The Frail Elder Waiver: nursing-home-level help at home
The Frail Elder Waiver lets people 60 and older who need nursing-home level care get MassHealth and home services instead. In 2026 the applicant's own income must be $2,982 a month or less and their countable assets $2,000 or less; a spouse at home can keep up to $162,660. On the Cape you apply through Elder Services of Cape Cod & the Islands.
The numbers
| Minimum age | 60 (60–64 must be disabled) |
| Income limit (300% of SSI, 2026) — applicant's income only | $2,982 a month |
| Asset limit — applicant | $2,000 |
| Spouse at home may keep (2026) | $162,660 |
| Services you must use | at least one FEW service a month |
Who qualifies
You must be 65 or older, or 60–64 with a disability, and be assessed as needing the level of care a nursing home provides but prefer to stay at home. Only your own income counts, not your spouse's.
- Income of $2,982 a month or less (2026).
- Countable assets of $2,000 or less; a married couple's assets are treated under the nursing-home spousal rules, so the spouse at home can keep up to $162,660.
- You must live in the community — not in assisted living, a rest home or a group home — and not be enrolled in PACE, One Care or another waiver.
- If your income or assets are too high, you may still qualify by spending down or meeting a deductible.
What it pays for
FEW members get full MassHealth Standard plus more than 28 home services arranged by a care manager, such as:
- Home health aide and personal care
- Homemaker, companion and chore help
- Home-delivered meals and transportation
- Respite for family caregivers
- Dementia coaching and medication dispensing
- Personal emergency response and remote monitoring
How to apply on Cape Cod
Call Elder Services of Cape Cod & the Islands and ask for a clinical eligibility assessment for the Frail Elder Waiver. You will also complete the MassHealth senior application (SACA-2) for the financial part.
Mistakes families make
- Assuming a spouse's income disqualifies you. For FEW only the applicant's income is counted.
- Giving away assets before applying. MassHealth's transfer rules apply to FEW applicants.
- Moving into assisted living and expecting FEW to follow; it does not cover people living there.
Who to call on Cape Cod
| Who | Number | For |
|---|---|---|
| Elder Services of Cape Cod & the Islands | 1-800-244-4630 (508-394-4630) | Free home assessment, home care, Frail Elder Waiver, nursing-home screening; South Dennis |
| MassHealth Customer Service | (800) 841-2900 (TTY 711) | Applications, forms, questions about your case |
| MassOptions | (800) 243-4636 | Statewide line that connects you to elder and disability services |
What we could not confirm: MassHealth's regulations already apply transfer (gift) rules to FEW applicants. Legal-services training materials (MLRI, April 2026) say MassHealth expects to start checking a full five years of records for waiver applicants in fall 2026; no MassHealth memo announcing this was published as of 29 Sep 2026. Ask before giving anything away.
Next: All the ways to pay for care · Two-minute benefits check · What care costs on the Cape · Elder law attorneys
This page explains the rules; it is not legal advice. For your own situation, talk to an elder law attorney or SHINE.