The 10 Best In-Home Care Services for Seniors in Boston, MA for 2023

Boston, Massachusetts, is one of the top 10 retiree-friendly cities in the nation, according to Caring’s 2022 Senior Living report. It boasts low health care costs to two nationally-ranked health care facilities for geriatrics, Brigham and Women’s Hospital and Massachusetts General Hospital. An extensive public transportation system makes it easy for seniors to get around, and the city is regarded as one of the most “walkable” in the country.

According to Genworth Financial’s 2021 Cost of Care Survey, Boston residents pay an average of $6,292 per month for non-medical home care services. Home health care, which includes light medical services such as medication management or wound care, costs slightly less at $6,244.

Below we’ve compiled a comprehensive directory of every home care provider in Boston– complete with services offered and reviews from families who’ve actually used the service. In addition to our in-depth provider listings, we’ve compiled resources to help seniors and their families to access all the tools they need to age in place safely and gracefully.

The average monthly cost of home care in Boston is $6,292, nearly $400 higher than the state average and $1,335 higher than the national average. Around 40 miles west of the state capital in Worcester, the average cost is approximately 9% lower. Farther west in Springfield, home care is significantly more affordable, representing an average saving of just over $950 per month. Barnstable Town in Massachusetts’ southeast corner is the only city in the state where the average monthly home care cost is more expensive, around 6% higher than the Boston average.

Non-medical in-home care in Boston costs $6,292 per month on average, while in-home health care, which can include certain skilled nursing services and rehabilitation therapies, is around $50 less. Average monthly assisted living facility fees are about $525 higher, and full-time nursing home care is significantly more expensive — over double the cost at $13,155. For some seniors, adult day care, offered outside the home during weekday business hours only, can represent an affordable alternative; prices average less than 26% of the typical cost of home care in the city.

Given the high cost of in-home care, many people use one or more forms of financial assistance to cover the expenses. Below, we explain some of the most common sources of financial help for paying for in-home care. If none of these options are available to you, you can reach out to your Area Agency on Aging or Aging and Disability Resource Center to learn about local resources.

• Long-Term Care Insurance: Long-term care insurance covers expenses related to senior care, including in-home care. Depending on the policy type, beneficiaries may receive a cash payment to use towards long-term care or reimbursement for qualifying long-term care expenses. Note that there are limitations- typically a maximum benefit of $150 per day- and exact coverage terms vary depending on the exact policy, so always check the details.
• Medicare: Medicare does not cover in-home care because it is classified as custodial, or non-medical, care. However, some Medicare Advantage and Medicare Supplement plans, which offer expanded benefits, may cover in-home custodial care.
• Medicaid: Medicaid coverage of in-home care varies between different states because it is not a federally mandated benefit. Currently, all states cover some in-home care either through their standard Medicaid or a waiver program. The specific coverage rules are set individually by each state.
• Veterans’ Benefits: The Aid and Attendance benefit is a monthly cash payment that beneficiaries can use to pay for senior care, including in-home care services. To qualify for A&A, Veterans must already receive the VA pension and meet several additional requirements, including needing assistance with the activities of daily living. Contact the Department of Veterans Affairs to learn more.
• Reverse Mortgages: Home Equity Conversion Mortgages (HECMs) are federally insured loans that are available to homeowners age 62 and over. Reverse mortgages allow you to access a portion of your home’s equity in cash, tax free. Many seniors use reverse mortgages to finance their care expenses, including in-home care. Note that although there are no monthly payments due on reverse mortgage loans, borrowers do have to repay the loan once the last surviving homeowner passes away, moves, or sells the home.