Massachusetts Group Adult Foster Care and the SSI-G Assisted Living Benefit

Program Description

 Combining the benefits from these programs will pay for personal care as well as room and board in assisted living residences.

This program helps elderly, low income Massachusetts residents with the cost of group adult foster care. Group adult foster care includes assisted living care, provided the residence has been approved by the GAFC Program. The residences included this program tend to be smaller group homes.

The Program pays for personal care services and medication management and administration, but does not cover living costs, such as room and board. Massachusetts, however, provides financial assistance for assisted living room and board costs through Supplemental Security Income (SSI-G) Assisted Living Benefit. This can be used in combination with the GAFC Program. The GAFC Program is under the administration of MassHealth—the Massachusetts Medicaid program.

Free assistance is available to help Massachusetts residents find affordable assisted living within the state.  Get started here.

 

Eligibility Guidelines

In addition to being aged 22 or older and a Massachusetts resident, the eligibility requirements for the GAFC program consider both the applicant's health and their financial situation. To qualify, the applicant must need help with at least one of their activities of daily living, e.g. dressing, bathing, or using the bathroom. A medical doctor must document and certify the participant's conditions and the level of care required.

Income
Financially, the applicant must qualify for MassHealth. MassHealth is the state name for the Medicaid program. Massachusetts considers both the applicant's income and their countable assets. In 2017, the monthly income maximum for a single senior is $1005 per month, a married couple with both spouses applying can have up to $1,354 per month in income.

This income limit is for aged applicants only, which means that they must be 65 or older. Applicants under 65 have a lower income limit. Massachusetts also permits people to qualify for MassHealth through demonstrating that they have very high reoccurring medical expenses. This is known as the medically needy pathway and it does not depend on the applicant’s age. 

Assets
The maximum value of the applicant's countable assets is set at $2,000 for an individual or $3,000 for a couple. However, there are many exceptions to this rule. Countable assets do not include one's home or vehicle. Married couples with only one applicant are permitted up to a maximum of $120,800.


MassHealth eligibility is complicated and there are many gray areas and different income levels depending on the applicant's conditions. Persons who do not meet the strict financial limits are encouraged to consult with a MassHealth eligibility expert prior to making an application to ensure the best possibility of acceptance into this program.

Benefits and Services

The GAFC Program pays for the cost of personal care and medication administration in group adult foster care or at approved assisted living communities throughout the state of Massachusetts. This program does not pay for room and board. Personal care includes assistance with the five activities of daily—bathing, transferring or mobility, toileting, dressing, and eating—as well as other important activities, such as personal hygiene.


SSI-G provides funding for the room and board portion of adult foster care or assisted living. The maximum monthly benefit is estimated to be up to $1,000 per month. 

 

 

How to Apply / Learn More

There are several options to apply.  One can call 1-800-841-2900 or visit any of the Massachusetts Area Agencies on Aging.  Both GAFC and SSI-G are available statewide.  

Did You Know?  Assisted living communities are designed to create a family like environment and over half of them limit their residents to less than 10 people.