Medicaid for nursing home and home care in Massachusetts
In short: MassHealth, the Massachusetts Medicaid program, can pay for a nursing home or for care at home through the Frail Elder Waiver if you need nursing-home-level care. A single person can keep no more than $2,000 in countable assets, and a spouse at home can keep much more. In a nursing home you keep $72.80 a month and the rest of your income goes toward your care. Apply to MassHealth with the senior application, and call MassOptions at 800-243-4636 to find your local Aging Services Access Point.
Who qualifies
You must live in Massachusetts and be 65 or older (or meet the disability rules if younger). A medical review must show you need the care a nursing facility gives. For the Frail Elder Waiver, a nurse or case manager from your local Aging Services Access Point (ASAP) does this review.
| Rule | Nursing home | Frail Elder Waiver (care at home) |
|---|---|---|
| Age | 65 or older (younger with a disability) | 65 or older, or 60 to 64 with a permanent disability |
| Income | Most income goes toward the cost of care | Countable income up to $2,982 a month (300% of the SSI federal rate), counting only your own income |
| Assets, one person | $2,000 | $2,000 |
| Home equity limit | $1,130,000 | $1,130,000 |
Over the limit? For the Frail Elder Waiver, you can still qualify by spending down extra assets, by meeting a deductible (paying some medical bills yourself first), or both.
What counts and what does not
These assets are not counted:
- Your home in Massachusetts, as long as your equity is no more than $1,130,000. The equity limit does not apply if your spouse or a qualifying child lives there.
- One vehicle for the household, whatever its value.
- Money set aside for funeral and burial costs, up to $1,500, and burial arrangements.
- Certain special-needs and pooled trusts.
Bank accounts, stocks, retirement accounts you can cash in, and second homes generally count.
Gifts and transfers
MassHealth looks back 60 months (five years) for anything you gave away or sold for less than it was worth. A transfer can cause a penalty period when MassHealth will not pay for nursing home care. The penalty length is the value given away divided by the average private cost of nursing home care in Massachusetts. MassHealth lists that average at $450 a day for 2026. Gifts to your spouse and to a blind or disabled child are allowed.
If you are married
The rules protect a spouse who stays at home (the "community spouse").
| Spouse at home can keep | 2026 amount |
|---|---|
| Assets, at least | $32,532 |
| Assets, at most | $162,660 |
| Monthly income, at least (from July 1, 2026) | $2,705 |
| Monthly income, at most | $4,066.50 |
If the spouse at home has less income than the minimum, part of the other spouse's income can go to them. The amount can be higher when housing costs are high; MassHealth uses a standard shelter amount of $811.50 a month (from July 1, 2026). If the spouse at home needs more assets to produce enough income, either spouse can ask for a fair hearing to raise the asset allowance.
What each program pays for
Nursing home care
MassHealth Standard pays the nursing facility after you pay your share. You keep a personal needs allowance of $72.80 a month for things like clothing and haircuts. The rest of your income, after any allowance for your spouse at home and health insurance premiums, goes to the nursing home.
Frail Elder Waiver
The Frail Elder Waiver pays for more than 30 services at home, such as personal care, homemaker help, home health aides, respite for caregivers, home-delivered meals, transportation and home changes for safety. A case manager writes a service plan with you. To stay on the waiver you must use at least one waiver service each month. You cannot live in assisted living, a group home or a rest home, and you cannot be on another waiver or in PACE at the same time.
How to apply
- For home care, start with your ASAP. Call MassOptions at 800-243-4636 or visit massoptions.org to find your local Aging Services Access Point. Ask for a clinical eligibility assessment for the Frail Elder Waiver. The ASAP can also help with the MassHealth application.
- Fill out the application. Use the Application for Health Coverage for Seniors and People Needing Long-Term-Care Services. You can complete it online on mass.gov (you need an email address and must finish in one sitting), or print it.
- Gather documents. Include Social Security numbers, proof of income and assets, proof of any health insurance, and proof of citizenship or immigration status.
- Send it. Mail: MassHealth Enrollment Center, Central Processing Unit, P.O. Box 290794, Charlestown, MA 02129-0214. Fax: (617) 887-8799. Do not mail or fax to the walk-in centers.
- Wait for the notice. MassHealth reviews the application, may ask for more papers, and sends a written decision. The state does not post a set time frame.
You can also visit a MassHealth Enrollment Center in Charlestown, Chelsea, Springfield, Taunton, Tewksbury, Quincy or Worcester. Walk-ins are limited, so book an appointment if you can.
After you apply
- Report changes in income, assets or address to MassHealth.
- Appeal a denial within 60 calendar days of getting the notice. Send the Fair Hearing Request Form and a copy of the notice to the Board of Hearings, fax 1-617-887-8797, or email [email protected]. You can also call MassHealth at (800) 841-2900.
- Estate recovery: after a member dies, MassHealth may seek repayment from the probate estate for long-term care received at 55 or older. It waits while a spouse, a child under 21, or a blind or disabled child is living, and waives recovery for estates of $25,000 or less.
Common mistakes
- Giving money to family before applying. Gifts in the last five years can delay coverage.
- Thinking you must sell your home. The home usually does not count if equity is under the limit or a spouse lives there.
- Forgetting the spouse's protections. The spouse at home may keep up to $162,660 in assets.
- Applying for the waiver without the ASAP assessment. MassHealth decides the money side, but the ASAP decides the care need.
Free help
- MassOptions: 800-243-4636, to reach your ASAP and options counselors.
- MassHealth Customer Service: (800) 841-2900, TTY 711, Monday to Friday, 8 a.m. to 5 p.m.
- SHINE (free Medicare counseling): (800) 243-4636.
See also paying for a nursing home, Medicare and all benefits in Massachusetts.
Phone numbers: Free help lines for Massachusetts agencies
Sources
- mass.gov/info-details/program-financial-guidelines-for-certain-masshealth-applicants-and-members · checked 2026-10-18
- mass.gov/doc/130-cmr-519000-masshealth-coverage-types-4/download · checked 2026-10-18
- mass.gov/doc/130-cmr-520000-masshealth-financial-eligibility-0/download · checked 2026-10-18
- mass.gov/info-details/frail-elder-waiver-information-for-applicants-and-participants · checked 2026-10-18
- mass.gov/info-details/eligibility-for-people-age-65-and-older-and-people-who-need-long-term-care-services · checked 2026-10-18
- mass.gov/how-to/apply-for-masshealth-coverage-for-seniors-and-people-of-any-age-who-need-long-term-care · checked 2026-10-18
- mass.gov/how-to/how-to-appeal-a-masshealth-decision · checked 2026-10-18
- mass.gov/doc/medicare-savings-program-msp-faqs-0/download · checked 2026-10-18
- mass.gov/info-details/massachusetts-medicaid-estate-recovery · checked 2026-10-14
Page last reviewed: 2026-10-18