In-Home Care in Massachusetts

Approximately 17% of Massachusetts’s population comprises people aged 65 and above, and there are diverse reasons to retire in The Bay State. The cost of health care is lower than the national average, and there are more physicians per capita, with 306 physicians to 100,000 people compared with the U.S. average of 210. The state has several high-performing hospitals, including the nationally ranking Massachusetts General Hospital and Beth Israel Deaconess Medical Center. While overall costs of living are slightly higher than national figures, the lower-than-average sales tax can help Massachusetts retirees stretch their funds further.                

Older adults value the diverse choices for senior care in Massachusetts, including options for individuals to age at home, such as home health care and in-home care. Home health care is medical care provided by a nurse, rehabilitation therapist or other clinicians. In-home care is the provision of non-clinical care by an aide, including assistance with daily activities, housekeeping and companionship. The median monthly cost of home health care and in-home care in Massachusetts is $5,911.  

This guide compares the cost of in-home care around Massachusetts and with nearby states and covers funding options, such as Medicaid and Medicare. It also provides a list of low-cost resources to help elders age at home.

Per Genworth’s 2021 Cost of Care Survey, the average cost of in-home care in Massachusetts is $5,911 per month. This is approximately $950 more than the nationwide average of $4,957. Costs of in-home care typically run higher in Massachusetts than in most neighboring states. Seniors in Connecticut can expect to pay around $5,243 each month for in-home care. In New York, average rates increase slightly to $5,339. Vermont and Rhode Island share the same monthly median of $5,720. In-home care costs a little more in New Hampshire, where fees are around $6,006 per month.

Costs of in-home care vary throughout Massachusetts. At $5,339 per month, Springfield has the state’s lowest average rates. Pittsfield is the next most-affordable city for in-home care, with a monthly median of $5,625. Fees increase slightly to $5,720 in Worcester, while seniors in the state capital of Boston typically pay around $6,292 per month. On the coast, Barnstable Town has the highest median prices, with in-home care costing roughly $6,673 per month.

In Massachusetts, aging at home is generally more affordable than residential long-term care. While in-home care and home health care each cost around $5,911 per month, average monthly prices increase significantly to $12,623 for nursing home care. Assisted living runs around $6,500 per month, costing almost $600 more each month as compared to in-home care. Costing on average $1,587 per month, adult day health care is the most affordable care option for Massachusetts seniors.

Traditional Massachusetts Medicaid, known as MassHealth, provides funding for non-medical in-home care through the Adult Foster Care program. Live-in caregivers can move into the senior’s home or elderly citizens can move into the private home of another person.

The program applies to those who cannot live independently because of medical or mental issues.

Medicaid pays for an adult caregiver to live with a senior and provides around-the-clock assistance and supervision. Costs of accommodation and meals are not included. Services may include:

Caregivers may be friends or relatives, but a senior’s spouse cannot provide care under the program. Since up to three people may live in an adult foster care home, both spouses can apply for assistance, if eligible. An ineligible spouse cannot receive assistance while living with their eligible partner and designated caregiver.

To be eligible for Adult Foster Care (AFC), seniors must need practical hands-on help with daily activities or constant supervision. However, there is no functional requirement for nursing home level of care.

Seniors who do not qualify for Adult Foster Care may be eligible for help via Medicaid waiver programs.

Individuals may complete general MassHealth applications online through the Massachusetts Health Connector. However, people 65 or above and anyone applying for long-term care services must apply in person, by mail or by fax.

Seniors may apply in person at one of six MassHealth Enrollment Centers. MECs are located in Quincy, Charlestown, Chelsea, Springfield, Taunton and Tewksbury.

To apply by post, seniors should either download an application form or call (800) 497-4648 to request a form via post. Applications can be faxed to (617) 887-8799 or mailed to:

MassHealth Enrollment Center
P.O. Box 290794
Charlestown, MA 02129-0214

What Information You Will Need

Applicants must include detailed information on application forms and provide supporting evidence when claiming Medicaid. To make the application process easier, gather recent bank statements, pay stubs, tax returns, health insurance policies and assets. Claimants will need to provide their Social Security number and may be asked for proof of identity, residence and citizenship.  

In general, Medicare does not cover the cost of non-medical home care. That being said, there are situations in which Medicare provides some coverage for medical home care, referred to as “Home Healthcare.” There are several eligibility restrictions for coverage, including that individuals must be homebound and have a referral from their doctor specifically for home healthcare services.

Below is an overview of some of the skilled medical professionals whose in-home services are typically covered by Medicare – for more in-depth information, refer to our Guide to Home Healthcare.

• Physical Therapists: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), treat ongoing conditions such as arthritis, and assist in recovery from surgeries and procedures such as a knee or hip replacement.
• Visiting Nurses: Licensed nurses can provide a number of medical services for those who don’t need to stay in the hospital, but do need regular medical services such as wound care, changing feeding tubes, etc.
• Occupational Therapists: Occupational therapists help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, and other daily activities.
• Speech Therapists: Speech therapists help seniors who are struggling to adequately communicate due to a stroke, dementia, or any other cause regain the ability to functionally communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets, teaching special techniques to swallow safely, and retraining associated muscles.

As mentioned above, in-home care is distinctly different from home healthcare. But, there can be some overlap in services between the two types of care. So, while Medicare doesn’t cover non-medical in-home care, there are in-home care services that may be covered in special circumstances when they’re provided in conjunction with home healthcare (such as an occupational therapist helping with eating or dressing)

To find quality home care providers near you, simply input the zip code or city where you would like to start your search. We have an extensive directory of home care agencies all across the nation that includes in-depth information about each provider and hundreds of thousands of reviews from seniors and their loved ones.