Massachusetts Medicaid for Seniors & Long-Term Care
Updated August 2026
MassHealth covers nursing facility care and a wide range of home and community-based services for seniors who meet both clinical (functional) and financial eligibility requirements.
$2,000
Individual asset limit (community-based seniors)
$2,982/mo
LTC income limit (300% FBR, 2026)
Personal Care Attendant (PCA) Program
MassHealth's largest HCBS program
MassHealth long-term care requires in-person enrollment at a MassHealth Enrollment Center
Seniors and individuals applying for MassHealth long-term care coverage — including nursing facility care — must apply in person at a MassHealth Enrollment Center. Online or phone applications are not accepted for this pathway. Call MassHealth at (800) 841-2900 to find your nearest Enrollment Center and schedule an appointment before a facility admission if possible.
What MassHealth covers for seniors in long-term care
Massachusetts operates several HCBS waiver programs that support seniors living at home as an alternative to nursing home admission.
- Nursing facility (nursing home) care — 24-hour skilled nursing and custodial care
- Personal care attendant (PCA) services at home
- Home health aide visits
- Adult Day Health services
- Respite care for family caregivers
- Assisted living supplemental services (through Group Adult Foster Care)
- Hospice care
- Durable medical equipment and home modifications
- Skilled nursing and physical/occupational therapy at home
MassHealth long-term care financial eligibility (2026)
MassHealth long-term care uses non-MAGI financial eligibility rules — the same asset-tested approach used in all states for nursing facility coverage. Massachusetts publishes its financial guidelines annually; the figures below are effective January 1, 2026.
| Financial figure | 2026 amount |
|---|---|
| LTC income limit (300% FBR) | $2,982/mo |
| Individual asset limit (community-based seniors) | $2,000 |
| Married couple asset limit (community-based) | $3,000 |
| Community spouse minimum resource protection (CSRA) | $32,532 |
| Community spouse maximum resource protection (CSRA) | $162,660 |
| Home equity limit (nursing facility applicant) | $1,130,000 |
| Average daily nursing facility cost (eff. 11/01/25) | $450/day |
| Personal needs allowance (nursing facility resident) | $72.80/mo |
LTC income limit (300% FBR)
- 2026 amount
- $2,982/mo
Individual asset limit (community-based seniors)
- 2026 amount
- $2,000
Married couple asset limit (community-based)
- 2026 amount
- $3,000
Community spouse minimum resource protection (CSRA)
- 2026 amount
- $32,532
Community spouse maximum resource protection (CSRA)
- 2026 amount
- $162,660
Home equity limit (nursing facility applicant)
- 2026 amount
- $1,130,000
Average daily nursing facility cost (eff. 11/01/25)
- 2026 amount
- $450/day
Personal needs allowance (nursing facility resident)
- 2026 amount
- $72.80/mo
Home and community-based waiver programs for Massachusetts seniors
Massachusetts operates several home and community-based programs that let seniors receive long-term care outside a nursing facility.
- Frail Elder Waiver (FEW) — the 1915(c) HCBS waiver for MassHealth members age 60 and older who meet nursing facility level of care; operated day-to-day by the Massachusetts Executive Office of Aging & Independence and offers services ranging from basic to intensive support levels
- Personal Care Attendant (PCA) Program — MassHealth's largest HCBS program; members hire, train, and supervise their own personal care attendants, including family members (spouses excluded)
- Group Adult Foster Care (GAFC) — supplemental care for seniors in assisted living settings; MassHealth pays for personal care and chore services while the member pays room and board separately
- Adult Foster Care (AFC) — provides 24-hour supervision and care in a caregiver's home; adult family members (not spouses) may be paid as caregivers
- Senior Care Options (SCO) — an integrated care program for seniors dually eligible for Medicare and MassHealth, coordinating all medical and long-term care services through a single health plan
Nursing facility coverage
MassHealth covers skilled nursing facility care for seniors who meet clinical and financial criteria. Clinical eligibility requires a documented need for skilled nursing care — typically assessed through a standardized instrument. Financial eligibility means income and countable assets fall within the program's limits.
Once approved, MassHealth pays the nursing home directly. The resident contributes most of their monthly income toward the cost of care — typically all income minus the $72.80/month personal needs allowance. If income exceeds the institutional MassHealth limit, Massachusetts may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible.
MassHealth estate recovery
Massachusetts participates in Medicaid estate recovery. MassHealth may seek reimbursement from the estate of a member who received long-term care services at age 55 or older, or who resided in a nursing facility. The home is generally exempt during the member's lifetime and the lifetime of a surviving spouse or qualifying dependent. Massachusetts applies a 60-month (5-year) asset transfer look-back for nursing facility applicants. An elder law attorney can help families understand these rules before assets are transferred.
What long-term care Medicaid typically covers
Long-term care MassHealth covers a range of institutional and home-based services for eligible seniors and adults with disabilities.
- Skilled nursing facility care — room, board, nursing services, and most medical care in the facility
- Physical, occupational, and speech therapy provided in a nursing home
- Personal care assistance with daily activities (bathing, dressing, eating) through HCBS waivers
- Home health aide visits for those receiving care at home
- Adult day health care programs
- Respite care to give family caregivers temporary relief
- Durable medical equipment prescribed by a physician
- Transportation to and from medical appointments
MassHealth (Massachusetts Medicaid)
- MassHealth Customer Service: (800) 841-2900
Related guides
Medicaid for Seniors
How Medicaid pays for nursing home and long-term care for older adults.
Read more →Estate Recovery
When states can seek reimbursement from an enrollee's estate after death.
Read more →Medicaid & Social Security
How Social Security benefits and Medicaid eligibility interact.
Read more →