Massachusetts Home Health: Local Terms and Definitions, How to Pay for Home Health, and Questions to Ask
Massachusetts, long celebrated for its world-class health system, is ranked #1 in the nation for health care affordability and access, reflecting its strong commitment to quality and reach in services that matter most to older adults. This high standard extends to home health care, which includes skilled nursing, therapy services, and personal support to help seniors remain safe and comfortable at home. With such a strong reputation for excellence, Massachusetts offers peace of mind for those seeking care in familiar surroundings.
*Take note that home health services are different from other types of care. Generally, when people think of senior care they immediately imagine a nursing home. This is definitely not the case. Nursing homes are far from your only option when providing care for a loved one.
Definitions of types of care
Home Care: Caregiver assistance related to activities of daily living, including: mobility, eating, toileting, bathing and personal hygiene, dressing and grooming or cognition support. These services are typically not covered by medical insurance and do not require a physician’s order.
Home Health: includes skilled nursing services, physical therapy, occupational therapy, speech language therapy and medical social services. A home health care agency may choose to be Medicare certified to be reimbursed for their services. Home health agencies may also teach you how to care for yourself. Services ordered by a physician, covered by Medical Insurance and typically provided following a hospital or skilled rehab stay.
Rehabilitation & Therapy: treatment for an injury, illness, or pain with the goal of restoring function, including nursing and therapy services. Rehab is ordered by
a physician and services are provided by nurses and physical, occupational, and speech therapists. Examples include working with a physical therapist to help you walk and with an occupational therapist to help you get dressed.
Respite Care: short term relief for family caregivers to take a break from the caregiving responsibilities and allows for a healthier and better quality of life for both the caregiver and care receiver. Respite services include: companionship, personal care, recreational activities and security. Respite care can be provided as short stay or for a longer period that allows the family caregiver to go on vacation or a business trip. Longer duration respite care is generally found at select senior housing communities although some Companion services may provide this service in the home.
Hospice Care (Palliative Care): emphasizes comfort measures and counseling to provide social, spiritual and physical support to the dying patient and his or her family. The goals of hospice are to keep the patient as comfortable as possible by relieving pain and other symptoms. Hospice care, is typically offered in the last six months of life and covered under Medicare Part A .
Local Terms and Definitions
In Massachusetts, “home health” refers to skilled medical services provided in a person’s residence by licensed professionals such as nurses, therapists, and home health aides, often under a physician’s direction. These services may include wound care, medication management, rehabilitation therapies, and health monitoring for chronic conditions. The state may also refer to this care as “skilled home health services,” “visiting nurse services,” or “in-home skilled care.”
About Massachusetts
Massachusetts, known as the “Bay State,” is famous for its pivotal role in American history, vibrant cultural scene, and picturesque mix of coastal shorelines, rolling hills, and charming small towns. Home to about 7 million residents, roughly 18% of the population is age 65 or older. Major cities include Boston, Worcester, Springfield, and Cambridge, with iconic landmarks such as the Freedom Trail, Cape Cod, and historic Harvard University.
How much does Home Health in Massachusetts cost?
In Massachusetts, home health care services generally cost between $38 and $42 per hour, depending on the provider and type of care. This typically includes skilled nursing visits, physical or occupational therapy, health monitoring, and assistance with medical needs. Costs vary across the state, with rates averaging around $37 per hour in Boston, closer to $29 per hour in Worcester, and reaching as high as $50 per hour in areas like Cape Cod for specialized skilled care.
How to pay for Home Health and available coverage
Medicare:
Generally Medicare reimburses the cost of Home health services. Medicare typically covers your loved one when recovering from an illness or an accident or a surgery.
*Medicare covers the specific ailment. When treatment is completed Medicare coverage stops.
Medicare is not a long-term care solution.
Medicaid:
Medicaid programs are put in place on a state-by-state basis. Each state will have their own regulations regarding the coverage of care. Some individuals at a certain low-income level may qualify for Medicaid Home and Community Based Service Waivers.
Veteran Aid and Attendance:
This benefit is available to some military veterans or surviving spouses.
- A veteran may qualify for as much as $2,050 each month.
- A veteran with a sick spouse may be eligible for $1,600 per month.
- If a veteran has passed, their surviving spouse can qualify for $1,300 per month.
Private Insurance:
- Most health insurance companies typically cover some services for acute medical needs.
- Do be aware, long-term coverage vary by plan. Not all long-term insurance will assist with home health services as the needs of the person tend to be temporary.
Private pay:
Families which can afford to do so may pay for care with private funds. Private pay can be a combination of retirement funds, personal savings, pension payments and family members may contribute funds toward a loved one’s care as well.
Questions to ask when looking for Home Health
- How long has the agency been serving this community?
- Does the agency have any printed brochures describing the services it offers and how much they cost?
- Is the agency an approved Medicare provider?
- Is the agency currently licensed to practice (if required in the state where you live)?
- Does a national accrediting body certify the quality of care?
- Does the agency offer seniors a “Patients’ Bill of Rights” that describes the rights and responsibilities of both the agency and the senior being cared for?
- Is there a care plan in place that outline the patient’s course of treatment, describing the specific tasks to be performed by each caregiver?
- How closely do supervisors oversee care to ensure quality?
- Will agency caregivers keep family members informed about the kind of care their loved one is getting?
- Are agency staff members available around the clock, seven days a week, if necessary?
- Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day?
- How does the agency ensure patient confidentiality?
- How are agency caregivers hired and trained?
- What is the procedure for resolving problems when they occur?
- How does the agency handle billing?
- Is there a sliding fee schedule based on ability to pay, and is financial assistance available to pay for services?
- Will the agency provide a list of references for its caregivers?
- Who does the agency call if the home health care worker cannot come when scheduled?
- What type of employee screening is done?
Local Resources and Links – Massachusetts
Central Massachusetts Agency on Aging seeks to outreach to older persons and their caregivers, hoping to educate them on services and programs that are meant to serve and assist them to remain safely and securely in our communities.
Age Strong Commission As an AAA, the Commission provides funding to community partners to provide services to seniors in the neighborhoods. The Commission also provides direct services to seniors such as advocacy, information and referral, transportation, volunteer opportunities and cultural and social events.
Executive Office of Elder Affairs State Agency that contracts with local service providers.
Greater Springfield Senior Services, Inc. is an Area Agency on Aging (AAA) and Aging Services Access Point (ASAP) providing services to help preserve the independence, and quality of life of elders and disabled persons desiring to remain within their own.
Eldercare Locator This is a great resource to search for specific care in specific counties and cities. This database is a nationwide resource that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.
Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on CareAvailability.com. Find & compare plans in your area. Determine if you qualify for premium savings
Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources
The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support, and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available.
