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Assisted Living Massachusetts
Known for its rich history, a range of scenery and world-renowned healthcare, Massachusetts has a number of qualities that appeal to retirees. Seniors ages 65 and older account for 17%, nearly 1.2 million, of the state’s 7 million resident population. Though most of the state’s best healthcare, such as Massachusetts General Hospital and Tufts Medical Center, can be found in and around the Boston area, Massachusetts’ smaller square mileage means access is easier than in many larger states.
Ranked 3rd out of 50 overall in the 2024 Senior Living Report, Massachusetts has 105 primary care physicians to every 100,000 people, much higher than the U.S. average of 77. In fact, the state came in first out of all states in terms of health care, a resulting combination of access to physicians, an average satisfaction rate and better rates of preventable hospital admissions. And while assisted living costs are much more than the national average of $4,500, other aspects of senior health in Massachusetts, like their quality of life, came in strong with high rankings.
This guide provides a comprehensive overview of assisted living in Massachusetts and highlights ways families can help fund their care expenses. The guide also takes a closer look at how costs compare across the state as well as how different types of care compare. A listing of statewide agencies that can inform, support and advocate for families is given, and a summary of the various regulations to which assisted living facilities are held liable is also provided.
The Cost of Assisted Living in Massachusetts
When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in Massachusetts and its 61 cities.
The Cost of Assisted Living in Massachusetts's Top Cities
Massachusetts averages $5,599 a month for assisted living, but there's a wide variation among its cities. Worcester is one of the more expensive in the state, with an average cost of $5,950 a month, or $351 more than the state average. Springfield and Boston are less expensive, at $5,584 and $5,017, respectively. Quincy is one of Massachusetts' most affordable cities for assisted living, with an average of just $4,154.
Massachusetts
$5,599
Boston
$5,017
Quincy
$4,154
Springfield
$5,584
Worcester
$5,950
The Costs of Other Types of Senior Living
Assisted living may work well for some seniors, and the Massachusetts average cost of $5,599 fits some budgets, but there are other options as well. The close monitoring and therapy seniors get in memory care comes at a cost, which in Massachusetts averages $7,706 a month. Independent living is a less costly option, averaging $3,506 a month in the Bay State.
Assisted Living
$5,599
Memory Care
$7,706
Independent Living
$3,506
Does Medicaid Cover Assisted Living in Massachusetts?
In Massachusetts, Medicaid can be used to cover the costs of assisted living through three different programs: the Program of All-Inclusive Care for the Elderly (PACE), the Moving Forward Residential Supports Waiver and the Group Adult Foster Care Program. Each program has slightly different qualifications, but all cover a number of services that can be delivered in an assisted living residence.
What Assisted Living Services Are Covered By Medicaid in Massachusetts?
The above waiver programs provide eligible seniors with a number of benefits as outlined in their care plans. These include:
- Assistance with activities of daily living
- Occupational, physical or other therapies
- Medication assistance
- Transportation
In most cases, seniors plan their own services, and plans are overseen by a caseworker or other qualified health professional and revisited on an ongoing basis to ensure the services match the current need. For recipients who live at home, a number of additional services, such as home care, meals, and respite care may also be provided.
Assisted Living Waiver Programs in Massachusetts
Several programs exist to help cover care services in an assisted living residence. Recipients can get day-to-day help with their life activities like walking, dressing and eating, as well as medication management, therapies, medical attention and transportation.
| Program | Contact | Description |
|---|---|---|
| Moving Forward Plan Residential Supports Waiver | (855) 499-5109 | This home and community-based services waiver is for seniors who are already in a nursing facility, hospital or rehabilitation facility to move back into the community. In addition, individuals must be 65 or older, meet clinical and financial requirements, and be able to safely be served in the community. For the MFP-RS specifically, applicants must require the presence of support staff 24 hours a day. In addition to assisted living services, the MFP-RS waiver benefits include therapies, mobility services, specialized medical equipment, transportation and assistance transitioning from the clinical setting to the residential assisted living facility. |
| PACE | Varies by location | Available only in specific Massachusetts counties, PACE is administered by Massachusetts’ Medicaid program, MassHealth, and Medicare to give seniors a broad array of services and supports. Recipients do not need to be Medicaid-qualified, but their premiums can only be paid if they also meet Medicaid’s income and asset eligibility criteria. PACE recipients receive medical care, social services, therapies and transportation in an assisted living residential setting. |
| Group Adult Foster Care Program | Online | Available through Massachusetts’ regular Medicaid program, the Group Adult Foster Care Program provides care assistance in a group setting such as an assisted living residence. Recipients must need help with daily living activities such as grooming, dressing or bathing, and also receive help with laundry and cleaning. To qualify, seniors’ income must be equal to 100% of the Federal Poverty Level. Unlike other programs, the GAFCP requires that recipients not be in need of skilled nursing but rather assistance with daily living activities like being transferred from bed to a chair, personal hygiene and eating. |
How to Know If You’re Eligible for Medicaid in Massachusetts
In Massachusetts, Medicaid eligibility is determined through MassHealth, which pays for health care for the low-income or disabled. However, if interested seniors already qualify for Social Security Supplemental Income, the Social Security administration conducts the Medicaid screening.
General requirements include:
- Being 65 and older
- Being blind or disabled
- Meeting income and asset guidelines
As of 2023, single applicants must bring home no more than $32,904 a year in income and the same is true of single applicants in two-family households. In households where both spouses are applying, income limits increase to $65,808. Asset limits for individuals cap at $2,000, and $4,000 when both spouses are seeking coverage.
2022 Basic Medicaid Income Limits for Seniors in Massachusetts
*Depending on the facility setting, a recipient may not be able to keep income up to this level.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****Assets are limited to $2,000 per spouse
In addition to these income and asset limits, some additional guidelines must be met by those who receive PACE or the GAFCP. Assessments must show, to qualify for PACE, that the applicant requires a nursing level of care, and in the case of the GAFCP, that they need help with daily living activities instead. These daily living activities can include:
- Help with personal hygiene
- Assistance dressing and undressing
- Assistance moving from one location to another
- Help eating or drinking
In the case of the GAFCP and the MFP-RS, recipients must also currently reside in a group setting and a nursing home, hospital or rehabilitation facility.
How To Apply For Medicaid in Massachusetts
Applying for Medicaid in Massachusetts can be done online, at the MA Health Connector. Seniors who prefer completing a paper application can print and fill out the Massachusetts Application for Health and Dental Coverage and Help Paying Costs. Applications can also be submitted in person, at one of the state’s Enrollment Centers, or by calling the MassHealth Customer Service Center at (800) 841-2900 Monday through Friday between 8 a.m. and 5 p.m.
Information You Will Need
Before applying, the following documents should be gathered and ready:
- Proof of age
- Proof of Massachusetts state residency and citizenship
- Social Security number
- Policy numbers for any current health care
- Proof of all sources of income: tax returns, veterans’ benefits, retirement income, Social Security and any disability income
- Proof of all assets bought or sold within the past five years, including bank account, investments, trusts and properties
How to Get Help Applying for Medicaid
Massachusetts has several state programs to help seniors with Medicaid-related issues, including the application process and questions about benefits, claims and disputes. Individuals can use these resources to find information about filing a complaint or an appeal for a fair hearing and get one-on-one benefits counseling for free.
| Program | Contact | Services provided |
|---|---|---|
| My Ombudsman | (855) 781-9898 | Available to any MassHealth member currently enrolled in a MassHealth plan, My Ombudsman can help members with questions about their benefits or services, including long-term care benefits. Ombudsmen can explain the different types of benefits offered and help address problems. Although they cannot act as legal representation, they can help individuals file complaints. |
| Medicaid Fair Hearings | (800) 655-0338 | If Medicaid coverage is denied for a previously eligible service or Medicaid ended payments for a recurring service, individuals have the right to submit an appeal for a fair hearing. Decisions they feel weren’t made in their favor can then be disputed. |
| SHINE Program | (800) 243-4636 | SHINE provides free statewide health insurance counseling to seniors to help them understand the differences between the six kinds of MassHealth coverage needing long-term care services. Seniors can speak one-on-one with a counselor in-person or by phone to have their questions answered, and general eligibility guidelines can be obtained via the website. |
Does Medicare Cover Assisted Living in Massachusetts?
The short answer is that no, Medicare does not cover the cost of assisted living in Massachusetts. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.
For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Massachusetts.
Paying for Assisted Living Facilities in Massachusetts
Group Adult Foster Care, or GAFC, is a statewide program funded by MassHealth and pays for personal care services for eligible seniors and people with disabilities living in GAFC-approved housing. Some assisted living residences in Massachusetts accept payments from this program to help cover part of a resident's costs.
To be eligible, applicants must:
- Be 65 or older
- Have an income level of $1,012 or below
- Need assistance with at least one activity of daily living (such as dressing, bathing or eating) may apply for the program.
To learn more about eligibility requirements, detailed instructions about how to apply can be found at www.mass.gov. You can also visit any Massachusetts Area Agency on Aging for assistance with your application.
Other Financial Assistance Options for Assisted Living in Massachusetts
Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.
| Name | How To Apply | How It Works |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov | If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy. |
Free and Low-Cost Resources for Seniors in Massachusetts
There are many resources in Massachusetts that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Area Agencies on Aging | Massachusetts is home to many Area Agencies on Aging that provide supportive services to older adults. These agencies can help seniors get connected with local programs that assist them with daily needs, including caregiver support, transportation services, meal programs and health and wellness resources. AAAs also work to combat elder abuse and fraud and empower seniors to ensure a life of safety and dignity. |
Cash Assistance Programs
Cash assistance programs in Massachusetts provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Worcester State University Categorical Tuition Waiver | 508-929-8051 | Under Massachusetts law, adults 60 years of age and up may take classes at public universities without paying tuition. You may still need to pay campus and class fees, and not all classes are available under the waiver program. Contact a specific's college bursar's office for availability. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Massachusetts seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Meals on Wheels | Massachusetts Meals on Wheels supplies an estimated 30,000 meals per day to seniors across the state, either as a home-delivery service or as congregate meals served in the community. There are more than 20 agencies across the state that help to manage local and regional Meals on Wheels programs. Any senior struggling to prepare meals on their own may be eligible for these services. Costs are based on a sliding scale. | |
| Massachusetts Supplemental Nutrition Assistance Program (SNAP) | 877-382-2363 | The Department of Transitional Assistance operates Massachusetts' Supplemental Nutrition Assistance Program to provide monthly funds on an electronic benefits card, contributing to seniors' healthy food budget. To be eligible, seniors must provide proof of residency, Social Security number or similar documentation and proof of income, including any veteran's benefits and Social Security payments. Seniors who participate in SNAP can receive money back on their EBT cards by purchasing local produce through the Healthy Incentives Program. |
| Massachusetts The Charity Guild Food Pantry | 508-583-5280 | Located in Brockton, the Charity Guild Food Pantry distributes perishable and nonperishable foods to seniors, families and individuals in need. It's part of The Greater Boston Food Bank and its doors are open to anyone, not just those living in Brockton. Seniors needing assistance may visit the pantry Tuesday through Thursday and every other Saturday. Those who are homebound can arrange to have food parcels delivered to their door. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Massachusetts collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| Easterseals Massachusetts Long-Term Device Loan Program | 800-244-2756 | Easterseals Massachusetts long-term device loan program is for those on low incomes who may be unable to purchase medical equipment for home use. The service provides assistive technology, such as phones with large tactile buttons, wrist-cuff blood pressure monitors and screen reading devices. |
| Massachusetts Compassionate Care ALS | 508-444-6775 | Compassionate Care ALS is a nonprofit that helps people who have been diagnosed with ALS. In addition to support services, the organization provides new and gently used equipment to people diagnosed with ALS. These can include voice amplifiers, speech communication devices and wheelchairs. |
| Massachusetts Hospital Equipment Loan Program | 781-322-1052 | The Hospital Equipment Loan Program loans medical equipment free of charge and for home use only. Subject to donations and availability, seniors can request various devices, such as electric lift chairs, exercise bikes, rollators and under mattress supports. |
| Massachusetts REquipment Inc. | 800-261-9841 | REquipment connects residents with reconditioned mobility items, accessibility aids and assistive technology. Clients can reserve equipment online or over the phone. All items are free, and delivery or pickup is available for a nominal fee. |
Health Insurance & Prescription Drug Coverage for Seniors
Massachusetts seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts ConnectorCare | ConnectorCare plans help residents with incomes not exceeding 300% of the federal poverty level. Because several insurers participate in ConnectorCare plans, you should check that a plan satisfies your medical care and prescription drug needs | |
| Massachusetts MassOptions | 800-243-4636 | MassOptions is a statewide service that helps older adults connect with programs and supports in the community. It has an up-to-date online database with service providers, which seniors can browse through on their own or call the toll-free hotline for one-on-one assistance. The program also administers the statewide health insurance options counseling program, which provides free, unbiased advice and information to Medicare beneficiaries. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Massachusetts have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Home Modification Loan Program (HMLP) | 866-500-5599 | The Home Modification Loan Program provides older residents with interest-free loans, which they can use to adapt their homes to their needs. Loans are repaid when the owner sells the property or transfers the title deed. |
| Massachusetts Weatherization Assistance Program | The purpose of the Weatherization Assistance Program is to improve the energy efficiency of seniors' homes, which can reduce utility costs, while also making living spaces safer. |
Senior Centers
Senior centers in Massachusetts bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Councils on Aging | 413-527-6425 | Throughout the state of Massachusetts, 350 Councils on Aging and Senior Centers provide local help to seniors on the community level. This may include transportation and meals, as well as outreach and companionship services. Many of these services are provided free of charge to qualified seniors living at home. |
Senior Engagement
Senior engagement resources and programs in Massachusetts help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts North Shore Community College Tuition Waivers | 978-762-4000 | Massachusetts residents aged 60 and older are eligible for a categorical tuition waiver at the state's educational institutions. Seniors can use this discount to sign up for in-person or online courses offered by North Shore Community College. Course fees still apply. |
Social Security Offices
Social Security offices in Massachusetts help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several Massachusetts resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Age 65 or Over Exemption | 800-392-6089 | The exemption is $700 for a single adult, and a married couple may be eligible for $700 each if they're both aged 65+ before the final day of the tax year. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Massachusetts retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Fuel Assistance Programs | 617-573-1100 | Massachusetts Fuel Assistance Programs are aimed at assisting seniors with home heating costs during the state's severe winters. Residents who receive SNAP or other low-income benefits can qualify for the Low Income Home Energy Assistance Program (LIHEAP) as well as discounted utility rates. Applications for LIHEAP open on October 1. Seniors may be eligible for one-time emergency financing from the Salvation Army Good Neighbor Fund or Joe-4-Oil. |
| Massachusetts Low Income Home Energy Assistance Program (LIHEAP) | 617-573-1100 | The Massachusetts Low Income Home Energy Assistance Program (LIHEAP) assists eligible seniors with their home heating bills. Residents who qualify must have income equal to or lower than 60% of the estimated state median income for Massachusetts. Applications are open online on October 1 and available in person at one of several local LIHEAP agencies. Residents must provide a photo ID, a list of household members, income proof and a heating bill copy. |
Veteran's Services
Massachusetts retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts VA Benefits and Health Care | Massachusetts VA Benefits and Health Care offers medical care and practical assistance for senior veterans. It also oversees three national cemeteries. Older veterans with medical needs can obtain treatment at four medical centers located in Brockton, Leeds, Jamaica Plain and West Roxbury. Edith Nourse Rogers Memorial Veterans Hospital and several community-based outpatient clinics offer varying levels of medical care. Seniors can check if they are receiving all the financial assistance they qualify for and can also access community supports through seven vet centers. |
Assisted Living Laws and Regulations in Massachusetts
In Massachusetts, the Executive Office of Elder Affairs is responsible for ensuring assisted living residential facilities comply with particular regulations that set the standard for care statewide as well as standards for staffing, environmental and safety features.
| Topic | Rule |
|---|---|
| Assisted Living Service Plan Requirements | Before a resident is admitted to an assisted living facility in Massachusetts, they must have a care or service plan. Plans have a wide scope and include any psychosocial history, level of needed daily living activities assistance, and dietary needs or allergies. The plan must include a current health evaluation. This plan must be reviewed on a semi-annual basis by a nurse or the community’s service coordinator. |
| Assisted Living Admission Requirements | Admission to an assisted living facility is contingent upon the resident’s needs falling within the scope of care offered. If a prospective resident’s needs exceed those offered by the ALR, that person won’t be admitted. The personal care services include dressing, grooming, bathing and medication management. ALRs do not provide skilled nursing care. It is important to discuss your loved one’s care needs with AL staff to determine whether they would be eligible for admission. |
| Assisted Living Scope of Care | The scope of care offered by assisted living facilities includes housing and personal care services. Medication management and assistance with daily living activities such as grooming or eating are included. Memory care is also offered by some assisted living communities in Massachusetts. Skilled nursing care, such as wound dressing or catheter management, is not typically offered by ALRs. |
| Assisted Living Medicaid Policy | Medicaid is accepted by some ALRs for residents who qualify under the MassHealth program. MassHealth has certified some ALRs as Group Adult Foster Care-approved housing, so funding can be provided to cover personal care services ( room and board are not covered). Seniors in Massachusetts who receive the SSI-G benefit may be able to use it to cover the housing costs of their ALR. |
| Assisted Living Facility Requirements | ALRs in Massachusetts must meet safety and accessibility requirements like lockable doors on each unit, access to a kitchenette or to a refrigerator, sink, and heating appliance. A washstand, toilet, and bathtub or shower are required for every three residents in older facilities, and newer facilities must have private bathrooms for each unit. Each assisted living facility is required to meet state codes for building and fire safety as well as sanitary conditions. |
| Medication Management Regulations | Staff at assisted living facilities are responsible for managing each resident’s medication, and for delivering their medications, either with reminders and assistance on a daily basis or at a higher level of medication supervision that may include administration of eye drops, application of medicated creams or crushing up of medicines and feeding them to residents. As outlined by the Executive Office of Elder Affairs, staff may not administer injections to residents. |
| Staffing Requirements | While there is no exact number of staff required to be employed by assisted living facilities, the Executive Office of Elder Affairs stipulates that assisted living facilities must retain sufficient staff at all times to “ensure the health, safety, and welfare of the residents”. Residences with Special Care Residents are required to have a minimum of two staff members present at all times in that unit to assist residents. |
| Staff Training Requirements | Staff at ALR need a seven-hour orientation on elder abuse, financial exploitation, infection control, emergency preparedness, cognitive impairment, food safety, and sanitation. Orientation includes medication management training. The first days on the job involve shadowing more experienced staff members. Staff working in SCR must complete an additional seven hours of training. Staff need 10 hours of ongoing education annually. Two of those hours must be dementia-focused. |
| Background Checks for Assisted Living | Background checks are required by all would-be AL employees, and Massachusetts’ assisted living residencies may not employ any individual convicted of a felony related to illegal sale or theft of controlled substances. |
| Requirements for Reporting Abuse | In ALRs, managers, whom Massachusetts law classifies as mandated reporters, are legally obligated to report any suspected cases of abuse or neglect, which includes any instance of financial abuse, emotional, physical or sexual abuse or caregiver neglect. Staff members are trained to recognize and report suspected cases of neglect or abuse, and residents are encouraged to report abuse in the assisted living residence by calling (800) 922-2275 or by filing a report online. |
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