Massachusetts’ Medicaid program, MassHealth, supports aging seniors during daytime hours with its Adult Day Health (ADH) program. Through a combination of daytime services, this program aims to provide a care environment that supports elders in their emotional, cognitive, and physical wellbeing.
Trained staff assists seniors with their Activities of Daily Living (ADL), such as bathing and dressing, as well as provide skilled nursing tasks. In addition to the elderly who require adult day health services due to the process of aging, this program also serves persons with severe conditions, as well as those who have been diagnosed with Alzheimer’s disease and other related dementias.
By providing Adult Day Health, the state health administrators hope to delay institutionalization and help facilitate a community-aging alternative to nursing home care. Not only is adult day care much less expensive than nursing home care, many Massachusetts families and seniors prefer this type of care over being institutionalized. Family caregivers also benefit by being able to continue to work during business hours without the need to hire a private caregiver.
Massachusetts residents are eligible if they meet the following criteria:
Applicants must also meet the financial requirements of MassHealth.
Single seniors, as of 2023, cannot have more than $1,215 in monthly income. Couples are allowed up to $1,526 a month, regardless of whether one or both spouses are applying. This figure is 100% of the Federal Poverty Level (FPL), which changes annually.
Seniors over 65 in Massachusetts must have less than $2,000 in countable assets. If married, couples are allowed up to $3,000 in assets. However, not all assets are counted toward the limit. Some resources that are considered exempt are one’s home, provided the equity value is under $1,033,000, household belongings and a vehicle, among other items.
If your assets and / or income are over the published limits, this is not necessarily the end of the process. Massachusetts permits residents to “spend down” their monthly income on qualified medical expenses in order to meet the income limit. In addition, assets can be reallocated and / or “spent down” on qualified purchases.
However, this is a complicated process, and it is advised that one consult a Medicaid professional before attempting to do so. As mentioned above, violating Medicaid’s look-back rule will result in a denial of benefits and services.
The Adult Day Health program helps elders avoid the need for more intensive care in a 24-hour facility. The following is a general list of services that are available via the Adult Day Health program in Massachusetts:
Individuals interested in applying for the Adult Day Health program must first be enrolled in MassHealth for senior services. Detailed information on applying for MassHealth can be found here.
To apply for Adult Day Health benefits, one can contact their local Aging Services Access Point, or call MassHealth Customer Service Center at 800-841-2900.
Learn more about this Massachusetts Medicaid program in the Adult Day Health Manual on the state website.