In-Home Dementia Care in Massachusetts

Paying for care in Massachusetts: Frail Elder Waiver

Medicare does not pay for the long-term help dementia requires. In Massachusetts the programme that can is FEW, administered by MassHealth, through the Executive Office of Aging & Independence.

Who qualifies

The Frail Elder Waiver is for people aged 65 and over, or 60 to 64 with a disability, who meet the level of care for a nursing facility but prefer to remain in the community. Applicants must meet clinical eligibility, need waiver services and go on receiving at least one each month, and live in a community setting that meets the federal Community Rule - which does not include assisted living, group homes or rest homes. The cited page does not describe any dementia-specific eligibility route, so ask the office that administers the programme how a dementia diagnosis is weighed in that assessment.

The financial limits

Single applicant

Not published on the cited page; the requirement is to meet the financial rules for MassHealth Standard in the community, and special financial rules apply to waiver applicants

Married couple

Not published on the cited page; spousal rules apply

Look-back period

Not published on the cited page; standard MassHealth transfer-of-asset rules apply

How to apply

MassHealth applicants and members can apply for the Frail Elder Waiver at any time - there is no enrolment window. Clinical eligibility is assessed before enrolment, and a participant must keep receiving at least one waiver service each month to stay eligible.

What is unusual about Massachusetts

Enrolment is open year-round rather than through a waitlist or registry, and eligibility continues only while the person actually uses the services - so a family that stops using them can lose the waiver even though the person still qualifies clinically.

Rules and figures change. Confirm the current position with the programme itself before making a financial decision.