Program Description
MassHealth’s (Medicaid) Adult Foster Care program allows elderly participants to move into a caregiver’s home and receive care there instead of living in a nursing home or another institutional facility. Alternatively, a caregiver can move into the participant’s home.
Most commonly, the caregiver is a friend or family member of the care recipient. However, it is not a requirement that the caregiver and care recipient be acquainted. The state pays the caregiver for the 24-hour personal care that they provide. Typically, personal care includes assistance with the Activities of Daily Living (ADLs), like bathing, toileting, grooming and other personal hygiene, as well as the Instrumental Activities of Daily Living (IADLs), such as meal preparation, housekeeping, and laundry.
The Adult Foster Care program does not pay for the individual’s room and board. It only covers the cost of care services.
Under this program, family members can receive payment for caring for elderly relatives in their homes.
Eligible family members that can be paid as caregivers include siblings, adult children, and other relatives. But they cannot be the care recipient’s spouse, a parent of a minor, or the legal guardian.
The Adult Foster Care program is operated by the Massachusetts Executive Office of Health and Human Services and is part of the state’s MassHealth program.
Eligibility Guidelines
General Requirements
The following are requirements to participate in the Adult Foster Care program:
- Applicants must require assistance or cueing with at least one of their activities of daily living.
- However, applicants cannot require the level of care that would be provided at a nursing home.
Financial Requirements
In addition to the medical requirements, program participants must be financially eligible for MassHealth (Massachusetts’ Medicaid).
Income Limits
For 2024, the income limits are $1,255 per month for an individual, and $1,703 per month for a couple, regardless of whether both applicants are applying for services. (These limits are based on 100% of the Federal Poverty Level, which changes annually in March).
Asset Limits
MassHealth also considers the applicant’s financial resources. A single applicant is limited to $2,000, and a married couple cannot have assets greater than $3,000. However, many assets are considered exempt. Examples include one’s home, given the applicant or his or her spouse lives in it and the equity value is at or below $1,071,000, household items, personal effects, and burial trusts.
Over the Financial Limits?
If an applicant is over these limits, there are other pathways to qualifying. Massachusetts has a Medically Needy Medicaid program in which individuals whose medical expenses are extraordinarily high can qualify even though their income is greater than the limits. A MassHealth financial planning adviser can help “spend down” or re-organize a candidate’s income so that they become elligible.
Persons unsure of their financial eligibility should consult with a MassHealth planning expert. Any planning must be done before applying. Read more.
Benefits and Services
Care recipients are able to receive the following services:
- Companionship
- Non-medical and medical transportation
- Housecleaning
- Medication reminders
- Assistance with bathing, dressing, meals, and transitioning, such as help getting out of bed
- 24 hour supervision
- Nursing oversight
How to Apply / Learn More
The Adult Foster Care program is available in all counties in the state. Interested individuals can learn more about the program and apply by calling MassOptions at 800-243-4636 or contact their local Aging Services Access Point.
A detailed PDF about the program is available for download here.
