Retirees in Massachusetts benefit from rich cultural opportunities and beautiful scenery. The Bay State can also be a good financial choice for seniors. With 17% of the state’s 7 million residents aged 65 and over, Massachusetts has developed a range of programs that support people as they age. Although assisted living costs are higher than average at $6,500 per month, financial assistance, such as Medicaid and Supplemental Security Income, can help seniors stay on budget.

The overall cost of living in Massachusetts is high, but health care costs are lower than the national average, and seniors can access world-class facilities like the Massachusetts General Hospital. Some retirees may also find that the tax system offers benefits since Social Security and public pensions are exempt from state income tax, and groceries and prescription medicines are exempt from sales tax.

This guide has information about the cost of assisted living in Massachusetts, including prices in different cities. It also details how Medicaid can help pay for assisted living and provides information about other free and low-cost resources available to seniors in the state.

How Much Does Assisted Living Cost in in Massachusetts?

The 2021 Genworth Cost of Care Survey shows that the average cost of assisted living in Massachusetts is $6,500 per month. This is $2,000 higher than the national average of $4,500. When compared to its neighbors, Massachusetts isn’t the most expensive state for assisted living. The average in Rhode Island is $6,826, for example. However, other neighboring states have lower costs. New Hampshire’s prices are close to Massachusetts at $6,053 monthly. Costs in Vermont and Connecticut are more than $1,000 lower at $5,250 and $5,129 respectively. New York has the most affordable assisted living costs in the area with seniors paying an average of $4,580 per month.

The Cost of Assisted Living in Massachusetts’ Top Cities

Assisted living costs in Massachusetts differ widely depending on where the facility is located. Barnstable is the least affordable city with prices there averaging $7,000 per month. Costs in Boston are also higher than the state average at $6,819. In other areas of the state, prices are below the Massachusetts average. In Worcester, seniors pay $5,685 per month, and in Springfield, the cost is $5,048. Pittsfield’s costs are substantially lower than other parts of the state; seniors there pay an average of $2,084 per month for assisted living.

The Cost of Assisted Living vs. Other Types of Care

There are other senior living options in Massachusetts that may be better suited to an individual’s budget or needs. Adult day health care is the most affordable choice at $1,587 per month. Older adults who want to remain living at home can receive in-home care or home health care for $5,911 per month. Nursing home care costs almost twice as much as assisted living at $12,623 for a semiprivate room.

Can You Use Medicaid to Pay for Assisted Living in Massachusetts?

Medicaid in Massachusetts is known as MassHealth. It provides a range of benefits to eligible state residents, including some coverage for assisted living. These benefits are part of the Group Adult Foster Care (GAFC) program. This initiative provides care in certain group settings, including assisted living residences that have been approved by MassHealth. The program pays for services provided in assisted living, such as personal care and transportation, but it doesn’t cover the cost of room and board.

Medicaid’s Coverage of Assisted Living in Massachusetts

The GAFC program is available to people who are eligible for MassHealth and meet certain requirements. In addition to meeting the financial criteria, applicants must have:

• A doctor’s approval stating that the services are required.
• Clinical approval from a designated agent.
• A need for daily personal care.

The program only provides care at facilities that are approved for the program. These tend to be smaller group homes rather than large communities.

GAFC covers a range of services provided in assisted living residences. This includes medication management, house cleaning and transportation. The program also pays for personal care and assistance with activities of daily living, such as bathing, toileting, dressing, eating and mobility. The program doesn’t pay for the cost of room and board. However, participants are often eligible for the Supplemental Security Income Assisted Living Benefit, which can help with these living costs.

People interested in this program must first apply for MassHealth. Once accepted, seniors can contact the MassHealth office at (800) 841-2900 to ask about the program.

Eligibility for Medicaid in Massachusetts

Medicaid is designed to help low-income residents access health care, so an individual’s financial circumstances make up the primary eligibility criteria. Applicants must meet income and asset limits to be eligible for the program.

The GAFC program is part of MassHealth, so seniors must meet the financial criteria for regular Medicaid. Single applicants can have an income of up to $1,133 per month, and for married applicants, the income limit is $1,526. If only one spouse is applying, the income of both the applicant and nonapplicant counts towards eligibility. Rule are different for long-term care and waivers for nursing home alternatives.

The income limit is $2,000 for single applicants and $3,000 for married applicants. Again, the assets of both the applicant and nonapplicant are counted if only one spouse is applying for regular Medicaid; however, not all assets are counted in the calculation. Exemptions include personal belongings, an automobile and burial trusts. The primary home is also excluded if a nonapplicant spouse will remain living there.

2022 Medicaid Income Limits for Seniors in Massachusetts

	Income Limits*	Asset Limits
Single Applicant	$13,596	$2,000
Two-Person Household (One Person Applying)	$18,312	$3,000
Two-Person Household (Both People Applying)	$18,312	$3,000

*per year

In addition to financial criteria, applicants must also be:

• A Massachusetts resident
• A U.S. citizen or eligible immigrant
• In need of care provided in a group home setting

Applying for Medicaid in Massachusetts

Individuals can fill out a Senior Application form and return it by mail or fax to the MassHealth Enrollment Center. It can also be hand-delivered to the center in Charlestown. Seniors can apply in person by scheduling an appointment with a MassHealth representative. Local enrollment centers can be found in Springfield, Taunton, Tewksbury and Quincy.

Before You Apply

Application forms must be returned with various documents that allow officers to verify the information provided. MassHealth requests proof of:

• Monthly income
• Value of assets
• Identity
• U.S. citizenship or immigration status
• Social Security number(s)

Where to Go to Get Help

Massachusetts has a number of resources available for people who need help applying for Medicaid. The state produces a detailed guidebook for seniors and has customer service officers available to answer questions. Additionally, independent enrollment assisters are available to assist with applications.

Resource	Contact	Service
Enrollment Assisters	Local offices	Enrollment assisters, including Navigators and Certified Application Counselors, work for hospitals and community groups. They’re trained to help people apply for coverage and can also answer questions about eligibility, benefits and regulations. Assisters can be found throughout the state, and all help is provided for free.
MassHealth Customer Service	(800) 841-2900 or (877) 623-6765	MassHealth Customer Service can answer questions about applications over the phone and in person at MassHealth Enrollment Centers.
Senior Guide to Health Care Coverage	Online	The Senior Guide to Health Care Coverage is a detailed guidebook to health care options for older adults in Massachusetts. It includes information about eligibility, programs available, benefits and how to apply for MassHealth.

Can You Use Medicare to Pay for Assisted Living in Massachusetts?

Unfortunately, Medicare does not cover the cost of assisted living in Massachusetts. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

For more information about what Medicare visit medicare.gov.

Are There Other Financial Assistance Options for Assisted Living in Massachusetts?

	How to Apply	How It Works
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free and Low-Cost Resources for Seniors in Massachusetts

Seniors in Massachusetts have access to a wide range of programs and resources that can provide support. Government offices offer financial assistance to help pay for medications, care and housing. Local programs can also offer services that help seniors stay independent and healthy.

Resource	Contact	Service
Massachusetts State Supplement Program	(877) 863-1128	The State Supplement Program is an additional payment made to people who receive Supplemental Security Income. The amount available to participants depends on the individual’s living arrangements. Assisted living payments are known as SSI-G. This payment is used to pay for room and board in certified assisted living facilities. Those who earn too much to receive SSI may be eligible for a partial payment from the state.
Prescription Advantage	(800) 610-0241	Prescription Advantage helps seniors and people with disabilities lower their prescription drug costs. For people who have Medicare or a prescription drug plan, the program helps fill coverage gaps. Those who aren’t eligible for Medicare may be able to receive primary coverage through Prescription Advantage. Generally, the program isn’t available to MassHealth participants, but those who use MassHealth to help pay for health insurance premiums may be eligible.
Supportive Senior Housing Initiative Program	Local Housing Authorities	The Supportive Senior Housing Initiative Program is a state-funded program that brings the benefits of assisted living to public housing. Residents of participating public housing developments can access supportive services, including housekeeping, meals, case management and medication reminders. The communities also have personal care staff on-site around the clock to help with activities of daily living, medication reminders and more. Applications are managed locally, so interested seniors should contact their local housing authority. Some communities may have waiting lists.
Councils on Aging	Contact Local Centers	Councils on Aging serve as Massachusetts’ Area Agencies on Aging. There are 350 councils across the state that provide outreach, transportation, health screenings and social activities. Councils also act as advocates for older adults in their community. As local agencies, each council has different programs and services based on the needs of local seniors.
Ombudsman Programs	(617) 727-7750	Massachusetts has a number of ombudsman programs that help older adults resolve complaints relating to their care. The Community Care Ombudsman advocates for people who receive home health care or services through community-based MassHealth programs. The Long Term Care Ombudsman is responsible for those in nursing and rest homes, while the Assisted Living Ombudsman helps resolve problems for people in assisted living facilities. The ombudsman can also provide information about claims that have been filed against facilities to help seniors make informed decisions about their care.
Executive Office of Elder Affairs	(617) 727-7750	The Executive Office of Elder Affairs oversees a range of programs that help older adults stay living safely in the community. It partners with nonprofit agencies throughout the state to support seniors and caregivers and is actively working to make Massachusetts an age-friendly state. Programs ofered by the office include health insurance counseling, advocacy services and legal assistance.

COVID-19 Rules for Assisted Living in Massachusetts

The following information is based on research done on several government websites, including mass.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/8/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Yes
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	Not Available*
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

*NOTE: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Assisted Living Laws and Regulations in Massachusetts

Assisted living facilities in Massachusetts must follow the regulations set out by the state to ensure the health and safety of residents. The Executive Office of Elder Affairs licenses facilities and conducts regular inspections to ensure that communities meet the state’s high standards for assisted living residences.