Massachusetts Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Massachusetts.
7.6 million Medicaid long-term care recipients nationwide
MassHealth (Massachusetts Medicaid)
Processing Time
45 days for standard applications, 90 days for disability applications, retroactive benefits available for 3 months
Massachusetts Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Massachusetts, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Massachusetts follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month (HCBS waiver)
Married Couple (One Applying)
$4,000 combined (both in nursing home)
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$162,660 (community spouse)
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Massachusetts Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $13,900/month average (the average monthly nursing home cost in Massachusetts).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Massachusetts
Nursing Home Care
Medicaid pays 100% of nursing home costs in Massachusetts once eligibility is established. The average monthly cost is $13,900/month average. Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Group Adult Foster Care (GAFC) / SSI-G Program: MassHealth's GAFC program covers medical and personal care services in assisted living facilities but does not cover room and board. However, eligible low-income individuals may qualify for SSI-G (Supplemental Security Income - Category G), a Social Security program that provides supplemental income to cover room and board costs in GAFC-approved assisted living facilities. Not all facilities accept GAFC and SSI-G.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Massachusetts offers 4 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Frail Elder Waiver (FEW)
Serves frail elders aged 60+ (or 60-64 if physically disabled) who require nursing facility level of care. Provides case management, adult day health, personal care, respite care, and other services to help seniors remain in the community.
Program Details →Adult Supports Waiver
Provides services for adults with intellectual disabilities, including day habilitation, employment support, and community living supports.
Program Details →Acquired Brain Injury (ABI) Waiver
Serves individuals with acquired brain injury who need nursing facility level of care, offering specialized rehabilitation and support services in community settings.
Program Details →Traumatic Brain Injury (TBI) Waiver
Provides comprehensive services for individuals with traumatic brain injury, including case management, community living supports, and specialized therapies.
Program Details →How to Apply for Medicaid in Massachusetts
Massachusetts Medicaid applications typically take 45 days for standard applications, 90 days for disability applications, retroactive benefits available for 3 months. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Massachusetts through:
- Online at MAhealthconnector.org
- Phone: 1-800-841-2900 (Mon-Fri 8am-5pm)
- Mail application to MassHealth Enrollment Center
- In-person at MassHealth Enrollment Center (limited walk-in)
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Massachusetts from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Massachusetts-Specific Programs and Resources
Senior Care Options (SCO)
Combines MassHealth and Medicare benefits into one plan for individuals 65+ enrolled in both programs. Major 2026 change: All SCO enrollees must now be enrolled in Medicare Parts A and B plus MassHealth Standard to remain eligible.
Learn MoreMedicare Savings Program
Income limit increased to 225% of federal poverty level ($2,824/month single, $3,833/month couple). Asset limit removed as of March 2024. Pays Medicare premiums and other healthcare costs including prescriptions.
Learn MoreMedically Needy Pathway
Allows individuals over income limits to qualify through spend-down. Medically needy income limit is $522/month (individual) or $650/month (couple) in 2026.
Learn MoreNeed Help with Massachusetts Medicaid?
Contact MassHealth (Massachusetts Medicaid) for specific questions about eligibility, application status, or covered services.
Main Office Phone
1-800-841-2900Application Helpline
1-800-841-2900