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STATE PROFILE • Last updated: April 24, 2026

Massachusetts Medicaid & Elder Care

Massachusetts' MassHealth offers long-term care support for seniors through institutional Medicaid, HCBS waivers, and a Medically Needy pathway, with eligibility rules and benefits varying by program.

leaderboard RANKED #39 NATIONALLY

Medicaid Report Card

Overall State Performance Index

D Grade
ELIGIBILITY ACCESSIBILITY STRONG
WAIVER AVAILABILITY STRONG
QUALITY OF CARE CRITICAL

Based on CMS Nursing Home Compare + state Medicaid agency data

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Massachusetts Monthly Costs

NURSING HOME (SEMI-PRIVATE) $14,881 State Avg / Month
ASSISTED LIVING $6,500 State Avg / Month
ADULT DAY HEALTH CARE $2,310 State Avg / Month

Massachusetts senior care costs, such as assisted living and nursing home care, typically trend significantly higher than the national average.

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Waiver Programs

Frail Elder Home & Community-Based Services Waiver

The Frail Elder Home & Community-Based Services Waiver (FEW) provides a variety of supports at home, in adult foster care homes, and in congregate housing for individuals who meet nursing home level of care. It serves persons with Alzheimer's disease and other related dementias, aiming to delay nursing home admissions.

  • check_circle Personal Care Assistance
  • check_circle Homemaker Services
  • check_circle Home Modifications
  • check_circle Meal Delivery
  • check_circle Personal Emergency Response Systems

insights Program Snapshot

Functional criterion
Nursing Home Level of Care
Income Limit (Individual)
$2,982/month (2026)
Administered by
MassHealth / Executive Office of Health and Human Services
Purpose
Delay nursing home admissions

2026 Eligibility Requirements

Criteria Individual Limit Married (Both Applying)
Monthly Income $522 $650
Asset Limit $2,000 $4,000
Home Equity Limit $1,130,000
Level of Care Nursing Home Level of Care (NHLOC)
Massachusetts operates a Medically Needy Pathway, allowing individuals with income above the standard limits to 'spend down' their excess income on medical expenses to qualify for MassHealth.
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Estate Recovery Warning

Massachusetts MERP: Limited to Federal Mandates
info MassHealth seeks recovery from the probate estates of deceased members aged 55 or older who received long-term care or other services.
info Recovery is limited to the costs of nursing home care, home and community-based services, and related hospital and prescription drug services for deaths after August 1, 2024.
info MassHealth will waive estate recovery for all probate estates valued at $25,000 or less.
info Recovery may be delayed or waived in cases of undue hardship or if a surviving spouse or permanently disabled child resides in the home.

Massachusetts' Medicaid Estate Recovery Program (MERP) is limited to federally mandated recovery from probate estates for long-term care costs for those aged 55 and older. Exemptions exist for small estates and certain surviving family members.

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Spend-Down & Asset Protection

Medically Needy Pathway Miller Trust Not Required Medically Needy State

PROTECTED ASSETS

Primary home up to $1,130,000 equity One vehicle (any value) Personal belongings Irrevocable burial trust/bank account up to $1,500 Term life insurance and employer life policies with no cash value

COMMON PITFALLS

  • warning Look-back Period: Gifts or asset transfers made within 60 months (5 years) of applying can trigger significant penalties and periods of ineligibility.
  • warning Excess Income: Failing to properly 'spend down' excess income on medical expenses through the Medically Needy Pathway can prevent eligibility.
  • warning Joint Accounts: The full balance of jointly held bank accounts or other assets may be counted as belonging to the applicant, impacting asset eligibility.
Community Spouse Resource Allowance (CSRA): $162,660

First Steps for Families

1

Locate your ADRC

Contact your local Massachusetts Aging and Disability Resource Center.

2

Gather 5 years of records

Bank statements, deeds, asset transfers for the Medicaid look-back period.

3

Financial assessment

Consult a Medicaid planner if assets exceed $2,000.

View Full Application Process ↓
Massachusetts state capitol

Resource Contact

MassHealth (Executive Office of Health and Human Services)

call (800) 841-2900
Official site open_in_new

How to Apply for Massachusetts Long-Term Care Medicaid

1
Assess Level of Care

Obtain medical certification confirming the need for long-term care services, such as Nursing Home Level of Care.

2
Gather Records

Collect five full years of financial statements and verification for all transactions over $1,000, along with income and asset proofs.

3
Complete Application

Fill out the 'Application for Health Coverage for Seniors and People Needing Long-Term-Care Services' (SACA-2).

4
Submit Application

Submit the completed application online, by mail, fax to (617) 887-8799, or by calling the MassHealth Customer Service Center at (800) 841-2900.

5
Attend Interviews

Participate in any required caseworker evaluations or interviews to determine functional and financial eligibility.

6
Receive Determination

Await MassHealth's final eligibility determination and activation of benefits for long-term care services.

Documents You'll Need

Financial Verification

  • 5 years of bank statements
  • Stock/bond certificates
  • Retirement account information
  • Verification of transactions over $1,000

Income Verification

  • Social Security award letters
  • Pension stubs
  • VA benefit statements
  • Two most recent pay stubs (if employed)

Medical/Identity

  • Social Security card
  • Medicare card
  • Doctor's clinical assessments
  • Proof of disability (if applicable)

Property/Residency

  • Home deed
  • Vehicle registration
  • Proof of Massachusetts residency
  • Proof of citizenship or eligible immigration status
timer Federal Deadline: 45 Days
update Typical Massachusetts Processing: 90 Days

Frequently Asked Questions About Massachusetts Medicaid

Does Massachusetts Medicaid pay for assisted living?

MassHealth (Massachusetts Medicaid) generally does not cover the room and board costs of assisted living facilities. However, programs like the Group Adult Foster Care (GAFC) program and PACE can help cover personal care and other services received within state-certified assisted living residences for eligible individuals.

What is the Massachusetts Medicaid income limit for seniors in 2026?

For seniors in Massachusetts, the 2026 Medically Needy Income Limit (MNIL) is $522 per month for an individual and $650 per month for a couple. For Home and Community-Based Services (HCBS) waivers, the income limit for a single applicant is $2,982 per month. Massachusetts allows a 'spend down' process for those exceeding these limits.

How long is the HCBS waiver waitlist in Massachusetts?

The Frail Elder Home & Community-Based Services (FEW) Waiver in Massachusetts is not an entitlement, and waiting lists may exist due to limited participant slots, though specific waitlist data is not publicly available. In contrast, the Group Adult Foster Care (GAFC) program is an entitlement, meaning there is no waitlist for eligible individuals.

Will Medicaid take my parent's house in Massachusetts?

The Massachusetts Medicaid Estate Recovery Program (MERP) can seek reimbursement from a deceased MassHealth member's probate estate, which may include their home, for long-term care costs. However, recovery is limited to federally mandated services for those aged 55 and older, and estates valued at $25,000 or less are exempt. Waivers for undue hardship or if a surviving spouse or disabled child lives in the home may also apply.

Can I be paid to care for my parent through Massachusetts Medicaid?

Yes, Massachusetts Medicaid (MassHealth) offers programs that allow family members to be paid caregivers. The Adult Foster Care (AFC) Program, for example, enables a family member to be compensated for providing care to an eligible individual in their home or the caregiver's home.

Medicaid vs Medicare for long-term care in Massachusetts?

Medicare is federal health insurance primarily for individuals aged 65 and older, or those with certain disabilities, but it generally does not cover long-term care services. MassHealth (Medicaid) is a joint federal and state program for low-income individuals that *does* cover long-term care services, including nursing home care and home and community-based services, for eligible Massachusetts residents.

TOPICAL GUIDES — HOW MEDICAID WORKS

EXPLORE MASSACHUSETTS

Last updated: April 24, 2026. Sources: MassHealth (Executive Office of Health and Human Services), CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.