massachusetts MFP Community Living (MFP-CL) is a Medicaid waiver program for seniors in Massachusetts. The program pays for many of the services seniors need to remain independent at home in their community. The aim of the waiver program is to assist seniors who wish to stay independent at home, rather than move into a residential care facility. Services the waiver pays for cover many of the needs seniors have when living at home, including:

  • Adult companions
  • Chore assistance
  • Day services
  • Home health aides
  • Homemaker services
  • Occupational therapy
  • Peer support groups
  • Personal care services
  • Physical therapy
  • Respite care
  • Skilled nursing
  • Durable and disposable medical equipment
  • Speech therapy
  • Employment support
  • Transportation services
  • Residential habilitation and group home care
  • Shared living support
  • Home and vehicle accessibility modification
  • Transitional services

Who Is Eligible?
Beneficiaries must be citizens or permanent legal residents of the United States and residents of Massachusetts. Applicants must be aged 65 or over and eligible for Medicare. Applicant income is limited to $2,205 a month and countable assets are limited to $2,000, or $3,000 for married couples. Applicants must also be considered “medically needy,” which includes a medical reason for residential or skilled nursing care.

How to Apply
Seniors interested in applying for the Massachusetts MFP Community Living Waiver can apply online at the website of the Massachusetts Executive Office of Elder Affairs. The office can be reached by phone at (800) 243-4636.

More Ways to Pay for In-Home Care

While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance, and more. Read Caring.com’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost In-Home Care Resources in Massachusetts

Massachusetts residents have more than a few resources that can help them live at home in their own communities. Resources open to seniors on low and fixed monthly incomes include meal delivery, transportation assistance and free fitness programs.

Resource NameContact InformationServices Offered
Massachusetts Nutrition Program for SeniorsCall (800) 243-4636 to check eligibilityMassachusetts Nutrition Program for Seniors is a statewide nutritional support program aimed at seniors and low-income residents aged 60 and over. The program operates hundreds of sites in Massachusetts that provide screening and advice for seniors who may be at risk of food insecurity. Free food parcels are distributed at program centers, as well as throughout a network of nonprofit distributors throughout the commonwealth.
Legal Services Center of Harvard Law School LITCCall (866) 738-8081The Legal Services Center of Harvard Law School (LITC) is a low-income legal clinic that specializes in helping seniors in Massachusetts find and make use of free legal advice tailored to their needs. Topics the clinic offers support for include estate law, tax issues and guardianship. Other services are available at no cost for qualifying seniors.
SilverSneakersCheck eligibility online at the SilverSneakers website.SilverSneakers promotes senior health by providing free gym memberships for seniors aged 65 and over who are enrolled in a Medicare Part B plan. Any plan or membership structure is eligible for Medicare beneficiaries, and no share of cost is charged to participants.
Massachusetts Lifespan Respite ProgramCall (978) 774-5000 x386The Massachusetts Department of Developmental Services offers limited respite services for seniors who need temporary short-term assistance and supervision during the day.
The RIDECall (617) 337-2727The Massachusetts Bay Transit Authority offers point-to-point transportation assistance for seniors in the state who have difficulty going to and from medical office visits. The program also provides no-cost rides for seniors who need to schedule personal trips for shopping, family trips and other close-range destinations. Vehicles used for this service are all ADA-accessible and have wheelchair lifts and tie-downs.
Senior Farmers’ Market Nutrition ProgramCall (602) 542-0379The Senior Farmers’ Market Nutrition Program connects seniors with fresh produce with coupon books that can be redeemed at local farmers’ markets and organic groceries. Seniors who meet the program’s income and eligibility criteria can get up to $40 in coupons for fresh produce at participating senior centers and local markets.


In-Home Care Laws and Regulations in Massachusetts

The Massachusetts Division of Health Care Facility Licensure and Certification has jurisdiction in the commonwealth over home health services and in-home care. The state does not require licensing of in-home caregivers, though there are some requirements individuals and agencies are expected to abide by.

Scope of CareIn-home caregivers may assist with activities of daily living and other nonmedical services. In-home caregivers may, at the discretion of themselves and their agencies, provide lift assistance and total transfer for seniors with limited mobility.
Care Plan RequirementsHome care agencies must provide their patients and the appropriate family members with information about the services to be rendered, the name and qualifications of the caregiver, all foreseeable expenses associated with care and a range of the hours the caregiver is available for them. Seniors, or their guardians if needed, have a right to be part of the decision-making process for the care plan.
Medication Management RequirementsIn-home caregivers are permitted to assist seniors with administering medications that have assisted administration indicated as part of their regimen. Medical direction is required for interventions such as IV drugs and other invasive procedures. Caregivers must not administer medication themselves, nor are they permitted to make medication decisions on behalf of seniors under their care.
Staff Screening RequirementsMassachusetts has no state laws regarding employment standards or screening requirements for caregivers. Clients are generally able to conduct pre-employment background screening on their own before work starts in the home.
Staff Training RequirementsMassachusetts mandates no preliminary training for in-home caregivers and no continuing education requirements. Professional caregivers generally have some training and accreditation from a private entity, but no state-level requirements are in place.
Medicaid CoverageThe Home and Community Based Services Waiver (HCBS) assists Massachusetts seniors with many of the costs associated with in-home care. To participate, seniors must meet Medicaid eligibility criteria and have a medical need that would otherwise qualify them for placement in a residential care setting.
Reporting AbuseAll home care agencies in Massachusetts, regardless of licensing and scope, are mandated to report incidents of suspected elder abuse and other serious reporting events (SREs) to the state Department of Public Health. The department can be reached by calling (800) 462-5540. For suspected abuse of a senior aged 60 and over that takes place outside of a care setting, reports can be submitted by phone to the state Elder Protective Services division at (800) 922-2275.

Frequently Asked Questions

How much does in-home care cost in Massachusetts?

In-home care costs an average of $5,186 a month for seniors in Massachusetts. This is close to the cost of similar care in several nearby states, but it is somewhat more than the average price seniors pay nationwide. The cost of in-home care in the commonwealth is competitive with other forms of senior care in the state.

Does MassHealth pay for in-home care?

MassHealth, the state Medicaid program in Massachusetts, does not pay for in-home care directly. A set of Medicaid waivers are available to beneficiaries to help pay for home care and associated expenses. Less direct assistance is available through MassHealth as a health insurance provider, such as the cost of outpatient care and prescription medications, but the program does not pay for in-home services.

Are there financial assistance programs for in-home care in Massachusetts?

Seniors and their loved ones have several options to help pay the costs associated with in-home care in Massachusetts. In addition to the MassHealth waivers and other government support, several nonprofits operate in the commonwealth to provide health services, transportation assistance and nutritional support for independent seniors on fixed incomes

Does Medicare pay for in-home care?

Medicare does not pay for all in-home care, but several services are covered under Original Medicare Parts A and B. Medicare Advantage plans also pay for such in-home services as visiting nursing care, social services and physical, occupational and speech therapy. Medicare does not pay for caregiver services, homemaker assistance or other nonmedical forms of support for seniors.

What are “activities of daily living”?

The term “activities of daily living” refers to a set of tasks caregivers can assist seniors with at home. These are typically the common personal chores of bathing, dressing and preparing meals. The term can also be used to cover some routine activities outside of the home, such as shopping for groceries.

Home Care Services in Massachusetts (516)