Does MassHealth Provide Home Care for Seniors?

POSTED ON: October 25, 2022

home health care for seniors

Yes, MassHealth does provide home care for seniors in Massachusetts. MassHealth (Massachusetts Medicaid) offers several programs specifically designed to help seniors receive home health care for seniors instead of moving to a nursing home or assisted living facility.

At a glance – MassHealth home care programs:

– Personal Care Attendant (PCA)
– For seniors needing help with daily activities
– Massachusetts Community Choices
– Comprehensive at-home services for MassHealth Standard members
– PACE & Senior Care Options (SCO)
– Combined Medicare/MassHealth home health programs
– Frail Elder Waiver (FEW)
– For seniors at risk of nursing home placement
The Heritage Law Center helps Massachusetts seniors and families navigate MassHealth eligibility and home care program applications. Read on for details about each program.

Seniors want to age at home, according to the American Advisors Group’s Importance of Home Survey, which was done in June 2021. 90% of seniors said they want to live their later years in their current home instead of moving to an assisted living facility. More than four in five seniors said they feel safer at home than anywhere else. 50% of seniors said the COVID-19 pandemic encouraged them to want to stay at home in what they consider a safe place. With that in mind, let’s talk about MassHealth home care for seniors.

To qualify for these services, the senior must meet specific medical and financial criteria.

MassHealth for Seniors: Who Qualifies?

To receive MassHealth home care for seniors, your loved one must generally meet these requirements:

Medical Criteria:
– Need assistance with two or more activities of daily living
– Be at risk of nursing home placement (for some programs)
– Have a documented disability or chronic condition

Financial Criteria (2026):
– Assets: Generally under $2,000 for individuals
– Income: Must meet MassHealth Standard income limits
– Primary residence is typically excluded from asset calculations

Does MassHealth cover assisted living?
Not directly. MassHealth does not pay for assisted living facility costs, but it may cover some health services within an assisted living setting through specific programs.

Does MassHealth pay for home health aides?
Yes, through the PCA program, Community Choices, PACE, SCO, and FEW programs described below.

The Heritage Law Center guides seniors through MassHealth eligibility to maximize benefits.

MassHealth Personal Care Attendant (PCA) Program

This program pays for a specified number of hours of personal care services at home each month for a person who has a disability or chronic condition and needs help with two or more activities of daily living: mobility, taking medications, bathing and grooming, dressing, passive range-of-motion exercises, eating, and toileting. You can hire a PCA of your choosing or get help to find one.

Massachusetts Community Choices

This program is designed for MassHealth Standard enrollees who are 60 or older and eligible to be in a nursing home. It helps with a variety of at-home services, such as skilled services, home health aides, housekeeping, laundry, meal preparation, and transportation to and from doctors’ appointments. It can also provide a place to go for care and companionship during the day (adult day health). Choices services must be provided through agencies that have contracted with MassHealth, meaning you don’t have the flexibility to hire your own workers.

The Program for All-Inclusive Care for the Elderly (PACE) and Senior Care Options (SCO)

PACE and Senior Care Options are programs under which Medicare and MassHealth combine to pay health care providers a fixed monthly amount to provide all the care needs of participating seniors.

PACE is for individuals over age 55 living with disabilities who otherwise would need nursing home care. It provides a wide range of medical, social, recreational, and wellness services to eligible participants, including home health care and in-home services.

SCO is for people 65 years of age and older. It’s a comprehensive health plan that covers all of the services normally paid for by Medicare and MassHealth. Members get their services through a senior care organization and its network of providers. The services include certified home health aides and homemakers, plus other in-home care.

Because the PACE and SCO programs use a team approach of staff physicians, nurses, and therapists, patients must give up their own doctors. These programs may use adult day health centers rather than provide home care during the day. PACE and SCO programs aren’t available in all areas of Massachusetts.

Frail Elder Waiver Program (FEW)

FEW can provide home and community-based services (HCBS) for elderly Massachusetts residents (ages 60-64 who have a disability or are age 65 and older) who are at risk of being placed in a nursing home. Long-term services and support to be provided will be based on the needs of the elder. The program supports elders by providing services to assist with self-care and everyday tasks. They can include personal care services like housekeeping, laundry, grocery shopping, skilled nursing care, adult day programs, and more.

Massachusetts Home Care Program: How The Heritage Law Center Can Help

Navigating MassHealth home care programsis complex. Many seniors and families don’t know:
– Which senior care options MassHealth provides in their area
– How to apply without making costly mistakes
– Whether they qualify financially without proper planning
– How to protect assets while still qualifying

The Heritage Law Center provides comprehensive MassHealth planning and elder law services throughout Massachusetts, including Woburn, Essex County, Middlesex County, and New Hampshire.

We help with:
– MassHealth eligibility assessment
– Asset protection before applying
– Application guidance for PCA, FEW, PACE, and SCO programs
Estate planning to protect your family home

Contact The Heritage Law Center at (617) 299-6976 for a free consultation about MassHealth home care options.

An Elder Care Lawyer Can Help

Many of these MassHealth home care for seniors services have complicated eligibility and application procedures. As an experienced Massachusetts elder law attorney, I can guide you through this often-confusing area to ensure that you or your loved one can continue to live at home for as long as possible. If you’re interested in getting more information, please contact us today for your free, no-obligation consultation.