Paying for care is one of the biggest worries families bring to us. The good news is that there are more options than many people realize. Here's an overview of the main ways Massachusetts families pay for in-home care.
1. Private pay
Most families pay for non-medical home care out of pocket, using savings, retirement income, or help from family members. Private pay gives you the most flexibility over schedule, hours, and caregiver. To understand what drives the price, read what home care costs in Massachusetts.
2. Long-term care insurance
Many long-term care insurance policies cover in-home care. Common things to check:
- Benefit trigger. Many policies start paying when a licensed health professional certifies that the person needs help with at least two activities of daily living, such as bathing, dressing, eating, toileting, continence, or transferring, or has a severe cognitive impairment.
- Elimination period. This is a waiting period, often 30 to 90 days, before benefits begin.
- Daily or monthly limit and the total lifetime benefit.
- Paperwork. Most insurers need a plan of care and regular invoices.
Call the insurance company, ask for the home care benefit details in writing, and start the claim early.
3. MassHealth programs
MassHealth, Massachusetts' Medicaid program, offers several programs that can help eligible residents get support at home. Eligibility depends on age, income, assets, and care needs.
- Personal Care Attendant (PCA) Program. For MassHealth members with a permanent or chronic disability who need physical help with at least two activities of daily living. The member, or a surrogate, hires and directs their own PCA.
- Frail Elder Waiver (FEW). For people 60 and older who meet nursing-facility level of care but can live safely at home with support.
- Adult Foster Care (AFC). Supports a person living with a caregiver, who may be a family member, in a home setting.
- Senior Care Options (SCO) and PACE. Managed care programs that coordinate medical care and support services for eligible older adults.
Rules are specific and change over time. Contact MassHealth, MassOptions, or an elder law attorney to confirm what your loved one qualifies for.
4. State Home Care Program through your local ASAP
Massachusetts funds a Home Care Program for residents 60 and older, and for younger adults with Alzheimer's disease, who meet income and need guidelines. It's run through local Aging Services Access Points (ASAPs). For Lowell and much of the Merrimack Valley, the local ASAP is Elder Services of the Merrimack Valley and North Shore. They can also tell you about caregiver support programs.
5. Veterans' benefits
- Aid and Attendance and Housebound allowances are added to a VA pension for eligible wartime veterans and surviving spouses who need help with daily activities or are largely housebound. The money can be used toward home care.
- VA Homemaker and Home Health Aide care and Veteran-Directed Care are available through the VA health care system for enrolled veterans who qualify.
Start with the VA at va.gov, or ask a Veterans Service Officer (VSO). Every Massachusetts city and town has one, and their help is free.
6. Medicare (limited)
Medicare covers short-term skilled home health care in specific situations, but generally not ongoing personal care or supervision. See Does Medicare pay for home care?
How Ardno can help
Ardno works with private-pay families and with families using long-term care insurance, MassHealth programs, and veterans' benefits. Every benefit has its own rules, so call us and we'll talk through how your loved one's coverage applies, and what paperwork you'll need, before care starts.
Call (978) 479-0499 or request a free consultation.
This guide is general information, not legal or financial advice. Program rules change. Confirm details with the program or a qualified advisor.