Everything you need to know about getting paid to care for a loved one in Massachusetts
Yes. You must have active MassHealth to qualify. MassHealth is what funds the care hours and allows you to choose a family caregiver. Many families do not realize which coverage they have or whether they might qualify. We help you check your MassHealth status and guide you through the application if you believe you may be eligible.
Yes. You may qualify in Massachusetts if you have both Medicare and Medicaid, as long as your MassHealth plan approves you through the Adult Foster Care (AFC) program. Medicare alone does not cover daily hands-on care, but Medicaid does. Once Massachusetts confirms you need help with daily tasks, you may choose a family member or friend as your caregiver (excluding spouses). We help you understand your options and next steps.
No. Having only Medicare does not qualify you for FreedomCare in Massachusetts. Medicare does not cover in-home caregiving hours. To join the program, you must have active MassHealth. If you believe you may qualify for Medicaid, FreedomCare can help you understand the requirements and walk you through the application.
To qualify in Massachusetts, you must have MassHealth and need hands-on help with daily tasks. Eligibility is based on:
If you qualify, you may choose a family member or friend as your caregiver, and we help you through the entire process.
No. Massachusetts does not base eligibility on specific illnesses. The state focuses on functional needs and whether you require help with daily tasks such as bathing, dressing, grooming, mobility, or meal preparation. If the Adult Foster Care (AFC) assessment shows you need consistent hands-on support, you may qualify to choose a trusted family member or friend as your caregiver.
Yes. Receiving disability benefits or SSI does not prevent you from qualifying in Massachusetts. Many people who receive SSI automatically qualify for MassHealth. If you have Medicaid and need help with daily activities at home, you may be able to choose a family caregiver. FreedomCare can confirm your eligibility and help you understand each requirement.
Yes, but in Massachusetts you must switch your approved hours to your family caregiver. You cannot split the same Adult Foster Care (AFC) or PCA hours between a family member and an agency-provided worker. If you’re thinking about switching, we help you understand the steps, what paperwork is needed, and how the transition works.
Yes. Massachusetts allows in-home caregiving while on hospice as long as the services do not duplicate each other. Hospice handles medical and end-of-life needs, while your caregiver helps with bathing, grooming, meal prep, and safety. We help you review your plan so both services align properly.
In Massachusetts, you have flexibility in choosing someone you trust to be your caregiver. Eligible caregivers may include:
Caregiver requirements:
Restrictions in Massachusetts:
If you are unsure whether someone qualifies, we can walk you through it.
Yes. In fact, Massachusetts requires the caregiver and the person receiving care to live together in the same home. This is common in the Adult Foster Care (AFC) Program. The caregiver must be at least 18 and legally authorized to work. Spouses and legal guardians are not eligible to be paid. If you qualify under MassHealth, we help you get started.
No, there is no cost to participate in FreedomCare. The program is funded entirely through MassHealth, so if you qualify, the state covers the cost of care and your chosen caregiver is paid. There are no enrollment fees and no out of pocket expenses for families. We help you understand eligibility and make sure everything is set up correctly so cost is never a barrier to getting care at home.
Yes. If you join FreedomCare, your approved hours under Adult Foster Care (AFC) or PCA shift from your current home care agency to your chosen family caregiver. You cannot receive the same set of hours from both an agency and a family caregiver. If you want to switch, we help you understand the steps and ensure the transition is smooth.
The patient enrollment process follows these steps:
Step 1: Confirm MassHealth eligibility
You must have active MassHealth or be eligible to apply, since MassHealth is required to receive care through the Adult Foster Care program.
Step 2: Complete a clinical assessment through the Adult Foster Care (AFC) Program
A clinical assessment is completed to evaluate daily care needs and determine whether AFC services are appropriate.
Step 3: Receive authorization from MassHealth
Based on the assessment, MassHealth issues authorization approving services and outlining eligibility for care.
Step 4: Complete caregiver enrollment and paperwork with FreedomCare
Your chosen caregiver completes required enrollment steps and paperwork so care can be officially authorized.
Step 5: Begin care with your family caregiver after your scheduled start date
Once everything is approved and finalized, care begins on your confirmed start date with your family caregiver in place.
Our team is here to support you through every step.
Please contact FreedomCare first. In Massachusetts, switching depends on whether you receive services through the Adult Foster Care (AFC) or PCA Program. We help determine whether a transfer request, reassessment, or notice to your current agency is required. Once approved, your chosen caregiver takes over the authorized hours. We coordinate the transition carefully so care continues without interruption.
Yes. Massachusetts allows you to change caregivers or enroll more than one caregiver. The authorization will stay the same and can be divided between caregivers. Many families add a second caregiver for backup support. FreedomCare helps each caregiver complete enrollment and stay compliant with state rules.
A Designated Representative can play an important role in helping your care run smoothly. They can manage schedules, complete paperwork, communicate with FreedomCare, and coordinate with your case manager when updates or changes are needed. Their role is to help keep everything organized and reduce stress for you and your family. We work closely with Designated Representatives to make sure your daily care needs are fully supported.
Yes, someone with a part time job can also be a caregiver as long as they are able to provide all approved caregiving hours. Caregiving hours must be completed as outlined in the patient’s approved plan of care and cannot overlap with other work hours. Many caregivers balance part time work with caregiving by setting a clear weekly schedule. If you are unsure whether your schedule works, we help you review approved hours and plan a routine that fits both caregiving and employment.
No, caregivers in Massachusetts do not need to be certified or have professional caregiving experience under the Adult Foster Care program. The state focuses on safety, reliability, and the ability to provide consistent daily support rather than formal credentials. Caregivers must still complete required enrollment steps, but no license is needed. At FreedomCare, we help caregivers understand expectations and provide guidance so they feel confident delivering safe, meaningful care.
No, a misdemeanor does not automatically disqualify you from becoming a caregiver in Massachusetts. The state requires a background check, and only certain serious offenses result in disqualification. Many misdemeanors are reviewed individually with a focus on safety and program guidelines. If you are unsure how your record fits Massachusetts rules, we can help you understand the requirements before you apply.
The caregiver enrollment process follows these steps:
Step 1: Complete a health screening
This step confirms you are physically able to provide care safely and meet basic health requirements for the program.
Step 2: Pass a background check
A background check is required to ensure patient safety and confirm eligibility under state and program guidelines.
Step 3: Provide required enrollment documents
You will submit documents such as identification, work authorization, and other forms needed to complete enrollment.
Step 4: Complete required caregiver training
Any required training helps you understand your responsibilities, program rules, and how to provide care properly.
Step 5: Receive approval and begin care
Once all steps are completed and approved, you are officially authorized and can begin providing care.
Our team will help guide caregivers through each step of the onboarding process.
Once approved, the Caregiver will receive a weekly payment based on their daily rate. We help you understand your expected hours.
Caregivers in Massachusetts are paid on a weekly schedule, which helps provide consistency and predictability. You can choose to receive your pay through direct deposit, a pay card, or a mailed check based on what works best for you. Payments are issued for approved hours that are properly recorded. At FreedomCare, we make sure payments are timely and accurate, and we help you update your payment method anytime your situation changes.
Yes, there are a few additional requirements to be a caregiver, all designed to keep care organized and consistent. Caregivers must have:
We know technology can feel intimidating for some caregivers, especially when you are focused on caring for someone you love. Our team helps you get set up and walks you through everything so you feel comfortable and supported from the start.
Yes, you can care for more than one patient as long as each person is approved for services and you complete enrollment for each individual. Care must be provided separately, and you cannot give care to two people at the same time. Daily notes and documentation must be submitted for each patient individually. We help you set up a clear, workable schedule so everything stays organized and compliant.
No. Travel expenses are not reimbursed. Caregivers are paid for each day that daily notes are submitted. What should I do if there is an issue with my payment?
If a payment issue comes up, contact FreedomCare’s Care Support team. We review your daily notes submission, payment method, and app records to resolve the issue quickly. We want to make sure you’re paid accurately and on time.
Many families choose to enroll a second caregiver to provide backup support when the primary caregiver needs a day off or becomes sick. Having an additional caregiver in place helps ensure care continues without disruption and gives everyone peace of mind. If you do not already have a backup caregiver, we can help you add one and complete the enrollment steps. In Massachusetts, MassHealth may also offer payment options during periods when the patient is hospitalized, depending on the program and situation.
FreedomCare is available in Massachusetts through MassHealth programs that allow you to choose a trusted caregiver at home.
FreedomCare is also available in other states, including:
In each of these states, eligible residents can choose a loved one or trusted friend to provide in-home care through Medicaid programs or waivers. If you live in Massachusetts and want to know whether you or a family member may qualify, we guide you through eligibility, assessments, and every step that follows.
The program is funded by MassHealth, Massachusetts Medicaid. The state uses Medicaid dollars to help people receive care at home instead of entering a nursing facility. If you or a loved one is struggling with daily activities like bathing, dressing, mobility, or preparing meals, MassHealth can pay for in-home support under programs like the Adult Foster Care (AFC) Program. FreedomCare helps you understand the rules, complete required forms, and enroll your caregiver so support at home can begin smoothly.
n Massachusetts, Medicaid (MassHealth) covers individuals with limited income who need help with healthcare or daily activities, while Medicare mainly covers adults 65 and older or younger individuals with qualifying disabilities. For in-home caregiving in MA, Medicaid is the program that determines whether a family caregiver can be paid. Many families are unsure which coverage matters. We help you sort through MassHealth and Medicare so you understand exactly what applies in your situation.
This program works in Massachusetts through MassHealth’s in-home care programs, such as the Adult Foster Care (AFC) Program. If you qualify for MassHealth and need help with daily tasks, you may be able to choose a family member or friend as your caregiver. Massachusetts does not allow spouses to be paid. Once you are approved, we guide both you and your caregiver through enrollment, training, and weekly payment so care at home feels comfortable and manageable.
Enroll now to have a family member or a trusted friend care for you in your home.
