How to Pay for In-Home Care
How to Pay for Home Care in Massachusetts
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
This directory lists Massachusetts-specific and federal payment sources that can pay for, reimburse, offset, or help plan for home care. Some are direct payment sources; others are indirect supports that reduce the amount of private home care a family must buy. Massachusetts's strongest state-specific pathways include the state Home Care Program, MassHealth PCA, Adult Foster Care, the Frail Elder Waiver, Senior Care Options, One Care, and PACE, and VA benefits are broken out because they can be one of the strongest payment pathways for eligible Massachusetts veterans and surviving spouses.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Private Pay
Personal income, savings, investments and retirement funds
Direct paymentHelps pay for: Any lawful home-care expense: agency care, private caregivers, respite, transportation, companion care and household help.
Who qualifies: No program eligibility; limited by available household resources.
How to start: Compare written quotes using the same duties, schedule and minimum-shift assumptions.
Good to know: Most flexible option. CareScout reports a 2025 Massachusetts median of $91,520/year for non-medical in-home care based on 44 hours/week.
Family contributions or pooled family care fund
Direct paymentHelps pay for: Caregiver hours, respite, meals, transportation, supplies and other agreed care costs.
Who qualifies: Family agreement.
How to start: Create a written contribution plan and document payments.
Good to know: Can spread costs across adult children or other relatives while keeping spending transparent.
Direct-hire household caregiver
Direct paymentHelps pay for: Personal care, companionship, meal preparation, errands, supervision and other agreed duties.
Who qualifies: No public-benefit eligibility; tax and employment rules may apply.
How to start: Use a written employment agreement, timesheets and compliant payroll.
Good to know: A directly hired caregiver may be a household employee under federal rules.
Written family caregiver / personal-care agreement
Direct paymentHelps pay for: Reasonable compensation to a relative providing documented care.
Who qualifies: Care recipient has funds; arrangement complies with tax, employment and Medicaid rules.
How to start: Have an elder-law attorney review the agreement before payments begin if MassHealth may later be needed.
Good to know: Good documentation helps distinguish legitimate caregiver compensation from gifts or transfers.
Insurance / Planning
Traditional long-term care insurance
Direct payer / reimbursementHelps pay for: Home care, personal care, respite, adult day and other covered LTC services according to the policy.
Who qualifies: Policyholder must satisfy benefit trigger, elimination period, provider rules and limits.
How to start: Request the full policy and open a claim when qualifying care begins.
Good to know: Massachusetts regulates LTC policies; compare covered settings, home-health benefits, inflation protection and exclusions.
MassHealth-qualified long-term care insurance policy
Direct payer + planning protectionHelps pay for: Pays covered LTC benefits; certain qualifying policies may provide MassHealth eligibility/estate-recovery protections if requirements are met.
Who qualifies: Policy must satisfy Massachusetts qualification rules at the relevant time; MassHealth rules still apply.
How to start: Confirm qualification with insurer and obtain independent legal/financial advice.
Good to know: A standard LTC policy is not automatically MassHealth-qualified. Rules can change.
Hybrid life/LTC policy or chronic-illness rider
Direct/indirect payerHelps pay for: May reimburse or advance funds for qualifying long-term care or chronic-illness expenses.
Who qualifies: Depends on policy terms, health status and benefit trigger.
How to start: Request an in-force illustration showing the effect on cash value and death benefit.
Good to know: Using living benefits may reduce what is ultimately paid to beneficiaries.
Life insurance cash value, policy loan or accelerated death benefit
Cash-flow sourceHelps pay for: Can create cash that may be used for home care.
Who qualifies: Depends on policy type and contract terms.
How to start: Consult insurer plus tax/legal adviser before borrowing, surrendering or accelerating benefits.
Good to know: May affect taxes, Medicaid eligibility and the death benefit.
Home Equity / Assets
Reverse mortgage / HECM
Cash-flow sourceHelps pay for: Loan proceeds can be used for home care and related living costs.
Who qualifies: Generally homeowners age 62+ meeting HECM property, equity and financial requirements.
How to start: Complete HUD-approved counseling and compare lenders.
Good to know: Borrower must continue taxes, insurance, occupancy and property obligations; equity declines as the balance grows.
HELOC, home-equity loan, sale, downsizing or rental income
Cash-flow sourceHelps pay for: Private home care and other living costs.
Who qualifies: Depends on home equity, credit, housing needs and lender requirements.
How to start: Compare financing costs and long-term housing consequences.
Good to know: Debt secured by the home creates repayment risk; selling/transferring property can affect MassHealth planning.
Income Supports
Social Security, pensions and retirement withdrawals
Cash-flow sourceHelps pay for: Any privately purchased home-care expense.
Who qualifies: Depends on benefit entitlement and available household income.
How to start: Build a monthly care budget and preserve an emergency reserve.
Good to know: These are income sources, not separate home-care benefits.
Tax / Savings
HSA, federal medical-expense deduction and dependent-care credit
Indirect cost reductionHelps pay for: Qualified medical/LTC expenses and, in some cases, care that enables a taxpayer to work.
Who qualifies: Federal definitions, care-plan rules and documentation requirements apply.
How to start: Keep care plans, invoices, timesheets and proof of payment; consult a tax professional.
Good to know: Ordinary companionship/housekeeping do not automatically qualify; do not double-count an expense.
Massachusetts Senior Circuit Breaker Tax Credit
Indirect cost reductionHelps pay for: Refundable state tax credit can free household cash for care.
Who qualifies: Age 65+ plus Massachusetts residency, income, housing and property/rent tests.
How to start: File Schedule CB with the Massachusetts income-tax return.
Good to know: For tax year 2025 the maximum credit is $2,820; future limits change with annual rules.
Massachusetts age 65+ personal exemption
Indirect cost reductionHelps pay for: State income-tax exemption can modestly reduce taxes and preserve funds for care.
Who qualifies: Taxpayer age 65+ by year-end; state tax rules apply.
How to start: Claim on Massachusetts personal income-tax return.
Good to know: Small benefit, but useful alongside other cost offsets.
Medicare
Original Medicare home health
Direct medical payerHelps pay for: Intermittent skilled nursing, qualifying therapy, medical social work, supplies and limited home-health aide care tied to skilled services.
Who qualifies: Must meet Medicare home-health requirements, including need for skilled care and homebound status.
How to start: Ask the treating clinician to certify need and use a Medicare-certified home health agency.
Good to know: Does not provide indefinite custodial bathing, dressing, meal prep or supervision when those are the only needs.
Medicare Advantage supplemental in-home benefits
Plan-specific direct/indirect benefitHelps pay for: Some plans offer limited supplemental in-home support, meals, transportation or caregiver-related benefits.
Who qualifies: Must be enrolled in a plan offering the benefit and meet plan criteria.
How to start: Check the current Evidence of Coverage and obtain plan confirmation.
Good to know: Benefits vary by plan, county and year; do not assume “in-home support” means ongoing private-duty care.
Medicare caregiver training
Direct medical payer / cost reductionHelps pay for: Training for caregivers when needed to carry out the patient’s treatment plan.
Who qualifies: Medicare Part B coverage rules and clinician determination apply.
How to start: Ask the treating clinician whether covered caregiver training is appropriate.
Good to know: Does not pay caregiver wages, but can make family care safer and more sustainable.
GUIDE dementia-care model
Care coordination + respiteHelps pay for: Dementia care navigation, 24/7 support, caregiver training and limited qualifying respite through participating organizations.
Who qualifies: Generally Original Medicare A/B, dementia diagnosis and other CMS eligibility rules; not Medicare Advantage/PACE.
How to start: Find a participating GUIDE organization serving the patient’s ZIP code.
Good to know: Respite is capped under GUIDE rules and is arranged by the participating organization, not paid as unrestricted cash.
Medicare hospice benefit
Direct medical payer + respiteHelps pay for: Nursing, hospice aides, symptom-management drugs/equipment and short-term inpatient respite for qualifying terminal illness.
Who qualifies: Must meet hospice eligibility and elect the hospice benefit.
How to start: Ask a Medicare-certified hospice for an evaluation.
Good to know: Hospice is not a general 24/7 custodial caregiver benefit.
Durable medical equipment and home-safety medical equipment
Indirect cost reductionHelps pay for: Covered DME can reduce out-of-pocket costs for medically necessary equipment used at home.
Who qualifies: Medicare medical-necessity and supplier rules apply.
How to start: Use Medicare-enrolled suppliers and required clinician orders.
Good to know: Can reduce paid-care needs when equipment improves safe mobility/transfers.
MassHealth / Medicaid
MassHealth Standard
Direct medical/LTSS payerHelps pay for: Broad coverage including home health, PCA, long-term-care services, adult day health and adult foster care, subject to program rules.
Who qualifies: Massachusetts residency plus financial/categorical eligibility.
How to start: Apply through MassHealth using the seniors/LTC application when appropriate.
Good to know: Often the gateway to the state’s most significant home-care benefits.
MassHealth Personal Care Attendant (PCA) Program
Direct self-directed personal-care fundingHelps pay for: Funds approved PCA hours for help with ADLs/IADLs such as bathing, dressing, toileting, transfers, meal prep, shopping and housekeeping.
Who qualifies: MassHealth member with chronic/permanent disability, clinical need and ability to manage PCA services or use a surrogate/proxy.
How to start: Contact a Personal Care Management agency or MassHealth.
Good to know: Consumer-employer recruits, hires, trains and schedules PCAs; strong option for self-direction.
PCA family/trusted-worker option
Paid caregiver pathwayHelps pay for: An approved PCA can be a person chosen by the consumer, subject to program worker rules.
Who qualifies: PCA consumer must have approved hours and worker must meet program requirements.
How to start: Use PCM agency/fiscal intermediary process; confirm whether the proposed relative is permitted.
Good to know: A major route for directing Medicaid-funded care to a trusted worker.
PCA Complex Care differential
Caregiver workforce supportHelps pay for: Adds a higher pay differential for approved complex-care PCA tasks, helping sustain higher-need in-home care.
Who qualifies: Member must have approved complex-care tasks in the PCA assessment and required clinical documentation.
How to start: Work through PCP and PCM agency.
Good to know: Beginning Jan. 1, 2026, approved complex-care PCA work receives a $3.25/hour differential.
Adult Foster Care (AFC)
Direct personal-care funding + paid live-in caregiverHelps pay for: Daily personal care from a live-in caregiver plus nursing oversight and care management.
Who qualifies: MassHealth Standard/CommonHealth or qualifying integrated plan; clinical need for assistance/cueing with at least one ADL.
How to start: Contact an enrolled AFC provider or MassHealth.
Good to know: Caregiver may be related or unrelated but not the member’s spouse or legal guardian; caregiver and member live together.
Group Adult Foster Care (GAFC)
Direct personal-care fundingHelps pay for: Daily personal-care assistance from agency-employed direct-care workers, with nursing oversight/care management in qualifying home settings.
Who qualifies: Age 22+; MassHealth Standard/CommonHealth; need assistance/cueing with at least one ADL.
How to start: Contact a GAFC provider or MassHealth.
Good to know: Useful for residents of qualifying supported housing/community settings.
MassHealth Home Health
Direct medical payerHelps pay for: Home health agency services such as nursing, therapy and home health aide services when covered.
Who qualifies: MassHealth eligibility, medical necessity and provider requirements apply.
How to start: Ask clinician/plan and use enrolled home health providers.
Good to know: Can complement PCA or state Home Care services when skilled needs are present.
Adult Day Health
Direct LTSS payer / cost reductionHelps pay for: Structured daytime nursing/health oversight, ADL help, meals, activities and transportation when covered.
Who qualifies: MassHealth and medical-necessity/program rules apply.
How to start: Ask MassHealth, integrated plan or local provider.
Good to know: Can reduce the number of paid in-home hours needed on program days.
Frail Elder Waiver (FEW)
Direct HCBS payerHelps pay for: Personal care, homemaker, home health aide, respite, meals, transportation, PERS, home modifications, dementia coaching and other waiver supports.
Who qualifies: Generally age 60-64 with disability or 65+; nursing-facility level of care; MassHealth financial/clinical eligibility; safe community living.
How to start: Contact local ASAP for clinical assessment; MassHealth determines financial eligibility.
Good to know: One of Massachusetts’ strongest ways to fund ongoing home/community support for older adults who otherwise need facility-level care.
Moving Forward Plan Community Living (MFP-CL) Waiver
Direct HCBS payerHelps pay for: Personal care, homemaker, home health aide, respite, meals, skilled nursing, home modifications, transportation and other supports.
Who qualifies: Generally disabled adult or age 65+, currently in qualifying facility at least 90 days, MassHealth financial/clinical eligibility.
How to start: Apply through the MFP Waiver Unit.
Good to know: Designed specifically to help people leave nursing/rehab/psychiatric facilities and return to community living.
Acquired Brain Injury Non-Residential (ABI-N) Waiver
Direct HCBS payerHelps pay for: Community supports that can include personal assistance, habilitation, therapy, equipment and transition services.
Who qualifies: Qualifying acquired brain injury and institutional-transition criteria; MassHealth rules apply.
How to start: Contact MassAbility/waiver program.
Good to know: Important pathway for adults with acquired brain injury moving out of institutional settings.
Traumatic Brain Injury (TBI) Waiver
Direct HCBS payerHelps pay for: Home/community supports for eligible adults with traumatic brain injury.
Who qualifies: Age 18+ with qualifying TBI, clinical need and MassHealth financial eligibility.
How to start: Contact MassAbility waiver program.
Good to know: May support community living when ordinary home-care programs are insufficient.
DDS adult HCBS waivers
Direct HCBS payerHelps pay for: Home/community supports for qualifying adults with intellectual disabilities through Adult Supports, Community Living or Intensive Supports waivers.
Who qualifies: Adult with qualifying intellectual disability and waiver eligibility.
How to start: Contact Massachusetts Department of Developmental Services.
Good to know: Relevant to adults aging with lifelong intellectual/developmental disabilities.
Integrated Care
Senior Care Options (SCO)
Integrated Medicare + MassHealth payerHelps pay for: One plan coordinates Medicare/MassHealth and can cover home care, GAFC, home health, LTSS, transportation and other benefits.
Who qualifies: Beginning Jan. 1, 2026: generally age 65+, Medicare Parts A/B, Part D eligibility and MassHealth Standard; plan service area rules apply.
How to start: Contact MassHealth or a participating SCO plan.
Good to know: Can simplify care coordination and reduce out-of-pocket costs for eligible dual-eligible seniors.
One Care
Integrated Medicare + MassHealth payerHelps pay for: For eligible adults 21-64 with disabilities; combines Medicare/MassHealth and can cover home health, AFC/GAFC, adult day and other LTSS.
Who qualifies: Age 21-64, disability, Medicare A/B, Part D eligibility, MassHealth Standard/CommonHealth and other rules.
How to start: Contact MassHealth or a participating One Care plan.
Good to know: Especially relevant to younger adults with disabilities who need long-term support at home.
PACE (Program of All-Inclusive Care for the Elderly)
Integrated direct payerHelps pay for: Comprehensive medical and supportive care determined by interdisciplinary team, including home/community services needed to remain safely in the community.
Who qualifies: Age 55+ (55-64 generally requires disability determination), nursing-home level of care, service-area residency and ability to live safely in community.
How to start: Contact a Massachusetts PACE organization serving the ZIP code.
Good to know: MassHealth may pay the PACE premium for financially eligible participants; Medicare-only/private-pay options may exist.
Massachusetts Aging Programs
Massachusetts Home Care Program
Direct subsidized home-care servicesHelps pay for: Care management plus homemaker, personal care, supportive home care aide, home health, respite and other in-home/community services based on assessed need.
Who qualifies: Generally Massachusetts resident living at home; age/functional criteria apply.
How to start: Contact MassOptions or local ASAP for assessment.
Good to know: State-funded option can be less expensive than private pay and has no minimum service plan.
Home Care Program income-based cost sharing
Subsidized direct careHelps pay for: Same Home Care Program services with monthly or percentage-based cost sharing according to income.
Who qualifies: Program age/residence/functional rules plus current income/cost-share schedule.
How to start: Apply through local ASAP; request current 2026 cost-share calculation.
Good to know: MassHealth members are financially eligible; current 2026 guidelines use a $2,982/month income reference and higher-income participants may pay 50%-100% of service cost.
Aging Services Access Points (ASAPs)
Navigation + subsidized service gatewayHelps pay for: Connects older adults to Home Care, FEW, nutrition, caregiver support, transportation, housing, safety and other services.
Who qualifies: Primarily adults 60+ and caregivers; program-specific rules vary.
How to start: Use state ASAP locator or MassOptions.
Good to know: Massachusetts currently contracts with 23 ASAPs.
Family Caregiver Support Program
Respite + caregiver cost reductionHelps pay for: Free caregiver information, counseling, training, support groups, care planning and respite access.
Who qualifies: Unpaid caregiver age 18+ caring for adult 60+ or person of any age with Alzheimer’s/related dementia; other caregiver categories also qualify.
How to start: Call MassOptions and request a Caregiver Specialist.
Good to know: Can reduce burnout and partially offset the need for privately purchased respite.
Senior Nutrition Program / home-delivered meals
Cost reductionHelps pay for: Home-delivered or community meals, nutrition screening and counseling.
Who qualifies: Generally age 60+; home-delivered meals have frailty/isolation/homebound eligibility considerations. No income limit to participate.
How to start: Call MassOptions or local ASAP.
Good to know: Reducing food-preparation needs can lower paid caregiver hours.
Options Counseling
Navigation / planningHelps pay for: Free counseling to compare home/community supports and long-term-care choices.
Who qualifies: Older adults, adults with disabilities, caregivers/families.
How to start: Access through MassOptions/ADRC network.
Good to know: Useful before committing to private pay, facility care or a waiver application.
Community Transition Liaison Program (CTLP)
Transition cost reduction / navigationHelps pay for: Helps nursing-facility residents age 22+ plan discharge and connect to community programs and supports.
Who qualifies: Nursing-facility resident age 22+ interested in community living; insurance type does not bar access.
How to start: Ask facility or Aging Services network about CTLP.
Good to know: Can help unlock MFP/other services before paying privately after discharge.
Prescription Advantage
Indirect cost reductionHelps pay for: State prescription-drug assistance that can reduce medication expenses and preserve funds for home care.
Who qualifies: Income/age/disability and drug-coverage rules apply.
How to start: Call MassOptions/Prescription Advantage or apply using current state materials.
Good to know: Not a home-care payer, but can materially reduce another recurring senior expense.
SHINE Medicare counseling
Navigation / cost reductionHelps pay for: Free Medicare counseling to find coverage, subsidy and prescription-cost savings.
Who qualifies: Medicare-eligible Massachusetts residents and caregivers.
How to start: Call MassOptions and request SHINE.
Good to know: Can help identify Medicare Savings Programs, Part D Extra Help and appropriate coverage.
MassOptions
Navigation gatewayHelps pay for: Connects residents to aging/disability services, ASAPs, caregiver support, FEW, PACE and other programs.
Who qualifies: Open to people seeking aging/disability resource information.
How to start: Call or use state referral resources.
Good to know: Best first call when unsure which Massachusetts program fits.
Massachusetts Disability Programs
MassAbility Home Care Program (ages 18-59)
Direct/subsidized in-home supportHelps pay for: In-home task assistance intended to help qualifying adults with disabilities avoid hospitalization/out-of-home placement.
Who qualifies: Generally age 18-59, disability affecting homemaking, financial/program criteria, qualifying living arrangement and not receiving duplicative Home Care services.
How to start: Contact MassAbility Connect.
Good to know: Important non-elder pathway for adults under 60 with disabilities.
Household Cost Offset
SNAP Senior Assistance
Indirect cost reductionHelps pay for: Food benefits can preserve cash for caregiver expenses.
Who qualifies: SNAP financial/household eligibility; senior-specific application assistance available.
How to start: Call DTA Senior Assistance Office or apply through DTA.
Good to know: Massachusetts has a senior assistance line specifically for SNAP-only older adults.
LIHEAP fuel assistance / utility discounts
Indirect cost reductionHelps pay for: Heating/utility assistance can free money for home care.
Who qualifies: Income and program rules apply.
How to start: Apply through local fuel-assistance agency.
Good to know: Some public-benefit recipients may also qualify for utility discount rates.
Veterans
VA Homemaker and Home Health Aide Care
Direct personal-care supportHelps pay for: VA-authorized assistance with ADLs and household tasks from trained community aides.
Who qualifies: VA health-care eligibility/enrollment, clinical need, local availability and authorization.
How to start: Ask VA primary care/social work/geriatrics team for assessment.
Good to know: Hours are based on assessed need; not automatically full-time.
VA Skilled Home Health Care
Direct medical payerHelps pay for: Skilled nursing, case management, physical/occupational/speech therapy, wound care and other approved home-health services.
Who qualifies: Eligible veteran with clinical need and VA authorization.
How to start: Request through VA care team.
Good to know: May be combined with other VA home/community services.
Veteran-Directed Care
Self-directed care budgetHelps pay for: Approved service budget can allow veteran/representative to recruit, hire and supervise workers, potentially including family/friends subject to local program rules.
Who qualifies: Eligible enrolled veteran with qualifying personal-care need; availability varies by VA medical center/community.
How to start: Ask VA social worker or geriatric care team.
Good to know: One of the most flexible VA routes for personal-care support at home.
VA Respite Care
Direct respite benefitHelps pay for: Temporary relief for family caregivers in the home, adult day setting or short nursing-home stay.
Who qualifies: VA clinical eligibility and authorization; availability and copays may vary.
How to start: Ask VA social worker/caregiver support team.
Good to know: Can reduce privately purchased respite needs.
VA Home-Based Primary Care
Direct medical payer / care coordinationHelps pay for: Interdisciplinary primary care delivered in the home for veterans with complex chronic conditions who have difficulty using clinic-based care.
Who qualifies: Clinical eligibility, enrollment and local VA program availability.
How to start: Request assessment through VA primary care/social work.
Good to know: Does not replace custodial home care but can reduce travel and medical-care burden.
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Caregiver stipend/supportHelps pay for: For eligible veteran-caregiver dyads, may provide monthly stipend, training, counseling, CHAMPVA in some cases and respite.
Who qualifies: VA disability/personal-care and caregiver eligibility rules; formal application and assessment.
How to start: Apply through VA Caregiver Support Program.
Good to know: Potential direct support for the primary family caregiver.
VA Aid & Attendance / Housebound pension increase
Cash benefitHelps pay for: Additional VA pension income can be used toward home care or other living expenses.
Who qualifies: Must first meet VA pension and Aid & Attendance/Housebound eligibility rules.
How to start: Apply through VA or accredited representative/VSO.
Good to know: Not a direct home-care service; it is additional monthly pension income.
VA Community Care Network (CCN) — Massachusetts Region 1
Authorized community-care payerHelps pay for: VA can purchase authorized community services, including eligible home health and other covered care, from network providers.
Who qualifies: VA healthcare eligibility plus community-care criteria and referral/authorization.
How to start: Start with VA care team before scheduling routine community care.
Good to know: Massachusetts is in CCN Region 1; Optum administers Regions 1-3. Routine services generally require VA authorization.
2026 VA higher HCBS expenditure cap for certain complex conditions
Expanded benefit capacityHelps pay for: For eligible veterans with certain complex conditions, VA may fund qualifying in-home/community services up to 100% of comparable VA Community Living Center cost.
Who qualifies: Applies to specified complex conditions and eligible VA services; clinical rules/authorization apply.
How to start: Ask VA geriatrics/social work team whether the veteran qualifies.
Good to know: VA announced this increase in February 2026; can materially expand available home/community support for certain veterans.
Massachusetts Chapter 115 financial assistance
Cash / cost-offset benefitHelps pay for: Means-tested state veteran support for food, shelter, clothing, fuel, medical costs and other necessities, freeing household money for care.
Who qualifies: Eligible Massachusetts veteran/dependent facing financial hardship; income/assets and veteran-status rules apply.
How to start: Apply through local Veterans Service Officer (VSO).
Good to know: Every Massachusetts city/town has access to a VSO. Benefit is not restricted to home-care invoices but can strengthen the care budget.
Massachusetts disabled veteran / survivor annuity
Cash benefitHelps pay for: Annual cash payment can be used toward household or care costs.
Who qualifies: Certain 100% disabled veterans, Gold Star parents and unmarried surviving spouses, subject to state rules.
How to start: Apply through Massachusetts veterans services.
Good to know: As of Aug. 2025 the state annuity is $2,500 annually for qualifying recipients.
Where Massachusetts Families Can Start
Not sure where to begin? Match your situation to a contact below.
First call for aging/disability services; Home Care, ASAP, FEW, caregiver support, SHINE, PACE navigation
MassOptions
Medicaid/MassHealth, PCA, AFC/GAFC, waivers, SCO, One Care, PACE
MassHealth Customer Service
Home Care Program, FEW clinical assessment, nutrition, caregiver and local supports
Local ASAP
Home Care for qualifying adults 18-59 with disabilities
MassAbility Connect
Chapter 115 and state veteran financial benefits
Executive Office of Veterans Services
PCAFC, caregiver support, respite and local routing
VA Caregiver Support Line
Aid & Attendance / pension and federal veteran-benefit questions
VA Benefits
Long-term care insurance consumer questions
Massachusetts Division of Insurance
Before You Rely on Any Payment Source
Start with exact care needs
List ADLs/IADLs, dementia supervision, clinical tasks, hours and timing before comparing payment sources.
Call MassOptions early
MassOptions can route to the local ASAP, Home Care Program, FEW, caregiver support, SHINE and other state programs.
Do not overlook the state Home Care Program
Massachusetts offers subsidized home-care services with income-based cost sharing and no minimum service plan.
Screen for FEW if nursing-home level care is approaching
The Frail Elder Waiver can fund a broad mix of personal care, homemaker, respite, meals, transportation, technology and safety supports.
Ask about PCA for self-direction
MassHealth PCA gives the consumer significant control over recruiting and scheduling workers.
Consider AFC when a live-in caregiver is already present
Adult Foster Care may support a related or unrelated live-in caregiver, but spouses/legal guardians are excluded as AFC caregivers.
Use SCO/PACE as integrated-care choices
These programs can coordinate medical care and LTSS, but joining changes how services are delivered and network rules apply.
Medicare is mainly skilled/medical
Original Medicare home health does not provide indefinite custodial bathing, dressing, meals or supervision when those are the only needs.
GUIDE is dementia-specific
GUIDE can add care navigation, caregiver training and limited respite for qualifying Original Medicare participants.
VA authorization matters
Massachusetts is VA CCN Region 1, administered by Optum. Routine community care generally needs VA authorization before service.
Use Chapter 115 as a household-budget tool
Eligible Massachusetts veterans may receive state financial help for necessities, preserving income for care.
Do not transfer assets casually
MassHealth eligibility, spousal rules and estate recovery can make gifting or moving assets costly; get qualified elder-law advice.
Document family-caregiver payments
Written agreements, timesheets and reasonable compensation can reduce tax, family and Medicaid disputes.
Use cost offsets strategically
SNAP, fuel assistance, Prescription Advantage and tax credits do not pay caregivers directly but can preserve cash for care.
Recheck current rules
Income limits, cost-share schedules, plan contracts, PACE/GUIDE service areas and VA availability change. Verify before committing.
Program rules, income limits, and availability change over time and can vary by county. Confirm current details with the program directly, or ask a home care provider in Massachusetts to help you navigate the application process.
← Back to How to Pay for In-Home CareHome Care Providers in Massachusetts
These providers serve families in Massachusetts and can help you apply what you've learned above to your specific situation.
At Your Service HomeCare
Serving Massachusetts
At Your Service HomeCare provides home care services in Framingham, MA and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Acton, Arlington, Ashland and surrounding areas
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CARE Resolutions
Serving Massachusetts
CARE Resolutions provides home care services in Sherborn, MA and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Boston, Dover, Framingham and surrounding areas
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Family Pride Private Home Care – North Attleborough, MA
Serving Massachusetts
Family Pride Private Home Care provides home care services in North Attleborough, MA and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
North Attleborough, Attleboro, Wrentham and surrounding areas
View Provider Profile →