Everything You Want To Know

Medicaid / Massachusetts

Medicaid for Home Care in Massachusetts

Medicaid Certified Home Care Agency in Massachusetts

Agencies that want to claim Medicaid in Massachusetts must ensure they are a certified HHA (Home Health Agency). The regulations state that the homecare agency is eligible for Medicaid reimbursement if they possess adequate certifications and a license for the business. Detailed information is shared by the state’s Bureau of Licensing and Certification.

Governing Body: Massachusetts Medicaid


In Massachusetts, Medicaid is also known as MassHealth, which is a combination of CHIP and Medicaid programs, to provide health care coverage to pregnant women, children, persons with breast or cervical cancer, or people who are HIV-positive.

Medicaid Programs:

  • Adult Day Health Care
  • Personal Care Attendant
  • Group Adult Foster Care & SSI-G
  • Frail Elder Home & Community-Based Services Waiver
  • Enhanced Adult Family Care / Caregiver Homes Program

Income Requirements:

  • For seniors, income up to 100% of the FPL ($1,025 per month) for one person
  • For adults less than 65 years, income up to 138% of the FPL ($1,388 per month) for one person
  • For children less than 21 years, income up to 155% of the FPL ($2,098 per month) for two persons
  • For pregnant women, income up to 200% of the FPL ($2,775 per month) for two persons
  • For breast or cervical cancer patients, income up to 255% of the FPL ($2,564 per month) for one person

Application Process:

The application process for accessing Medicaid for Massachusetts residents is easy; anyone can apply for the available Medicaid programs by visiting MAhealthconnector.org.

Medicaid with CareSmartz360

Home care businesses require advanced solutions to integrate Medicaid into their services, and Caresmartz has been doing that across the states for home care agencies, private-duty care providers, and home care franchisors for several years. CareSmartz360 is a complete software solution to manage a home care business, and it supports all Medicaid payers, allowing businesses to focus on other operations and processes.

  • Effective and comprehensive management of the revenue cycle.
  • Allows agencies to fulfill billing requirements for Medicaid, Medicare, Insurance, and Private Pay.
  • Built-In feature to submit claims electronically.
  • Quickly create, review, approve and submit claims in paper invoice or 837P, 837I format.
  • Helps in generating error-free claims to save time and efforts.
  • Identify and manage accounts and claims that are overdue.
  • Robust reporting to evaluate financial performance.
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    50-State Medicaid Guide

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