How to Become a Paid Caregiver for a Family Member in Massachusetts


Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

Across the country, there are a variety of programs to help caregivers provide care for loved ones. Unfortunately, there is no uniform US criteria to become a paid caregiver for a family member, and Medicaid funds most programs. Caregiver resources are often in short supply, and many families are left out of these programs because their income and assets are too high.

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Is it possible to become a paid caregiver for a family member in Massachusetts? While Medicaid is a joint state and federal program to provide health insurance and programming for low-income and disabled individuals. How each state delegates its funds, and the programs they offer varies. The idea behind paid family caregiver programs is that often someone you know can provide the best care for you and may already be doing it. 

Receiving care at home is something most people wish for themselves and their loved ones. This avoids institutional care while saving the state and the government money. It’s also more comfortable for loved ones long-term, and it gives family members peace of mind. 

In short, Massachusetts does have a program that can assist caregivers with taking care of a loved one. However, with all Medicaid funding, families must meet specific care and financial criteria. Receiving the kind of support and resources available can help offset the loss of income if you have had to stop work to care for a loved one. In this guide, we’ll share how to become a paid caregiver for a loved one in Massachusetts. 

Can a Family Member Get Paid to Be a Caregiver in Massachusetts?

A family member can get paid to be a caregiver in Massachusetts under their Adult Foster Care program. Massachusetts Medicaid is called MassHealth. To qualify for the Adult Foster Care program, the recipient must be financially eligible for MassHealth. 

Receiving the support and resources of this program helps lower care costs and prevent caregiver burnout. To understand whether this is the right program for your family, let’s look into the Adult Foster Care program and how you can participate.

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What is the Adult Foster Care Program?

To begin, the Adult Foster Care program allows qualified individuals to often live in a caregivers’ home with other program recipients. Alternatively, the caregiver can move in with the person who needs care. 

It is not required that the caregiver be a family member, but this is the most common situation. The person being cared for can’t have care needs that exceed the skill or ability of the caregiver. This ensures they’re able to be cared for safely. That being said, a nursing home level of care is not required to participate in this program.

Other support services are part of the Adult Foster Care Program. These include:

  • An initial assessment and development of an individualized plan of care
  • The Adult Foster Care program provides nursing oversight by a registered nurse or care manager
  • A care/case manager conducts on-site visits to ensure compliance with policies and care needs
  • Documentation of the recipient's health condition
  • Education to provider and recipient about hygiene and any health concerns
  • Assist with coordination and referral to any other organizations or resources
  • Help with developing an emergency and caregiver backup plan
  • Assistance with transportation
  • Maintenance of durable medical equipment

As you can see from this list above, this is a helpful program for those who qualify. 


Next, how do you know if you’re eligible for this program in Massachusetts? Eligibility to participate in the Adult Foster Home program involves meeting financial and care criteria. 

Individuals need to apply to MassHealth (Massachusetts Medicaid) to participate in the Adult Foster Care program. To give you a general idea of the income level required, a household of one can earn no more than $17,131 a year. The asset level is $2000. This table provides the most current asset and income level for MassHealth.

Additionally, the recipient must be a Massachusetts resident over the age of 65. A doctor’s order is required to initiate the application.

Other eligibility criteria have to do with care needs or what is referred to as clinical criteria. In other words, what does the care recipient need help with? Is the help something that the caregiver can provide? If the member needs a higher level of care, they may need to go to a nursing home.

Activities of Daily Living (ADLs)

  • Bathing: Assistance with either a shower, bath, or bed bath if the person is bed-bound. Help with oral care such as brushing teeth or caring for dentures, also, providing hair care and shaving.
  • Dressing: Under the Adult Foster Home criteria, the member requires help with putting clothes on their upper and lower body. Not solely help with shoes or buttons, snaps, or zippers.
  • Toileting: The member must be lifted or assisted to the toilet
  • Transferring: Transferring is assisting someone by lifting or guiding them to another position, such as from the bed to a wheelchair or walker.
  • Mobility: Mobility can be a problem for many. But for a member of the Adult Foster Care program, the person must need assistance and guidance with walking or propelling a wheelchair.
  • Eating: The member needs assistance with getting food to their mouth or constant supervision while eating. 

Instrumental Activities of Daily Living (IADLs)

  • Transportation: Does the person need assistance to get to appointments through public transportation or some other means?
  • Meal preparation: The caregiver assists the recipient with shopping and preparing meals.
  • Housework: The caregiver can clean, do laundry, take care of the lawn, and maintain the residence.
  • Medications: Provides assistance with ordering, organizing, and managing medications.
  • Finances: Caregiver pays bills and manages all aspects of personal finance.
  • Communication: Can the person communicate verbally, on the phone, or otherwise?

How Much Do Family Members Get Paid for Caregiving in Massachusetts?

How much a family gets paid for caregiving in Massachusetts depends on the clinical assessment results of the person they are providing care to. For example, if the member is a Level 1, the caregiver is paid $48.10 a day. If the recipient is a Level 11, then the caregiver receives $82.67 a day. 

The Adult Foster Care program does not pay room and board for the member, so they are responsible for that unless the caregiver waives it. It’s important to calculate the value of this program vs. hiring a traditional caregiver or nursing facility. 

Do You Need to Get Training to Become a Paid Family Caregiver in Massachusetts?

Training of a caregiver is part of the Adult Foster Care program, and there are other requirements as well, including the physical conditions of the home itself. To become a paid caregiver under the program you:

  • Must be 18 years of age
  • Not suffer from alcohol or substance abuse disorder
  • Be available and physically able to provide 24-hour care and supervision
  • Pass a criminal background check
  • Pass a sex offender registry check
  • The caregiver must provide references
  • The caregiver must pass a physical and get a TB test
  • Ensure that the home is clean and in working order to support the care needed. This includes smoke detectors, a first aid kit, a carbon dioxide detector, a separate bedroom for the recipient, and adequate space for clothing and personal items.

For anyone considering becoming a caregiver under the Adult Foster Care program, you can do additional online caregiver training to bolster your skills. Although the program offers training and oversight, the more you know about caring for someone, the better. Being a caregiver isn’t a substitute for medical care. 

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5 Steps to Become a Paid Caregiver for a Family Member in Massachusetts

Luckily, the steps to take to become a paid caregiver for a family member in Massachusetts are relatively straightforward. Considering the time it can take to get on MassHealth and complete the paperwork for application to the Adult Foster Home program, look to other caregiver resources in Massachusetts for more specific help. For you, as a caregiver to be paid, your loved one must first go through the following steps to qualify for Mass Health.

Step 1. Apply for MassHealth

First, to qualify for the Adult Foster Care program and for your family caregiver to be paid, you must apply for MassHealth. The application goes over what you need to meet the financial criteria in great detail. It can take up to three months or longer to get qualified, so start this process early. 

Step 2. Apply for the Adult Foster Care program

Once you are approved for MassHealth, your primary care provider will fill out the PCP order form. This form spells out and identifies the specific areas in which you need assistance and care. Confirmation of care needs is necessary to be approved for the program and for your family member to be paid to provide that care.

Step 3. Find an adult foster home

Find an Adult Foster Home in Massachusetts. If you aren’t living with a family member, you will need to find a home that has an opening. If you will be living with someone you know as a caregiver, family or otherwise, they will need to fill out and conform to the requirements to become a paid caregiver through the program. The caregiver must live with you under the Adult Foster Care program.

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Step 4. Approval process

Once someone is approved for the Adult Foster Care program, they will receive a letter from MassHealth. A Registered Nurse or Care Manager will schedule a meeting to begin services. 

While you are waiting for approval, consider other options such as home health under your insurance (if you are already on MassHealth, you can request home health under that plan) to assist you in the short term until your family member can be paid.

Step 5. If you don’t qualify

If you don’t meet the eligibility requirements for either MassHealth or the Adult Foster Care program, you can consider paying your family member directly to care for you. Similarly, you can hire someone from a personal care agency to assist you. 

Don’t be discouraged if you’re unable to qualify through MassHealth. This can be a tricky process, and it’s good to explore your full range of options. 

Becoming a Paid Caregiver for a Family Member in Massachusetts

Caregiving as a family member can be taxing and overwhelming. Each state has programs to help you either financially or assist you with other caregiver support. 

If you think your loved one may qualify for you to be paid as a caregiver, apply. If you are approved for the program, the support will be invaluable. Everyone deserves compassion and care during life’s biggest transitions. 


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