How to pay for care on Cape Cod
One page per program, with the 2026 figures, the mistakes families make and who to call on the Cape. Every number is dated and sourced to MassHealth, the VA or the state.
Start here: the two-minute benefits check tells you which programs to ask about. Then read the ones it names.
MassHealth for nursing home careMassHealth (Massachusetts Medicaid) pays for long-term nursing home care once the resident's countable assets are $2,000 or less.MassHealth Standard for people 65+ at homePeople 65 and older who live at home can get MassHealth Standard if their countable income is at or below 100% of the federal poverty level ($1,330 a month for one person in 2026) and their countable assets are $2,000 or less ($3,000 for a couple).Frail Elder Waiver (FEW)The Frail Elder Waiver lets people 60 and older who need nursing-home level care get MassHealth and home services instead.MassHealth Personal Care Attendant (PCA) programThe MassHealth PCA program pays for a personal care attendant that you (or someone you name) hire, train and supervise.Adult Foster Care (AFC) and Group Adult Foster Care (GAFC)Both programs are MassHealth services for people who need daily help with at least one personal-care task.Senior Care Options (SCO)Senior Care Options is a free health plan for people 65 and older with MassHealth Standard that combines Medicare and MassHealth benefits with a care coordinator.PACE (Program of All-Inclusive Care for the Elderly)PACE provides all medical care, a day center, transportation and home help through one team for people 55 and older who need nursing-home level care.Massachusetts Home Care Program (Elder Services)The state Home Care Program, run on the Cape by Elder Services of Cape Cod & the Islands, provides help such as homemaking, personal care, meals and emergency response for people 60 and older who live at home.VA pension with Aid and AttendanceAid and Attendance is an addition to the VA pension for wartime veterans and surviving spouses who need help with daily activities, are largely bedbound, live in a nursing home, or have very poor eyesight.Long-term care insurance in MassachusettsIf you already have a long-term care policy, find it and read it before care starts.Reverse mortgages (HECM) in MassachusettsA federally insured reverse mortgage (HECM) lets a homeowner 62 or older borrow against their home without monthly mortgage payments, as long as they live there and keep up taxes and insurance.
No PACE on Cape Cod. Barnstable County has no PACE program in 2026. The nearest equivalents are the Frail Elder Waiver and Senior Care Options.
Also useful: what care costs on the Cape, will the house cover care? and elder law attorneys.