Types of Home Care Services in Massachusetts: A Family Guide
Massachusetts families can choose from several home and community-based care options. The best fit depends on the person’s age, medical and functional needs, insurance coverage, living arrangement, caregiver availability, and preference for directing their own care.
1. Adult Foster Care
Adult Foster Care is a MassHealth-funded service for eligible people who need daily physical assistance or cueing and supervision with at least one activity of daily living. The member lives with a qualified caregiver, while an approved provider supplies nursing oversight, care management, training, and ongoing support.
This option may fit families who already live together and provide substantial daily support. Spouses and court-appointed legal guardians cannot be paid caregivers, and all services require assessment and MassHealth approval.
2. Personal Care Attendant Program
The Personal Care Attendant program is generally self-directed. The eligible consumer or an approved surrogate hires, schedules, trains, and supervises personal care attendants for authorized tasks and hours. This model may suit someone who wants more direct control over staffing and scheduling.
3. Group Adult Foster Care
Group Adult Foster Care provides personal care services and care management to eligible individuals living in qualifying community housing. Despite the similar name, it differs from live-in family Adult Foster Care because direct-care staff are generally supplied through the program rather than an approved household caregiver receiving the payment.
4. Home Health Services
Home health services may include skilled nursing, therapy, or other medically necessary services delivered in the home under an appropriate order and coverage arrangement. These services address clinical needs and are different from the ongoing live-in personal-care model used in Adult Foster Care.
5. Private-Pay Home Care
Families may hire a private home care agency or individual caregiver for companionship, personal care, homemaking, or other support. Services, schedules, rates, supervision, and payment arrangements vary by provider. Families should review credentials, insurance, background screening, contracts, and cancellation terms carefully.
6. Assisted Living or Nursing Facility Care
Some individuals need a residential setting because their medical, behavioral, safety, or supervision needs cannot be met appropriately at home. Assisted living and nursing facilities offer different levels of residential support and should be evaluated based on the person’s care needs, finances, coverage, and preferences.
Quick Comparison
| Option | Typical setting | Who provides care |
|---|---|---|
| Adult Foster Care | Shared qualified home | Approved live-in caregiver with provider oversight |
| PCA | Consumer’s home | Consumer-directed attendants |
| Group Adult Foster Care | Qualifying community housing | Program direct-care staff |
| Home Health | Person’s home | Skilled clinical professionals |
| Private Home Care | Person’s home | Privately hired agency or caregiver |
| Residential Care | Assisted living or nursing facility | Facility staff |
Questions to Help Your Family Decide
- Does the person need hands-on assistance, supervision, skilled care, or companionship?
- Is there a trusted caregiver who already lives in the home?
- What MassHealth or other insurance coverage does the person have?
- Does the person want to direct and schedule their own workers?
- Can care be provided safely in the current home?
- How much nursing or clinical oversight is required?
For a closer program comparison, review Adult Foster Care vs. GAFC vs. PCA.
Could Adult Foster Care Be the Right Fit?
Complete Mass Care Link’s quick prequalification questions or call 866-880-8889. Our intake team can review the basic household information and explain the Adult Foster Care process.
This article provides general educational information. Eligibility, caregiver approval, payment, and authorization depend on current requirements and individual circumstances.