How to Qualify for Adult Foster Care in Massachusetts
Massachusetts Adult Foster Care helps eligible people age 16 and older receive daily support while continuing to live at home. A qualified family member or other caregiver who lives in the same home may receive training, nursing and care-management support, and a monthly caregiver payment based on the member’s assessed needs and MassHealth approval. Learn how much family caregivers may get paid in Massachusetts, or continue below for the main eligibility requirements and the easiest way to begin.
- The eligibility requirements for Adult Foster Care
- How to qualify for MassHealth, the Massachusetts Medicaid program
- What self-care activities are included in the Activities of Daily Living
Adult Foster Care Eligibility Requirements in Massachusetts
According to the Massachusetts Adult Foster Care Program Fact Sheet, to qualify for the adult foster care program, the individual must:
- Be a Massachusetts resident who is age 16 or older.
- Have an eligible MassHealth coverage type, generally MassHealth Standard or CommonHealth, subject to MassHealth verification.
- Have a medical or mental condition that requires daily hands-on assistance or cueing and supervision with at least one activity of daily living, such as bathing, dressing, toileting, eating, walking, or transferring.
- Be able to receive care safely in a qualified home setting.
- Live in the same qualified home as the caregiver. The caregiver must be age 18 or older.
- The paid caregiver cannot be the member’s spouse or court-appointed legal guardian. A parent cannot be paid through the program to care for a child under age 18.
Parents caring for a son or daughter age 18 or older can review the requirements for getting paid to care for a disabled adult child in Massachusetts.
While this list is short, it might just raise more questions if you are unfamiliar with the MassHealth eligibility requirements or the definition of the Activities of Daily Living.
Who is eligible for MassHealth?
MassHealth is the Massachusetts state-run public health insurance program combining Medicaid and the Children’s Health Insurance Program (CHIP). It covers low-to-medium income residents, families, children, people with disabilities, and seniors. Jointly funded by the state and federal government, it provides comprehensive coverage including doctors’ visits, hospital stays, prescriptions, behavioral health, and long-term care.
Eligibility requirements for MassHealth are based on residency (where you live) and your financial situation (how much money the people in your household have to live).
MassHealth Coverage Requirements
Residency requirements
According to Mass.gov, you must be a resident of Massachusetts to get MassHealth or other health care benefits that are funded by the state.
You meet residency requirements if:
- You live in Massachusetts and either intend to reside in Massachusetts, with or without a fixed address or
- You have come to Massachusetts with a job commitment or seeking employment and
- You are U.S. citizen or have verified satisfactory immigration status
You do not meet residency requirements for MassHealth if you are visiting Massachusetts:
- For personal pleasure, such as for vacation, or
- To receive medical care in a setting other than a nursing facility
Financial requirements
You must be financially eligible to qualify for MassHealth, the Health Safety Net, or the Children’s Medical Security Plan. To determine if you meet the financial requirements, MassHealth will consider:
- Your Modified Adjusted Gross Income (MAGI)
- Who is in your household
What Daily Care Needs May Qualify?
The Activities of Daily Living (ADLs) are a list of self-care tasks created by healthcare providers to measure how well someone with mental or physical limitations can live on their own without help. They include personal hygiene, using the bathroom, getting dressed and feeding yourself, or the activities in the following five categories:
- Ambulating: the ability to walk, sit, stand, lie down and get up, and climb up and down stairs, both inside and outside your home.
- Grooming: all activities necessary to maintain personal hygiene, like brushing your teeth, bathing, shaving, and hair and nail care.
- Toileting: the ability to control your bladder and bowels (continence), use the toilet safely, and clean yourself after use.
- Dressing: the ability to dress yourself properly, including using buttons and zippers.
- Eating: the ability to use cutlery and feed yourself.
- Transferring and mobility: moving safely between positions or locations, including getting in or out of a bed or chair and walking when assistance is required.
Families in Central Massachusetts can also review local Adult Foster Care information for Southbridge and South Central Massachusetts and Gardner and the Greater Gardner area.
Are you already caring for a loved one who needs daily help at home? Complete Mass Care Link’s quick prequalification questions or review what happens during the application process. Eligibility and payment are determined through assessment and MassHealth approval.
Official Sources
This article provides general educational information. Eligibility, caregiver approval, payment, and authorization depend on current requirements and individual circumstances.