The PCA program: hire your own helper at home
The MassHealth PCA program pays for a personal care attendant that you (or someone you name) hire, train and supervise. You need MassHealth Standard or CommonHealth, a permanent or chronic disability, and hands-on help with at least two daily activities such as bathing or dressing. On Cape Cod, Tempus Unlimited is a personal care management agency that serves the Cape and Islands.
The numbers
| Coverage required | MassHealth Standard or CommonHealth |
| Help needed | physical help with 2 or more activities of daily living |
| Minimum age of attendant | 16 |
| Meal preparation time | up to 7 hours a week, unless more is justified |
Who qualifies
You must have MassHealth Standard or CommonHealth, a disability that is permanent or chronic, and need physical assistance with two or more activities of daily living — bathing, dressing, eating, toileting, transferring or moving around. MassHealth must find the services medically necessary.
How it works
A personal care management (PCM) agency evaluates your needs, sends a request for hours to MassHealth, and trains you or your helper to manage the program. You are the employer: you hire, schedule and, if needed, let go of your attendant. A state-contracted fiscal intermediary handles payroll, and MassHealth pays the attendant.
If you cannot manage this yourself, a surrogate (such as a family member or legal guardian) can do it for you.
- Your spouse, a legally responsible relative, or your surrogate cannot be paid as your PCA.
- Adult children and other relatives can be hired if they are not your surrogate.
- When you live with family, MassHealth assumes they will do most household tasks like laundry and shopping.
Getting started on Cape Cod
Call Tempus Unlimited, which states it serves the Cape and Islands, or call MassHealth for the list of PCM agencies.
Mistakes families make
- Planning to pay a spouse as the PCA; MassHealth does not allow it.
- Choosing an adult child as both surrogate and paid PCA; one person cannot do both.
- Underreporting needs at the evaluation. Describe a bad day, not your best day.
Who to call on Cape Cod
| Who | Number | For |
|---|---|---|
| Tempus Unlimited (PCM agency) | (800) 924-7570, ext. 3 | PCA evaluations and training; serves the Cape and Islands |
| MassHealth Customer Service | (800) 841-2900 (TTY 711) | Applications, forms, questions about your case |
| 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 |
What we could not confirm: MassHealth's PCM agency list does not show which agency serves which towns. The Cape and Islands coverage comes from Tempus Unlimited's own website; confirm your town when you call. PCA wage rates were not verified for 2026 and are not included.
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.