How to Qualify for Adult Foster Care in Massachusetts
Currently more than 18,000 members benefit from the Adult Foster Care program in Massachusetts. The program provides training, nursing support and financial help to allow people who can no longer fully take care of themselves to stay at home and receive care from a friend or loved one. If you’re interested in applying for Adult Foster Care you might be wondering how to qualify. In this article we’ll explain:
- 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
Who is eligible for Adult Foster Care?
According to the Massachusetts Adult Foster Care Program Fact Sheet, to qualify for the adult foster care program, the individual must:
- Qualify for MassHealth Standard or CommonHealth (or be enrolled in MassHealth’s integrated care options: One Care, Senior Care Options (SCO), or PACE)
- Be age 16 or older
- Need help, either physical assistance or caring and supervision, with at least one Activity of Daily Living (ADL) such as bathing, dressing, eating, or mobility
- Have the ability to live safely in a home setting with a caregiver’s support
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).
How do you qualify for MassHealth?
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 are the Activities of Daily Living?
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.
- So in order to receive care through the adult foster care program, in Massachusetts, the care recipient must be unable to do one of those five activities on their own.
Are you taking care of a loved one at home or are you facing a choice between going to a nursing home or living at home and need help? Find out if you qualify for Adult Foster Care with this quick quiz from Mass Care Link.