Home Care in Massachusetts

Home care in Massachusetts costs an average of $36 per hour, which can be compared to the national average of $32.^[01] Monthly costs vary depending on how many hours of care your loved one needs. The following costs are estimated based on the average hourly rate in Massachusetts:

• Part-time care (20 hours/week): $3,103 per month
• Full-time care (44 hours/week): $6,827 per month

Several factors can affect home care costs in Massachusetts, including:

• Type of assistance needed, such as companionship, household help, or personal care
• Specialized support for conditions like dementia or mobility challenges
• Care provided during evenings, weekends, or holidays
• Around-the-clock coverage, including 24-hour or live-in care
• Caregiver qualifications, training, and years of experience

Massachusetts families have several ways to pay for nonmedical home care. Many rely on a combination of private funding sources, long-term care insurance, Medicaid, and other available benefits.

Private pay options

Personal financial resources that can help cover the cost of home care include:

• Social Security benefits
• Savings, investments, or pensions
• Long-term care insurance
• Life insurance conversion
• Reverse mortgage

VA benefits

Veterans and surviving spouses in Massachusetts may qualify for Department of Veterans Affairs (VA) programs that help offset the cost of home care. Eligible veterans and survivors who need help with daily activities may receive additional monthly payments through the VA Aid and Attendance benefit.^[02]

The VA also offers several in-home care programs for eligible veterans enrolled in VA health care, including Homemaker and Home Health Aide Care, Home-Based Primary Care, Skilled Home Health Care, Hospice Care, and Home Respite Care.^{[03,04,05,06,07]}

For more information about eligibility and available services, visit VA.gov or the Massachusetts Executive Office of Veterans Services website.

Massachusetts Medicaid

Medicaid is a joint program of the federal and state governments designed to help people with low incomes and certain conditions and disabilities. In Massachusetts, Medicaid is called MassHealth, and it can be used to offset the cost of home care services for eligible residents.

MassHealth helps eligible elderly recipients with the cost of home care through several programs and through the state’s regular plan:

• The Frail Elder Waiver (FEW) program
• Adult Day Health Care
• Personal Care Attendant program
• Senior Care Options program

Services provided by these programs include but aren’t limited to:

• Personal emergency response systems
• Help with activities of daily living (ADLs)
• Medication dispensing systems
• Respite care
• Medication reminders
• Laundry and housekeeping

While the state’s regular Medicaid plan is an entitlement program, meaning all eligible residents will receive services, waiver programs aren’t entitlements. If programs are full, your loved one may be placed on a waiting list. Eligibility depends on a person’s income and assets, as well as demonstrated medical need.

Medicare

Medicare may pay for skilled home health services, such as nursing care, physical therapy, or occupational therapy, when specific eligibility requirements are met. However, nonmedical home care is only covered when it is delivered in conjunction with approved home health services.^[12]

Massachusetts currently only regulates nonmedical home care agencies that accept funding from public programs, such as Medicaid.^[13] Home health agencies are regulated by the Massachusetts Department of Public Health.^[14]

Does Massachusetts require home care agencies to have a license?

No. Massachusetts nonmedical home care agencies are not currently required to have a license to operate.^[15] Home health agencies are required to be licensed.^[14]

Does Massachusetts conduct inspections of home care agencies?

No, nonmedical home care agencies aren’t inspected in Massachusetts.^[13]

Some agencies may also seek voluntary accreditation from organizations like The Joint Commission, which can indicate a higher level of quality.^[16]

What are hiring practices for home care agencies in Massachusetts?

Massachusetts requires home care aides who participate in consumer-directed programs, such as Personal Care Attendant (PCA), to have at least four hours of training.^[17] The state doesn’t impose hiring requirements on agencies that are paid privately by families.^[13]

Choosing the right agency is one of the most important steps in arranging care for your loved one. Here are some tips to guide your decision:

• Ask about training. Ensure caregivers receive proper onboarding and ongoing education.
• Read reviews. Look for consistent feedback about caregiver reliability and compassion.
• Request detailed pricing information. Agencies may require weekly hour minimums and charge higher rates for care provided overnight, on weekends, and on holidays.
• Understand services. Confirm the agency offers the level of care your loved one needs.
• Meet caregivers. A good personality match can make a big difference when it comes to the comfort of your loved one.

Read more: How to Choose a Home Care Agency