In 2019, Massachusetts had a population of 6,892,503 residents; 16.5% of these residents were 65 and older. Based on data released by the U.S. Census Bureau, the UMass Donahue Institute expects seniors to make up 21.2% of the Massachusetts population by 2030. With 192 miles of coastline, more than 100 museums and easy access to some of America’s most treasured historical sites, the Bay State is ideal for active seniors. Because Massachusetts has nationally ranked research hospitals and no state tax on Social Security income, it’s also a great place to retire.

Despite the many benefits of living in Massachusetts, the state does have a high cost of living, which affects the cost of senior care. As a result, seniors can expect to pay an average of $5,640 per month for assisted living, which is significantly higher than the national average of $4,051. This guide provides information on the costs associated with senior living, compares assisted living with other types of senior care and describes several programs that can make senior living more affordable.

The Cost of Senior Living in Massachusetts

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Seniors in Massachusetts have several types of long-term care at their disposal, depending on their health and care needs, financial situation and preferences. Active seniors who don’t need medical or personal care services may consider independent living communities. For older citizens who require some assistance with day-to-day activities, assisted living is ideal. Memory care is often offered in assisting living facilities, with trained staff and cognitively stimulating activities to support seniors with dementia. Nursing home care may be appropriate for elderly adults who need regular skilled nursing care.

Per Genworth’s 2021 Cost of Care Survey, costs of long-term care in Massachusetts are typically slightly higher than its New England neighbors. Independent living is the most affordable option, at around $4,225 per month. Older adults can expect to pay $6,500 for assisted living. Although memory care is often provided in assisted living communities, services are more intensive and subject to higher regulations, resulting in a higher fee of $8,125. Nursing facility care provides the highest possible level of care, reflected by the higher monthly average of $12,623.

The Cost of Assisted Living in Massachusetts

Assisted living in Massachusetts costs on average $6,500 per month, which is $2,000 more than the nationwide median of $4,500. To the southeast, costs are a little higher in Rhode Island, where seniors pay around $6,826 per month. Rates are lower in Connecticut, with a monthly median of $5,129. To the north, assisted living costs around $6,053 and $5,250 in New Hampshire and Vermont respectively.

The Cost of Nursing Home Care in Massachusetts

At around $12,623 per month, nursing home care in Massachusetts is costlier than the U.S. average of $7,908. Seniors in Massachusetts also pay more for nursing home care than their neighbors in Vermont and New Hampshire, where average rates are $10,585 and $10,950 respectively. At around $9,429, Rhode Island is one of the most-affordable nearby states for nursing home care. Connecticut prices are higher, at $13,764 on average per month.  

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

Paying for long-term care can be costly. Fortunately, Massachusetts has programs that can help older adults cover their care costs. Many senior citizens receive Medicaid assistance, known as MassHealth, to cover costs beyond what they can afford. Jointly operated by state and national governments, the program provides health insurance provisions for eligible seniors.

For residents of nursing homes, Medicaid covers care and services directly under the MassHealth Standard plan.

Through the Group Adult Foster Care (GAFC) Program, Medicaid may directly pay for services in assisted living or memory care facilities.

As independent living is for seniors who don’t need medical or personal care support, it isn’t covered at all by MassHealth. This is the same in most other states.     

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Partial	Medicaid	Yes**
Independent Living	None	N/A	N/A
Memory Care	Partial	Medicaid	Yes**
Nursing Home Care	Full	Medicaid	Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” then participant caps could be in place, and there may be a waiting list.

**There may be a waiting list for the entitlement GAFC program if no beds are available.

Medicaid’s Coverage of Assisted Living & Memory Care in Massachusetts

Medicaid may directly cover services in assisted living and memory care facilities through the Group Adult Foster Care (GAFC) program. The program doesn’t cover the costs of bed and board. Although an entitlement program, seniors may be waitlisted until a bed becomes available in a GAFC-certified facility; the program isn’t available for every assisted living or memory care community in Massachusetts.

To be eligible, older adults must require help with at least one activity of daily living or instrumental activity of daily living. They must have a medical, physical, mental or cognitive condition whereby they cannot live independently. Income and asset limits also apply. Services covered include assistance with bathing, dressing and toileting, meal preparation, transportation, medication management, laundry and housekeeping.    

To apply, seniors should complete the relevant application form and return it, along with supporting documents and the Long-Term-Care Supplement, to the main MassHealth Enrollment Center in Charleston. Seniors can obtain advice and assistance from the Customer Service Center at (800) 841-2900 or in person at one of the six MassHealth Enrollment Centers. Limited walk-in appointments are available so advance bookings are advised. 

Medicaid’s Coverage of Nursing Home Care in Massachusetts

Five in eight nursing home residents in Massachusetts receive Medicaid assistance. Funding covers bed and meals in addition to 24/7 skilled nursing care, personal care services, assistance with daily activities, medication management and rehabilitative therapies. Recipients must use all of their income toward care costs, with limited exceptions, and Medicaid covers additional amounts to meet the full cost of care. To qualify for nursing facility services, seniors may need a medical assessment from their physician.

Eligibility for Medicaid in Massachusetts 

Seniors applying for Medicaid in Massachusetts are subject to income and asset limits.

For single seniors, the income cap is $13,596 and the asset limit is $2,000. For joint applicant couples, the maximum permitted annual income is $18,312 and the asset limit is $3,000. For a two-person household where only one spouse applies for Medicaid, the applicant’s maximum income is $13,596. Asset limits are $2,000 for the applicant and $137,400 for their spouse.

2022 Massachusetts Medicaid Income Limits

	Income Limits*	Asset Limits
Single Person	$13,596	$2,000
Two-Person Household(Only one applicant)	$13,596 for applicant	$2,000 for applicant$137,400 for non-applicant
Two-Person Household(Two applicants)	$18,312	$3,000

*per year

Individuals must satisfy additional criteria to qualify for Medicaid assistance:

• Claimants must be U.S. citizens or qualified non-citizens.
• Applicants must reside in Massachusetts on a full-time permanent basis.
• Those applying for nursing home care must require a nursing home level of care. Those applying for assisted living or memory care under the Group Adult Foster Care Program must need assistance with daily activities.

Applying for Medicaid in Massachusetts

Although general Medicaid applications can be completed online, seniors applying for long-term care cover must apply in person, by mail or by fax.

Seniors can print the Application for Health Coverage for Seniors and People Needing Long-Term-Care Services or call (800) 497-4648 to arrange for an application form to be mailed to their home address.

The address for returning completed applications by post is MassHealth Enrollment Center, P.O. Box 290794, Charlestown, MA 02129-0214. Applicants may also visit one of the state’s six MassHealth Enrollment Centers to apply in person. Appointments can be made through the online booking system. Alternatively, applications can be faxed to (617) 887-8799.  

Before You Apply

For timely claim processing, applicants should prepare all supporting documents as required. Claims may be denied or delayed without all the necessary details. These include:

• Proof of identification
• Proof of U.S. citizenship, nationality or legal alien status
• Proof of Massachusetts residency
• Social Security number
• Up-to-date bank statements
• Proof of assets and income
• Proof of existing health insurance

 How To Get Help    

Massachusetts seniors have several options for obtaining Medicaid-related assistance and advice. The following resources can help individuals understand their entitlements, assess eligibility and help submit claims and appeals.

	Contact	What You Should Know
MassHealth Enrollment Center	(800) 841-2900	Individuals can visit one of Massachusetts’s six MassHealth Enrollment Centers (MECs) to check their eligibility for long-term care and for help completing application forms. Advisers can also provide status updates on pending applications.
American Council on Aging	Online form	The American Council on Aging provides detailed information for older adults via its website. Seniors can complete an online form for a free eligibility check and to be connected with affordable Medicaid planners throughout Massachusetts.
Massachusetts Council on Aging	(413) 527-6425	Massachusetts has a large statewide network of Councils on Aging and Senior Centers to assist older adults on a range of aging-related issues. Seniors may visit their local council or senior center, and some offer live and pre-recorded virtual programs. Advisors can help seniors complete Medicaid applications and they offer services including health insurance counseling, social activities, educational programs, health checks and transportation.

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

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing services
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Nursing Home Care Services Aren’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

Medicare Support & Resources in Massachusetts

Seniors and their loved ones can access free and low-cost services related to Medicare, including assistance applying for and understanding coverage, comparing plans and saving money on premiums and copays. 

Resource	Contact	What You Should Know
Serving the Health Insurance Needs of Everyone	(800) 243-4636	The Serving the Health Insurance Needs of Everyone (SHINE) program is provided by Massachusetts’s Executive Office of Elder Affairs. Medicare recipients and seniors who will soon become eligible for Medicare can take advantage of free, unbiased counseling. One-on-one in-person counseling sessions are available throughout the state, and seniors can book appointments via the helpline. Trained volunteers help people compare plans, understand costs and what coverage includes and apply for plans.
Social Security Administration	(800) 772-1213	Individuals may visit their local Social Security office for in-person guidance and help with Medicare claims and appeals. Beneficiaries can report any changes in circumstances and order replacement Medicare cards. Assistance is also available via the helpline between 8 a.m. and 7 p.m. on weekdays or seniors can submit questions through the online contact form.
Medicare.gov	(800) 633-4227	The official government Medicare website provides up-to-date information, including Medicare costs and eligibility criteria, as well as in-depth details about Medigap and Medicare Advantage Plans. Individuals can compare care providers, sign up for coverage and join the online mailing list to receive updates and news.

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

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in Massachusetts. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
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 Senior Living Resources for Seniors in Massachusetts

Older adults in Massachusetts have a range of free and affordable services, programs and benefits available to them. Provided by government and nonprofit agencies, these resources are geared toward empowering seniors, helping elders and their family members navigate aging-related options and maintaining the highest possible quality of life as people age. 

	Contact	What You Should Know
Area Agencies on Aging	Contact individual agencies directly	Massachusetts’s 22 Area Agencies on Aging comply with provisions of the Older Americans Act and operate under the Executive Office of Elder Affairs. Regional agencies provide diverse supportive programs, including education on aging concerns, health and well-being, nutrition, financial assistance and transportation.
Massachusetts Assisted Living Ombudsman	(617) 727-7750	Acting as advocates and advisors, assisted living ombudsmen ensure residents’ rights are upheld and help seniors resolve any issues related to the care standards and quality of life in assisted living facilities. The ombudsmen investigate complaints made against facilities by seniors and their loved ones.
The Attorney General’s Elder Hotline	(888) 243-5337	The Attorney General’s Elder Hotline is a free statewide advisory service. The hotline is available Monday to Friday from 10 a.m. until 4 p.m. and assists seniors on issues including elder abuse and neglect, consumer rights, long-term care, housing, debts and health insurance.
LGBTQIA+ Aging Project	(857) 313-6590	The LGBTQIA+ Aging Project promotes inclusion, fairness and community for older lesbian, gay, bisexual, transgender, queer, intersex and asexual people. Focusing on the specific needs of LGBTQIA+ seniors, the team provides unique support for community members and specialized training for aging-related organizations. The project also informs policy development at all levels and actively advocates for equal treatment and rights.
Aging and Disability Resource Consortia	Contact individual consortia directly	Operating across Massachusetts, the Aging and Disability Resource Consortia (ADRC) provides free options counseling for long-term care and aging support. Seniors can connect with a counselor via Aging Service Access Points (ASAPs) and Independent Living Centers (ILs).
Dementia Friendly America Massachusetts	Online contact form	A member of the nationwide Dementia Friendly America, DFA Massachusetts promotes inclusion and support for people with deteriorative memory loss conditions. With a network comprising organizations, local governments, first responders, private individuals and religious leaders, the initiative provides a range of online resources, engages with communities and hosts educational events. Its goal is to create more dementia-friendly areas and raise awareness of dementia-related issues. Under the project, regions have taken positive steps that include establishing memory cafes, setting up respite programs and arranging professional training.

COVID-19 Rules and Restrictions for Massachusetts Senior Living Facilities

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)

Senior Living Laws and Regulations in Massachusetts

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

In Massachusetts, the Department of Elder Affairs regulates senior living facilities. All facilities must follow the regulations outlined in the Code of Massachusetts Regulations to keep their licenses in good standing. These are some of the laws Massachusetts senior living facilities must follow.

Scope of Care

In Massachusetts, all senior living facilities must provide a minimum level of service. Required services include assistance with activities of daily living, housekeeping, laundry, management of self-administered medications and assistance with residents’ emergency needs.

Senior living facilities aren’t permitted to provide ongoing skilled nursing services. If residents require skilled nursing, it must be provided by a certified home health agency. Nurses employed by senior living facilities are prohibited from directing unlicensed staff members to administer medications or perform skilled nursing services.

Care Plan Requirements

Before a resident is admitted to an senior living facility, staff members must conduct an initial assessment to determine whether the facility can meet the individual’s needs. If the individual meets the facility’s admission requirements, staff members must develop a service plan based on the results of the assessment and an evaluation performed by a licensed medical professional. Every plan must include information related to the resident’s medical status, allergies, medication needs, personal care needs, psychosocial history, ability to manage medications and level of assistance required during emergencies.

Requirements for Memory Care Units

Facilities with special care units for residents with Alzheimer’s disease and other forms of dementia must meet additional requirements. For example, a special residence must have at least two staff members awake and on duty at all times. The facility needs to have a detailed plan describing the physical environment, the building’s physical design and the safety features available to protect residents. Memory care units must also have secure entry and exit doors in all common areas.

Staff members who work in special care units and have direct contact with residents must receive seven hours of initial training to help them meet the specialized needs of residents with dementia. All staff members must receive 10 additional hours of training each year.

Staffing Requirements

All prospective staff members must undergo a background check before starting work at a senior living facility in Massachusetts. Senior living facilities may not employ staff members who have been convicted of offenses that are reasonably related to the health or safety of residents. Individuals with felony convictions are prohibited from serving as managers of senior living facilities.

Every senior living facility must designate a manager and a service coordinator. Staff members who provide direct care to residents must be licensed health care professionals or complete a 54-hour training program. Licensed health professionals include registered nurses, certified home health aides and certified nursing assistants. Massachusetts has no minimum staffing ratio for senior living facilities. Still, every residence must have enough staff members on duty at all times to meet the needs of residents and respond to any emergencies.

Training Requirements

All direct-care staff must complete a seven-hour orientation that includes training in resident rights, elder abuse and exploitation, the aging process, emergency preparedness and other relevant topics. Staff members who provide personal care must also complete one hour of training in medication management.

Medication Management

All facilities are required to provide assistance with the self-administration of medications. Only staff members who have completed the necessary training are permitted to provide this type of care. Massachusetts also allows senior living facilities to offer limited medication administration services. If a facility chooses to provide this optional service, medications must be administered by a licensed nurse or another individual who meets the definition of a licensed practitioner.

Abuse and Neglect Reporting

Staff members are required to report allegations of abuse, neglect and exploitation to Elder Protective Services. Reports can be made by telephone at (800) 922-2275 or online at the Executive Office of Elder Affairs website.

Frequently Asked Questions

How much does assisted living cost in Massachusetts?

Massachusetts seniors can expect to pay $5,640 per month, on average, for assisted living. This is higher than the national average of $4,051 per month, but assisted living is more affordable in Massachusetts than it is in nearby New Hampshire.

Does Massachusetts Medicaid pay for assisted living?

Seniors with traditional Medicaid coverage can’t use their benefits to pay for assisted living; however, Massachusetts does have a Medicaid waiver program that aims to keep residents in their communities. The Moving Forward Plan Community Living waiver is available to seniors who are at least 65 years old and meet the Medicaid eligibility requirements.

Does Medicare pay for assisted living?

Although Medicare pays for nursing home care, it doesn’t provide coverage for assisted living.

What types of care are provided by assisted living facilities?

Assisted living facilities typically provide assistance with personal care, arrange for transportation to off-site appointments, take care of cleaning and laundry duties, help residents with the self-administration of their medications and plan social activities for residents. Some facilities have special care units that provide additional support to residents with dementia. In Massachusetts, an assisted living facility may also offer medication administration services, but a nurse or other licensed practitioner must administer all medications.

What is the difference between assisted living and nursing homes?

Nursing homes provide ongoing medical care to residents who need more assistance than an assisted living facility can provide. Although assisted living facilities provide personal care and assistance with some activities of daily living, they don’t offer skilled nursing services on a regular basis.

Learn More About Senior Living in Massachusetts

For more information about specific types of senior living in Massachusetts read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in Massachusetts

Learn more about the cost of senior living in the top Massachusetts cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.