Massachusetts Medicaid Personal Needs Allowance 2026 | MassHealth

The Massachusetts Medicaid personal needs allowance is $72.80 a month in 2026, and it has been frozen at that figure since 2008. When a resident enters a MassHealth-certified nursing facility, chronic-disease hospital, or licensed rest home under MassHealth's institutional long-term-care program, federal and state law let them keep this small portion of their monthly income for personal use. The figure is set under 130 CMR 520.026 of the MassHealth Financial Eligibility regulations and has been statutorily fixed since fiscal year 2008.

What This Guide Covers

When a Massachusetts resident enters a MassHealth-certified nursing facility, chronic-disease hospital, or licensed rest home under MassHealth's institutional long-term-care program, federal and state law require that the resident be permitted to retain a small portion of their monthly income for personal use, clothing, telephone service, snacks, haircuts, newspapers, modest gifts to grandchildren, transportation to family events, religious-observance items, small comforts that make life inside a long-term-care setting feel like a life rather than a billing cycle. This is the Personal Needs Allowance (PNA).

Massachusetts's PNA is $72.80 per month in 2026, set under 130 CMR 520.026 of the MassHealth Financial Eligibility regulations. The figure has been statutorily fixed since fiscal year 2008, meaning the same $72.80 has applied for approximately 18 years without adjustment for inflation. Adjusted for cumulative CPI-U inflation since FY2008, the original figure would equate to approximately $113.42 in 2026 dollars, meaning Massachusetts long-term-care residents have lost roughly 36% of their PNA's purchasing power over the period the law has stood unchanged.

This long freeze places Massachusetts in a regional cluster with several northeastern peer states, comfortably above the federal $30 floor and the lowest-tier states, but well below the national high set by Florida. Confirm any peer-state figure against that state's own regulation, since several states have moved their PNAs in the past two legislative cycles. The structural point is more important than any single dollar comparison: Massachusetts has chosen a fixed dollar figure with no inflation indexing, in contrast to states with statutory adjustment cycles or the federal floor mechanic (held at $30 since 1988 but explicitly subject to congressional change).

Three bills currently pending in the Massachusetts Legislature, S.887 (Sen. Joan Lovely), S.482 (Sen. Mark Montigny), and H.1411 (Rep. Thomas Stanley), would raise the institutional PNA to $100/month and introduce CPI-U annual indexing effective 7/1/2027. The Senate Joint Committee on Health Care Financing held a hearing on these bills on July 1, 2025, and on November 6, 2025 the Senate reported S.887 favorably and referred it to Senate Ways and Means with S.482 consolidated into the same vehicle. The House version, H.1411, remains in the Joint Committee with reporting deadline extended to June 15, 2026. As of May 2026, none of these bills has been enacted, and the operative figure remains $72.80.

Massachusetts is also distinctive within the cluster in three structural respects that affect how the PNA functions:

1. Massachusetts is a 1634 state and a medically-needy state, meaning SSI receipt automatically confers MassHealth eligibility, and applicants over the medically-needy income standard qualify by deducting medical expenses (spend-down) rather than by establishing a Qualified Income Trust (Miller Trust). There is no income cap that requires a QIT in Massachusetts.

2. Massachusetts uses the federal income-first MMNA methodology under 130 CMR 520.026(B), meaning the institutionalized spouse's income is attributed to the community spouse first to satisfy the community-spouse needs allowance, before any consideration of increasing the community spouse's resource allowance.

3. Massachusetts pursues estate recovery against the probate estate only under 130 CMR 515.011, meaning property held jointly with rights of survivorship, in a life estate, or in trust at the time of death is generally not subject to MassHealth recovery (an important consumer protection compared to states like Iowa or Minnesota that pursue expanded estate recovery).

This guide explains what the Massachusetts PNA is, what it can and cannot be spent on, how it sits within the patient-pay calculation that determines what a MassHealth resident owes the facility each month, why the figure has been frozen for 18 years, what the pending legislation would change, how Massachusetts compares to peer states, and what families can do to maximize the dignity of life inside a MassHealth-covered long-term-care facility for a Massachusetts loved one.

In This Guide

• The 60-Second Version
• What the Massachusetts PNA Is and Why It Exists
• The 18-Year Freeze: How $72.80 Was Set in FY2008 and Why It Has Held
• What the Massachusetts PNA Can Be Spent On
• What It Cannot Be Spent On
• The Patient-Pay Calculation: How $72.80 Survives the Income Surrender
• Worked Example 1: Eleanor Single, $2,400/Month → $2,124.30 Patient-Pay
• Worked Example 2: Frank Married, $3,500/Month with MMNA Deflection → $1,224.30 Patient-Pay
• Worked Example 3: Margaret Spend-Down, $1,800/Month and Above the Asset Limit
• Massachusetts Is a 1634 + Medically-Needy State (Not Income-Cap)
• Pending Legislation: S.887, S.482, H.1411, What $100 + CPI-U Indexing Would Mean
• The Optional State Supplement (SSP) for Rest Homes and Assisted Living
• Estate Recovery: Why Massachusetts's Probate-Only Approach Matters
• Senior Care Options (SCO) and One Care: PNA Inside Integrated Dual-Eligible Plans
• National PNA Comparison
• 12 Practical Tips for Massachusetts Families
• Cross-State Quick Comparisons
• 8 Common Pitfalls
• Where to Get Help
• Related Reading

The 60-Second Version

• Massachusetts's institutional PNA is $72.80/month in 2026, set under 130 CMR 520.026 of the MassHealth Financial Eligibility regulations.
• The figure has been statutorily fixed since FY2008, approximately 18 years without adjustment. Original FY2008 figure inflation-adjusted to 2026 would be approximately $113.42.
• The figure applies uniformly to MassHealth long-term-care residents in nursing facilities, chronic-disease hospitals, and licensed rest homes when MassHealth is paying.
• Massachusetts is a 1634 state and a medically-needy state, SSI receipt automatically confers MassHealth; over-standard applicants spend down rather than establish a QIT/Miller Trust.
• No income-cap, no QIT requirement, distinct from Texas, Florida (during certain pathways), and other income-cap states.
• Massachusetts uses the federal income-first MMNA methodology under 130 CMR 520.026(B); 2026 federal MMNA range is $2,643.75 minimum to $4,066.50 maximum.
• The institutional PNA is separate from the State Supplement Program (SSP) under 106 CMR 327, which governs rest-home and assisted-living-supported pathways via the Department of Transitional Assistance.
• Three pending bills, S.887 (Lovely), S.482 (Montigny), H.1411 (Stanley), would raise to $100/month and add CPI-U annual indexing effective 7/1/2027. Senate reported S.887 favorably to Ways and Means on 11/6/2025; House extended to 6/15/2026.
• Single-applicant institutional Medicaid asset limit is $2,000 under 130 CMR 520.003, meaning banked PNA accumulates fast (27 months of unspent PNA exceeds the cap).
• Massachusetts pursues probate-only estate recovery with a $25,000 auto-waiver threshold for small estates (effective 5/14/2021), more protective than expanded-recovery states.
• Federal floor under 42 USC § 1396a(q) is $30/month, Massachusetts sits 2.4× above the federal floor.

What the Massachusetts Medicaid Personal Needs Allowance Is and Why It Exists

When a MassHealth member enters a Massachusetts nursing facility, chronic-disease hospital, or licensed rest home under MassHealth's institutional long-term-care program, federal law requires the recipient to surrender substantially all of their monthly income to the facility as the recipient's "patient-paid amount" or "applied income", the resident's contribution to the cost of care. MassHealth covers the difference between the facility's contracted MassHealth daily rate and the resident's patient-paid amount.

But federal law also recognizes that surrendering 100% of income would strip MassHealth long-term-care residents of any ability to engage in life inside the facility. The Personal Needs Allowance is the federal mechanism that preserves a small monthly sum for these uses. 42 USC § 1396a(q) establishes a $30/month federal floor for the PNA and authorizes states to set higher figures. Massachusetts has set its PNA at $72.80/month under 130 CMR 520.026, above the federal floor by $42.80 (a 142% premium) but below the de facto $75 regional benchmark cluster (Texas, Connecticut, Ohio) by $2.20.

The Massachusetts PNA is unusual in three respects that distinguish it from PNAs in many other states:

1. It is statutorily fixed and not indexed. Unlike states such as Florida, where the PNA has moved through legislative cycles in recent years (last to $160 effective 7/1/2023), Massachusetts has not raised the institutional PNA since FY2008. The figure is set as a flat dollar amount in 130 CMR 520.026 and only changes through regulatory amendment by the Executive Office of Health and Human Services (EOHHS) or by underlying statutory action.

2. It is uniform across institutional settings. The same $72.80 applies in licensed rest homes, nursing facilities, and chronic-disease hospitals, and the same figure applies for SSI recipients in those settings. Massachusetts does not use the tiered-by-setting approach that California uses (institutional NF $35 / SSI in NF $62 / ALW $182).

3. It is administratively separate from the State Supplement Program (SSP). The institutional PNA under 130 CMR 520.026 governs MassHealth long-term-care residents whose institutional care is paid by MassHealth. The SSP under 106 CMR 327 is a separate Department of Transitional Assistance program providing supplemental cash assistance to SSI recipients in non-MassHealth-paid settings (rest homes outside MassHealth payment, assisted living served by Group Adult Foster Care providers in certain pathways). The two programs operate under different agencies, different regulations, and different rate structures, but readers and even practitioners frequently conflate them. This guide focuses on the institutional PNA.

The $72.80 figure represents a legislative and regulatory judgment about what dignity money should be, a judgment that has not been re-examined by the Massachusetts General Court for 18 years despite documented inflation erosion and persistent advocacy from organizations like Dignity Alliance Massachusetts, AARP Massachusetts, LeadingAge Massachusetts, the Massachusetts Long-Term Care Ombudsman Program, and elder-law nonprofits.

The 18-Year Freeze: How $72.80 Was Set in FY2008 and Why It Has Held

Massachusetts last increased the institutional PNA in fiscal year 2008. Since then, the figure has held at $72.80/month through 18 fiscal years, four governors (Patrick, Baker, Healey, and the FY2008-era Patrick administration that set the figure), multiple economic cycles, and the entire post-Affordable-Care-Act period of MassHealth expansion. The freeze is not the product of any single decision, it is the aggregate of two decades of legislative budget cycles in which PNA increases were considered but did not advance to enactment.

The inflation math is striking: a $72.80 figure set in FY2008 would, under cumulative CPI-U inflation through 2026, equate to approximately $113.42 in 2026 purchasing power. Stated differently, the 2026 PNA of $72.80 represents approximately 64% of the original FY2008 figure's real-world spending power. A Massachusetts nursing-facility resident in 2026 has roughly 64 cents of dignity money for every $1.00 the FY2008 resident had.

This erosion does not happen abstractly. It shows up in concrete spending power:

• A monthly cellphone plan that cost $25-$30 in 2008 now costs $35-$50, eating a larger share of the PNA.
• A haircut at the facility's contracted barber/stylist that cost $20 in 2008 now typically costs $30-$45.
• A daily newspaper subscription (Boston Globe, Boston Herald, regional dailies) has roughly doubled in price since 2008.
• Postage stamps have risen from $0.42 in 2008 to $0.78 in 2026 (USPS).
• The cost of clothing, hygiene products, snacks, and transportation has all moved similarly.

What was a meaningful month of dignity in 2008 is approximately two-thirds of that meaningful month in 2026 dollars. The arithmetic does not require advocacy framing, it follows from CPI-U.

Why has the figure held? Several factors:

1. PNA increases are budget items. Each $1 increase in the PNA produces a corresponding reduction in patient-paid amount, which means MassHealth must absorb that $1 per institutionalized member per month into its long-term-services budget. With approximately 30,000-35,000 MassHealth nursing-facility residents at any given time, a $25 PNA increase ($72.80 → $97.80) costs MassHealth roughly $9-10 million per year. In the context of a multi-billion-dollar MassHealth long-term-services line item, this is a manageable but not trivial amount. Each annual budget has competing claims.

2. Procedural friction. The PNA can be raised either through line-item budget action (where the figure is set in a budget rider) or through standalone legislation amending the underlying authority. Both pathways require alignment between House, Senate, and the Governor's office. In years when MassHealth budget pressure is acute, PNA increases tend to be deferred.

3. Coalition fragmentation. PNA advocacy is not a stand-alone constituency in the same way that, say, nursing-facility provider rates are. The most affected stakeholders, institutional MassHealth residents, are by definition among the most politically marginalized members of the Massachusetts population. Coalition organizations (Dignity Alliance MA, AARP MA, LeadingAge MA, the Ombudsman Program) have pushed for increases, but these coalitions also push for many other priorities, and the PNA does not always rise to the top.

The S.887 / S.482 / H.1411 effort in the 194th General Court (2025-2026 session) represents the most procedurally advanced PNA-increase effort in approximately a decade. The Senate's favorable report and consolidation of S.482 into S.887 on November 6, 2025, before referral to Senate Ways and Means is a meaningful step. Whether the bill will reach the Governor's desk by the end of formal sessions in late July 2026 remains uncertain.

What the Massachusetts PNA Can Be Spent On

The PNA is the resident's discretionary money. As long as the resident retains capacity to manage personal funds (or directs their representative payee), the PNA may be spent on essentially any lawful, personal purpose. Federal regulation 42 CFR § 483.10(f)(11) protects resident control over personal funds and prohibits facilities from steering or restricting resident spending decisions for non-allowable purposes.

Common allowable uses include:

1. Personal Care Items, toothpaste, deodorant, lotion, shampoo, hair products, shaving supplies, denture-care products, eyeglass-cleaning supplies, hearing-aid batteries, replacement reading glasses, and incontinence supplies beyond what the facility provides. (MassHealth-covered prescription drugs and MassHealth-covered DME do NOT come from the PNA.)

2. Communication, cellphone service ($25-$50/month for a basic plan; Massachusetts residents often maintain cellphones for family connection across the state and to family in New Hampshire, Rhode Island, Connecticut, and Vermont), prepaid phone cards, postage stamps, greeting cards, internet service for personal devices, basic Skype/FaceTime equipment for family video calls.

3. Clothing, replacement clothing, undergarments, socks, slippers, sweaters (Massachusetts's six-month heating season demands more sweaters and warm layers than warmer-state residents budget; many MA facilities maintain interior temperatures of 72-74°F regardless of outside conditions but residents experience cold readily), hats, basic shoes, lightweight outdoor clothing for outings.

4. Entertainment and Reading, local newspaper subscriptions (Boston Globe, Boston Herald, Worcester Telegram & Gazette, Springfield Republican, Cape Cod Times, Berkshire Eagle, etc.), magazines (AARP The Magazine, Yankee Magazine, Reader's Digest, regional historical publications), paperback books, crosswords, puzzles, knitting supplies, basic art supplies, religious/devotional materials, a small TV for the room, headphones for personal listening.

5. Social and Family, small gifts to grandchildren and family members (within MassHealth gift-rule limits), birthday cards, holiday cards, photographs and frames, modest contributions to family events, transportation to off-site family gatherings (a real consideration for residents with family in Boston, Worcester, Springfield, the Cape, the South Shore, the North Shore, MetroWest, etc.).

6. Comfort and Dignity, haircuts and salon services from the facility's contracted barber/stylist (Massachusetts facility salon services typically cost $25-$40 per visit), manicures, religious-observance items (Mass cards, rosaries, prayer books, kosher items, halal items, items for any tradition), preferred pillows or small comforters that the facility allows, slippers, robes.

7. Tobacco and Personal Discretionary, for residents who smoked at admission, cigarettes (subject to facility smoke-free policy, Massachusetts state law mandates smoke-free facility interiors but many facilities maintain designated outdoor smoking areas), e-cigarettes (where permitted), modest beer or wine (where facility permits and physician approves), small personal vices that contribute to quality of life.

8. Massachusetts-Specific Discretionary, for Massachusetts residents, modest spending on Massachusetts-specific cultural activities (a Boston Globe Sports section subscription for Patriots, Red Sox, Celtics, and Bruins coverage; a Yankee Magazine subscription for New England regional connection; Massachusetts Lottery scratch-off tickets where allowed by facility policy) supports cultural connection that is uniquely meaningful in Massachusetts senior populations.

The North Star principle: the PNA is the resident's money for the resident's life. The resident decides what brings them dignity and comfort. Family members and facility staff should support spending choices, not police them.

What It Cannot Be Spent On

Several categories of expense are NOT PNA-eligible because they are either MassHealth-covered (and therefore must not double-count) or facility-provided (and therefore must not be charged twice):

• Room and Board, included in the facility's MassHealth daily rate and recovered through patient-paid amount.
• MassHealth-Covered Services, physician visits, prescription drugs covered by MassHealth Part D and the MassHealth drug formulary, durable medical equipment, therapy services, hospital stays, etc. Note: prescription drugs that are NOT covered (over-the-counter medications, vitamins, supplements without prescription) may be PNA-eligible if approved by the resident's physician.
• Medicare Part B Premiums, these are deducted from gross income BEFORE patient-paid amount calculation under 42 CFR § 435.725 and 130 CMR 520.026. The premiums sit higher in the deduction stack than the PNA.
• Medigap Premiums, these are also deducted from gross income BEFORE patient-paid amount calculation, where the resident maintains a Medigap policy. Most Massachusetts nursing-facility MassHealth residents drop Medigap upon MassHealth eligibility, but those who retain Medigap deduct the premium higher in the stack than the PNA.
• Health Insurance Premiums for Other Coverage, supplementary insurance (e.g., an old retiree health plan from a Massachusetts employer like state government, Raytheon, or one of the large hospital systems) deducts higher in the stack than the PNA.

The deduction-stack ordering is established under 42 CFR § 435.725 and Massachusetts EOHHS operational policy under 130 CMR 520.026. The resident's gross income is reduced sequentially: first by the PNA ($72.80), then by health-insurance premiums (Medicare Part B, Medigap, etc.), then by community-spouse MMNA deflection (if married), then by court-ordered family-member support, then by uncovered medical expenses. The remainder is the resident's patient-paid amount.

The Patient-Pay Calculation: How $72.80 Survives the Income Surrender

The patient-paid amount calculation is the financial mechanic that produces a Massachusetts resident's monthly contribution to the facility. Here is the formula in Massachusetts deduction-stack order under 130 CMR 520.026:

Gross Monthly Income
  − Personal Needs Allowance ($72.80/month)
  − Medicare Part B Premium (~$202.90/month in 2026)
  − Medigap Premium (if applicable)
  − Other Health Insurance Premium (if applicable)
  − Minimum Monthly Maintenance Needs Allowance (MMNA) deflection to community spouse (if married)
  − Court-Ordered Family Member Support (rare)
  − Approved Uncovered Medical Expenses
  = Monthly Patient-Paid Amount to the Facility

For a single resident, the calculation typically reduces to:

Gross Income − $72.80 PNA − Medicare Part B Premium − any Medigap = Patient-Paid Amount

For a married resident with MMNA deflection, the calculation expands to include the community-spouse income protection (the MMNA range in 2026 is $2,643.75 minimum to $4,066.50 maximum). Massachusetts applies the federal income-first methodology under 130 CMR 520.026(B): if the community spouse has less than $2,643.75/month from their own sources, the institutionalized spouse may deflect from their own income to bring the community spouse up to that level. The deflected amount sits ABOVE the PNA in the stack, meaning the institutionalized spouse keeps the $72.80 PNA AND deflects whatever amount is needed to satisfy the MMNA.

Worked Example 1: Eleanor Single, $2,400/Month → $2,124.30 Patient-Pay

Eleanor is 79, widowed, and entered a nursing facility in Worcester in March 2026 after a stroke left her unable to manage independent living. She is approved for Massachusetts Institutional MassHealth (Standard) effective her admission date. Her income consists of:

• Social Security retirement benefit: $1,900/month
• Modest pension from her former Worcester Public Schools career as a music teacher: $500/month
• Total gross income: $2,400/month

Eleanor's gross income is well above the $522/month medically-needy income standard, but she is institutionalized, meaning she qualifies under MassHealth's institutional long-term-care rules where her income flows through the patient-paid amount calculation rather than facing the standard Medically Needy spend-down. Her Medicare Part B premium is automatically deducted from her Social Security check at $202.90/month. She has no Medigap (she dropped it upon MassHealth eligibility). Her monthly patient-paid amount calculation:

$2,400.00 gross income
−    $72.80 PNA
−   $202.90 Medicare Part B
=  $2,124.30 patient-paid amount to the nursing facility

The facility receives $2,124.30/month from Eleanor and MassHealth covers the difference between Eleanor's contracted Massachusetts MassHealth daily rate (approximately $325/day = $9,750/month for a 30-day month, Massachusetts rates run higher than national averages due to high cost-of-living and labor costs) and her patient-paid amount. MassHealth's monthly contribution: $9,750 − $2,124.30 = $7,625.70.

Eleanor's $72.80 PNA is deposited monthly into her resident-trust-fund account at the facility. She uses approximately $50-$70 each month on cellphone service ($28), the Worcester Telegram & Gazette subscription ($35 for senior rate), and a monthly haircut every 5-6 weeks ($30). The remainder accumulates in her resident-trust-fund account; by holiday season, she has saved enough to purchase modest gifts ($15-$20) for each of her four grandchildren. Her social worker reviews her resident-trust-fund balance quarterly to ensure she is not accumulating beyond Massachusetts's $2,000 institutional MassHealth asset limit (a real risk at $72.80/month accumulation if savings are not actively used, Eleanor's resident-trust-fund balance would reach approximately $873 by year-end without distribution, and would cross $2,000 in approximately 27.5 months of unbroken accumulation).

Worked Example 2: Frank Married, $3,500/Month with MMNA Deflection → $1,224.30 Patient-Pay

Frank is 82 and entered a nursing facility in Springfield in February 2026 with advanced Parkinson's disease. His wife Hilda, 80, lives in their longtime two-family home in nearby Chicopee. Frank is approved for Massachusetts Institutional MassHealth effective his admission date.

Critical step: Massachusetts is a 1634 + medically-needy state, NOT an income-cap state. Frank does NOT need a Qualified Income Trust (Miller Trust). His income flows through the patient-paid amount calculation regardless of amount. Frank's income:

• Social Security retirement benefit: $2,400/month
• Pension from his former Massmutual employment: $1,100/month
• Total gross income: $3,500/month

Hilda's own income:

• Social Security spousal benefit: $1,200/month
• Modest part-time bookkeeping work she has continued at age 80: $300/month
• Total community-spouse income: $1,500/month

Hilda's MMNA threshold under federal income-first methodology: assume her shelter costs (mortgage, property tax, heating oil for the New England winter, utilities) push her into the $2,900/month MMNA range after the shelter excess calculation. She has $1,500/month of her own; she needs $1,400/month deflection from Frank to reach $2,900. Frank's patient-paid amount calculation:

$3,500.00 Frank's gross income
−    $72.80 PNA
−   $202.90 Medicare Part B
−    $0.00 No Medigap (dropped upon MassHealth eligibility)
−  $1,400.00 MMNA deflection to Hilda (income-first methodology under 130 CMR 520.026(B))
−   $600.00 Approved uncovered medical (specialty Parkinson's care equipment co-pays)
=  $1,224.30 patient-paid amount to the facility

Frank keeps his $72.80 PNA AND deflects to Hilda, who receives the deflection directly. Hilda's monthly income rises from $1,500 to $2,900, protecting her from impoverishment as a result of Frank's nursing-facility admission.

This is the federal Spousal Impoverishment doctrine working as designed in the Massachusetts medically-needy framework. The income-first methodology means Frank's income is exhausted first to bring Hilda to the MMNA before anyone considers whether to seek a fair-hearing increase to her CSRA (community-spouse resource allowance). In practice, MassHealth almost never authorizes CSRA increases above the federal maximum of $162,660 because the income-first methodology typically suffices.

Worked Example 3: Margaret Spend-Down, $1,800/Month and Above the Asset Limit

Margaret is 78, widowed, and has been living in her own home in Lowell on a fixed income. She has begun to need long-term care after a fall and is considering nursing-facility placement. Her financial situation:

• Social Security retirement benefit: $1,800/month
• Bank savings: $40,000 (well above the $2,000 MassHealth institutional asset limit)
• Home: $385,000 (under the $1,130,000 Massachusetts home-equity exclusion, so the home is NOT a countable asset for institutional MassHealth)
• No pension, no Medigap, no other coverage

Margaret CANNOT qualify for MassHealth Standard institutional coverage today because her countable assets ($40,000) exceed the $2,000 single-applicant cap. She has three pathways:

1. Spend-down to the asset limit, Margaret can spend her $40,000 on her own care (private-pay nursing facility or assisted living, household repairs, replacement vehicle, prepaid funeral and burial under 130 CMR 520.008, modest gifts to family within the 5-year lookback considerations, etc.) until her countable assets reach $2,000. She must do so legitimately, gifts to family within the 5-year lookback could trigger a transfer penalty under 130 CMR 520.019, delaying her MassHealth eligibility by the divisor calculation (Massachusetts 2026 transfer-penalty divisor approximates $419/day or $12,732/month for nursing-facility-level care, a $40,000 gift would create a penalty of approximately 95 days of ineligibility once she enters a facility).

2. Establish an irrevocable trust for non-countable transfers, properly drafted irrevocable trusts using the Trust + Pour-Over LTC Planning framework can shelter assets from MassHealth countability if executed at least 5 years before institutionalization. This is technical territory requiring elder-law counsel and is rarely executable on a short timeline.

3. Use the Medically-Needy Spend-Down for medical expenses, MassHealth's medically-needy pathway allows applicants over the $522/month income standard to qualify by deducting incurred medical expenses against income on a 6-month basis. This pathway is most useful for community-Medicaid scenarios (HCBS, Frail Elder waiver, etc.) where the resident is not yet institutionalized but needs MassHealth coverage of medical costs.

For Margaret's institutional pathway, the most realistic plan involves Option 1 (legitimate spend-down on her own care over the next year or two as she transitions toward facility-level need), with potential exploration of Option 2 if she has 5+ years of runway. Once she reaches the $2,000 asset limit and enters a nursing facility, her patient-paid amount calculation will be:

$1,800.00 gross income
−   $72.80 PNA
−  $202.90 Medicare Part B
=  $1,524.30 patient-paid amount

Margaret's example illustrates an important reality of the MA PNA: the $72.80 figure is set the same regardless of underlying complexity in the eligibility pathway. Whether the resident reaches MassHealth through clean automatic 1634 SSI eligibility, through medically-needy spend-down, or through asset-spend-down to the $2,000 cap, the institutional PNA is $72.80/month across all pathways.

Massachusetts Is a 1634 + Medically-Needy State (Not Income-Cap)

Massachusetts's classification matters because it determines what pathway a high-income or high-asset applicant can use to achieve MassHealth institutional coverage:

1634 status (confirmed via SSA POMS SI 01715.020): Massachusetts has an automatic-enrollment agreement with the Social Security Administration. Receipt of SSI (Supplemental Security Income) automatically confers MassHealth Standard eligibility. The SSA is the gatekeeper for SSI eligibility (federal benefit rate $994/month for 2026 individual; $1,491 couple), and once SSI eligibility is established, MassHealth follows automatically without a separate Medicaid application.

Medically-needy status: Massachusetts maintains a medically-needy income standard ($522/month single, $650/month couple in 2026) under 130 CMR 506.000. Applicants over this standard but with documented medical expenses can deduct those expenses against their countable income over a 6-month period, qualifying for MassHealth coverage of services provided after the spend-down threshold is met. This is a flexible pathway used heavily for community-Medicaid scenarios (Medicare cost-sharing, Frail Elder Waiver, MassHealth-only services).

Not an income-cap state: Unlike Texas (300% SSI cap with Miller Trust requirement), Massachusetts does NOT impose a hard income cap as a denial threshold. High-income applicants entering institutional care simply have a larger patient-paid amount under 130 CMR 520.026, they are not denied. Qualified Income Trusts (Miller Trusts) are NOT used in Massachusetts because there is no income cap to circumvent.

Not a 209(b) state: Some practitioner sources mistakenly label Massachusetts as a 209(b) state. The SSA POMS SI 01715.020 (current published list) classifies Massachusetts as 1634, meaning Massachusetts uses the SSI eligibility methodology rather than a more restrictive state-specific methodology. 1634 status is functionally the opposite of 209(b).

For Massachusetts families, the practical implications are:

• No QIT/Miller Trust is needed, even for high-income applicants. The QIT setup costs ($1,500-$3,000 in legal fees) and ongoing trustee responsibilities that Texas families face are not part of the Massachusetts process.
• Spend-down provides flexibility for families with documented medical expenses, particularly in community-Medicaid scenarios.
• The institutional patient-paid amount mechanic absorbs higher incomes, there is no failure-to-qualify scenario at any income level (subject to asset limits).

Pending Legislation: S.887, S.482, H.1411, What $100 + CPI-U Indexing Would Mean

Three bills currently pending in the Massachusetts Legislature would together raise the PNA and introduce annual indexing:

S.887, Sen. Joan B. Lovely (lead sponsor)

Title: "An Act increasing the personal needs allowance for long term care residents."

Co-sponsors: Sen. Joanne Comerford, Sen. Jennifer Flanagan, Sen. Pavel Payano (Oliveira's seat post-redistricting), and approximately 25 additional senators and representatives across both chambers.

Filed: February 27, 2025, in the 194th General Court.

Procedural status (most advanced of the three bills):

• 2/27/2025: Filed and referred to Joint Committee on Health Care Financing.
• 7/1/2025: Hearing held before the Joint Committee on Health Care Financing (Gardner Auditorium).
• 11/6/2025: Senate reported S.887 favorably and referred to Senate Ways and Means, with S.482 consolidated into the same vehicle. This is a meaningful procedural advance.
• May 2026: Bill remains in Senate Ways and Means awaiting floor scheduling.

S.482, Sen. Mark C. Montigny

Title: "An Act increasing the personal care allowance for long term care residents."

Co-sponsors: Sen. Patricia Jehlen, Sen. Jennifer Flanagan, others.

Filed: February 27, 2025; originally referred to Senate Elder Affairs; discharged to Health Care Financing on 3/31/2025; consolidated into S.887 on 11/6/2025 in Senate Ways and Means.

H.1411, Rep. Thomas M. Stanley

Title: Same title.

Co-sponsors: Approximately 18 House sponsors as of early 2026.

Procedural status (less advanced than Senate vehicles):

• 2/27/2025: Filed and referred to Joint Committee on Health Care Financing.
• 7/1/2025: Hearing held alongside Senate bills.
• 9/15/2025: Reporting deadline extended to 3/18/2026.
• 3/19/2026: Reporting deadline extended again to 6/15/2026.
• May 2026: H.1411 remains in Joint Committee on Health Care Financing.

What the Bills Would Do

All three bills would:

1. Raise the institutional PNA from $72.80 to not less than $100/month, a $27.20 increase representing approximately 37% over the current figure.
2. Introduce CPI-U annual indexing effective July 1, 2027, meaning the PNA would adjust automatically each fiscal year based on the federal Consumer Price Index for All Urban Consumers, removing the need for periodic legislative action.
3. Apply uniformly to all institutional settings covered by 130 CMR 520.026 (nursing facilities, chronic-disease hospitals, licensed rest homes when MassHealth is paying).

If enacted, the change would put Massachusetts above the $75 regional benchmark cluster (Texas, Connecticut, Ohio) and would establish Massachusetts as one of only a handful of states with an indexed PNA, a significant policy precedent. The pairing of an immediate increase with prospective indexing addresses both the 18-year-freeze incident and the structural incentive problem that produced it.

Outlook

The procedural advance in November 2025 (Senate favorable report and consolidation in Ways and Means) is the most significant movement on this issue in approximately a decade. However, several factors make 2026 enactment uncertain:

• End of formal session. The Massachusetts General Court ends formal sessions in late July of each second-year session (2026, in this case). Bills not enacted by that date typically must be refiled in the next session.
• Senate Ways and Means is a chokepoint. Bills in Ways and Means face budget-priority screening and may not receive a vote unless leadership prioritizes them.
• House vehicle is behind. H.1411 remains in committee with the reporting deadline extended to mid-June. Without favorable House reporting, the Senate vehicle alone cannot enact.
• Budget interaction. The PNA increase has fiscal implications for MassHealth long-term-services line items, which may interact with the FY27 state budget cycle.

For Massachusetts families with a loved one entering institutional MassHealth care in 2026, the prudent assumption is that the operative figure remains $72.80 throughout 2026. If the bills enact and become effective in late 2026 or fiscal 2027, the increase would apply prospectively from the effective date.

Coalition support. Dignity Alliance Massachusetts, AARP Massachusetts, LeadingAge Massachusetts, the Massachusetts Long-Term Care Ombudsman Program, and approximately 29 legislative co-sponsors have publicly supported the increase. The Massachusetts Senior Care Association (MSCA) and trade-association nursing-facility advocacy have generally supported PNA increases as a matter of resident dignity, though their highest priorities tend to be Medicaid reimbursement rates rather than PNA.

The Optional State Supplement (SSP) for Rest Homes and Assisted Living

The Massachusetts State Supplement Program (SSP) is a separate program from the institutional MassHealth PNA, and the two are frequently confused. Understanding the distinction matters for families considering rest-home or assisted-living placement.

SSP regulation: 106 CMR 327.000 ("Eligibility requirements for State Supplement Program"), promulgated by the Department of Transitional Assistance (DTA), NOT by MassHealth/EOHHS.

State Living Arrangement (SLA) categories under 106 CMR 327.220:

• SLA E: Licensed rest home, fixed rate set by EOHHS, includes a personal-needs allowance distinct from the institutional MassHealth PNA.
• SLA G: Assisted Living Residence (ALR) served by a certified Group Adult Foster Care (GAFC) provider, where the resident is not receiving other federal/state assistance, this is the "SSI-G" pathway.

Key distinction: The SSP applies to settings where MassHealth is NOT paying the institutional rate. When the resident is in a rest home or ALR and MassHealth is paying institutional long-term-care, the institutional PNA under 130 CMR 520.026 applies ($72.80/month). When the resident is in a non-institutional setting receiving SSI plus state supplement, the SSP framework applies and the personal-needs allowance is structured differently, typically through retention of a portion of the SSI federal benefit rate plus state supplement.

For families navigating this distinction, the practical question is: "Is MassHealth paying the institutional rate to the facility?" If yes, 130 CMR 520.026 governs and the PNA is $72.80. If no (SSI plus state supplement, Medicare-only, or private-pay), a different framework applies.

The 2026 specific dollar rates for SLA E and SLA G are published by DTA through Field Operations Memos and are subject to periodic revision; readers in this pathway should contact DTA Policy directly or work with a Massachusetts elder-law attorney for current figures.

Estate Recovery: Why Massachusetts's Probate-Only Approach Matters

Massachusetts's estate recovery framework is governed by M.G.L. c. 118E § 31 and 130 CMR 515.011 (Estate Recovery) plus 130 CMR 515.012 (Living TEFRA Liens). Three features make Massachusetts's approach more consumer-protective than peer states:

1. Probate-only recovery. Massachusetts pursues estate recovery against the probate estate only. Property held jointly with rights of survivorship, in a life estate, in a properly drafted irrevocable trust, or in a beneficiary-designated account (POD/TOD bank accounts, IRAs with named beneficiaries, life insurance with named beneficiaries) generally is NOT subject to MassHealth recovery because such property does not pass through probate. This is a meaningful protection compared to "expanded estate recovery" states (Iowa, Minnesota, others) that pursue all assets the deceased had any interest in regardless of probate status.

2. $25,000 small-estate auto-waiver (effective 5/14/2021). MassHealth automatically waives recovery for probate estates valued at $25,000 or less. This is the "cost-not-effective" rule and represents a meaningful 2021 reform. Estates falling below this threshold do not face MassHealth recovery action.

3. Hardship waivers. Estates above the auto-waiver threshold may apply for hardship waivers under 130 CMR 515.011(F). Common hardship grounds include: continuing residence by a surviving family member who cannot purchase substitute housing; income-producing property necessary for surviving family support; surviving disabled child; significant family contribution to the property's preservation. Hardship waiver requests must be filed within 60 days of MassHealth's notice of claim.

Living TEFRA liens. During the resident's lifetime, MassHealth may place a TEFRA lien on real property of permanently institutionalized members under 130 CMR 515.012. The lien is removed if the resident returns home; it survives the resident's death and is satisfied through estate recovery. Living TEFRA liens are limited in scope (the resident's primary residence) and do not affect day-to-day asset use during life.

Effective for dates of death on/after 5/14/2021, MassHealth eliminated the previous 2-year conditional waiting period for residence/undue-hardship waivers when criteria are met, meaning families can resolve estate-recovery questions more quickly than under prior law.

For Massachusetts families with a loved one in MassHealth long-term-care:

• Joint tenancy with rights of survivorship between spouses (deeded "tenants by the entirety" in Massachusetts) is highly protective, the surviving spouse takes the property automatically without probate.
• Irrevocable trusts properly drafted at least 5 years before institutionalization can shelter assets from countability and from estate recovery.
• Life estate deeds can transfer remainder interests outside probate while preserving the resident's lifetime use.
• Beneficiary-designated accounts (IRAs, retirement plans, life insurance, POD/TOD bank accounts) generally pass outside probate and are not subject to recovery.

These planning options require execution well before institutionalization and the assistance of qualified Massachusetts elder-law counsel. The Massachusetts NAELA chapter and legal-aid organizations (Greater Boston Legal Services, MetroWest Legal Services, Justice Center of Southeast Massachusetts, Community Legal Aid in Worcester) maintain attorney referrals.

Senior Care Options (SCO) and One Care: PNA Inside Integrated Dual-Eligible Plans

Massachusetts is a national leader in fully integrated dual-eligible managed care, with two Massachusetts-specific products that affect the PNA in different ways:

Senior Care Options (SCO): For adults age 65+ who are dually eligible for Medicare and full MassHealth Standard. Effective 1/1/2026, SCO requires Medicare Parts A and B plus MassHealth Standard enrollment, restructured into Medicare Fully Integrated Dual Eligible Special Needs Plans (FIDE-SNPs) with companion MassHealth managed-care plans. SCO combines Medicare, MassHealth, behavioral health, LTSS, and care coordination through a single plan. Contracted plans for 2026 include Boston Medical Center HealthNet Plan, Commonwealth Care Alliance, Fallon, Senior Whole Health, Tufts Health Plan, UnitedHealthcare, and WellSense.

One Care: Serves dually eligible adults ages 21-64 with disabilities. Also restructured to FIDE-SNP form effective 1/1/2026 under a new five-year EOHHS contract through 12/31/2030. Combines Medicare, MassHealth, behavioral health, LTSS, and care coordination.

PNA application within SCO/One Care. When an SCO or One Care member is in an institutional MassHealth-paid setting (nursing facility, chronic-disease hospital, or licensed rest home), the same $72.80 PNA under 130 CMR 520.026 applies. Integration of Medicare and MassHealth into a single plan does not change the underlying PNA mechanic. The SCO or One Care plan's care manager will coordinate the patient-paid amount calculation with the facility's billing office, but the resident retains $72.80/month for personal use exactly as in non-managed-care settings.

Practical advantage of SCO/One Care. For residents who can manage in the community with intensive support, SCO and One Care often provide more LTSS than traditional fee-for-service Medicare + MassHealth, potentially delaying or avoiding nursing-facility placement entirely. When that is achievable, the resident retains far more than $72.80/month, they retain their full income (less Medicare premiums and any cost-sharing).

National Comparison: Massachusetts Medicaid Personal Needs Allowance vs Peers

The following table summarizes 2026 PNA figures in major peer states for context:

The peer-state figures above are illustrative; each state's PNA changes periodically through state regulation or legislation, so confirm any specific dollar amount against the source state's own rule before relying on it. The structural point holds: the Massachusetts figure reflects the long statutory freeze rather than recent legislative judgment about appropriate dignity money, and the pending bills, if enacted, would push Massachusetts above the regional benchmark cluster to $100 with CPI-U indexing built in.

The Massachusetts figure is also one of the few in the table that is statutorily fixed without indexing. The pending CPI-U indexing in S.887/S.482/H.1411 would, if enacted, give Massachusetts a more policy-forward PNA structure with automatic adjustment, removing the need for periodic legislative action.

12 Practical Tips for Massachusetts Families

1. Set Up the Resident Trust Fund Account at the Facility on Admission. The PNA is automatically deposited each month into a facility-administered resident-trust-fund account under 42 CFR § 483.10(f)(11). The resident or their representative payee may withdraw funds at any time during business hours. Most facilities provide quarterly statements.

2. Use the Full $72.80, Don't Bank It. Massachusetts's $2,000 institutional MassHealth asset limit is among the most restrictive in the country. Banked PNA at $72.80/month accumulates: 27.5 months of unspent PNA = $2,002, which would exceed the asset cap and jeopardize MassHealth eligibility. Active monthly spending or quarterly distributions to family for the resident's benefit are critical.

3. Cellphone Service Connects Family Across New England. Massachusetts families are often distributed across the Northeast, Boston, the South Shore, the Cape, MetroWest, the Worcester area, the Berkshires, and across the New Hampshire, Rhode Island, Connecticut, and Vermont borders. A $25-$40/month cellphone plan is one of the highest-value PNA expenditures.

4. Boston Globe and Regional Daily Subscriptions Carry Cultural Value. Massachusetts seniors who have read the Boston Globe, Boston Herald, Worcester Telegram & Gazette, Springfield Republican, Cape Cod Times, or Berkshire Eagle for decades often experience the daily newspaper as a critical anchor of normalcy. The $25-$45/month subscription is well within the PNA.

5. Salon and Barber Services Should Be Monthly. The facility's contracted barber/stylist typically charges $25-$40 per haircut. A monthly haircut is dignity-preserving and within the $72.80 PNA.

6. Sports Programming Matters in Boston. For Massachusetts seniors who follow the Patriots, Red Sox, Celtics, Bruins, college football and basketball, or local high-school sports, modest spending on programming-related items (a Boston Globe Sports section subscription, NESN-related publications, magazines) contributes meaningfully to cultural connection.

7. Family-Provided Cash Counts as Resources, Not Income. Family members may directly deposit additional money into the resident's personal account beyond the $72.80 PNA. These deposits ARE counted against the $2,000 asset limit. Time gifts to coincide with the resident's spending pattern.

8. Tobacco and Modest Vices Are PNA-Allowable. If your loved one smoked before admission, do not police their tobacco purchases (subject to facility smoke-free policy under MA state law). Federal regulation specifically protects resident discretion over PNA spending choices.

9. Spend-Down to the Asset Limit Should Be Strategic, Not Casual. If your loved one is over the $2,000 asset limit at admission, work with a Massachusetts elder-law attorney before spending. Gifts within the 5-year lookback can trigger transfer penalties under 130 CMR 520.019 (approximately $419/day or $12,732/month divisor for 2026). Legitimate spend-down on care, prepaid funeral and burial, household repairs, replacement vehicle, and own medical care does NOT trigger penalties.

10. Verify the Facility Is Not Withholding PNA as "Miscellaneous Charges." Some facilities improperly bill resident-trust-fund accounts for items that should be facility-provided. Common improper charges: extra incontinence supplies (which the facility is required to provide), copays for MassHealth-covered drugs (which are MassHealth's responsibility), basic toiletries the facility is required to stock. Dispute these with the Massachusetts Long-Term Care Ombudsman.

11. Monitor the S.887/S.482/H.1411 Legislative Status. If your loved one is institutionalized in 2026, the operative figure is $72.80. If the bills enact in late 2026 or in fiscal 2027, the increase to $100 (and CPI-U indexing from 7/1/2027) would apply prospectively from the effective date. AARP Massachusetts and Dignity Alliance Massachusetts maintain status updates.

12. Plan Estate Recovery Mitigation Early. Massachusetts's probate-only estate recovery framework (with the $25,000 auto-waiver) is more consumer-friendly than expanded-recovery states, but it still applies to probate-pass property. Joint tenancy with rights of survivorship, life estate deeds, irrevocable trusts (executed 5+ years before institutionalization), and beneficiary-designated accounts can all reduce estate-recovery exposure. Consult Massachusetts elder-law counsel.

Cross-State Quick Comparisons

For families with a loved one moving between MA and another state, common in cross-state retirement, family-relocation scenarios, or proximity-to-family decisions, the PNA differential can affect monthly disposable funds:

• MA → FL, Resident gains $87.20/month (MA $72.80 → FL $160). Over a typical 2-3 year stay, this is $2,093-$3,140 in additional dignity money. FL's PNA is the highest in the country.
• MA → TX, Resident gains $2.20/month (MA $72.80 → TX $75). TX has Miller Trust requirement that MA does not.
• MA → CT, Resident gains $2.20/month (MA $72.80 → CT $75, verified against Conn. Gen. Stat. § 17b-272). Wartime-veteran differential $165 in CT.
• MA → OH, Resident gains $2.20/month (MA $72.80 → OH $75, verified against OAC Rule 5160:1-6-07; OH raised from $50 effective 10/1/2025).
• MA → PA, Resident loses $12.80/month (MA $72.80 → PA $60).
• MA → MI, Resident loses $12.80/month (MA $72.80 → MI $60).
• MA → NY, Resident loses $22.80/month (MA $72.80 → NY $50). NY's broader Medicaid framework (much higher community-Medicaid asset limits, pooled income trust availability) compensates for community-Medicaid scenarios, but NY institutional PNA itself is lower.
• MA → CA, Resident loses $37.80/month (MA $72.80 → CA $35 institutional NF). CA's broader Medi-Cal framework (no QIT requirement; medically-needy share-of-cost pathway; AB 116 asset-test reinstatement at $130,000) compensates significantly for the lower PNA.

For most MA families, the PNA differential is just one factor in cross-state retirement and care planning. Asset limits, estate-recovery aggressiveness, MMNA methodology, nursing-facility availability, family proximity, climate, and cost-of-living all matter, and Massachusetts's 1634 + medically-needy + probate-only estate recovery combination is among the more consumer-protective frameworks in the country, partially offsetting the lower PNA figure.

8 Common Pitfalls

1. Banked PNA Pushing Resources Over $2,000 Asset Limit. Massachusetts's $2,000 institutional MassHealth asset limit is among the most restrictive in the country. A resident saving $72.80/month accumulates over $2,000 in 27.5 months, a real risk for residents who do not actively spend. Active monthly spending or quarterly family distributions prevent eligibility loss.

2. Co-Mingling Resident Funds With Facility Operating Funds. Federal regulation 42 CFR § 483.10(f)(11) requires facilities to maintain separate resident-trust-fund accounts. A facility that co-mingles funds is in violation; report to the Massachusetts Long-Term Care Ombudsman or DPH Bureau of Health Care Safety and Quality.

3. Confusing the Institutional PNA ($72.80 under 130 CMR 520.026) with the SSP-Pathway Personal-Needs Structure (106 CMR 327). These are separate programs administered by different agencies (EOHHS vs DTA) with different rate structures. The institutional PNA applies only when MassHealth is paying institutional LTC; the SSP framework applies in non-institutional settings.

4. Treating Massachusetts Like an Income-Cap State. Massachusetts is medically-needy and 1634, there is no income cap, no Miller Trust requirement. Practitioners or families who attempt to set up Miller Trusts in Massachusetts are wasting money on a procedural device the state does not recognize.

5. Assuming the PNA Will Increase Soon Because Bills Are Pending. S.887/S.482/H.1411 are in advanced procedural posture but have not enacted as of May 2026. Plan for $72.80 throughout 2026; if the bills enact, the increase to $100 will apply prospectively from the effective date.

6. Misuse by a Representative Payee or Family Member. Diverting the resident's PNA for non-resident purposes is a federal regulation violation and a Massachusetts elder-financial-exploitation issue under M.G.L. c. 19A § 14 and the Massachusetts elder-abuse statutes. The MA Long-Term Care Ombudsman, EOEA Protective Services, and local district attorney's office have authority.

7. Failure to Use the PNA Each Month. Cognitively impaired residents whose family does not visit may accumulate PNA without spending it, then face the asset-cap issue. Active monthly use for the resident's benefit is essential.

8. Confusing PNA With Other Income Components. SNAP benefits (suspended during institutional residence; the facility provides meals), Veterans Aid & Attendance (paid directly to the resident and counted as income for MassHealth budgeting), and Medicare Part B premium are all SEPARATE from the PNA.

Where to Get Help

If you have questions about the Massachusetts PNA, patient-paid amount calculation, estate recovery, or related MassHealth issues:

• Massachusetts Long-Term Care Ombudsman Program (Executive Office of Elder Affairs), 617-727-7750 (main EOEA line) or 617-222-7495 (local-rep referral). 1 Ashburton Place, 10th Floor, Boston, MA 02108. Resident-rights advocacy, facility-billing disputes, resident-trust-fund issues.
• MassHealth Customer Service Center, 1-800-841-2900 (TTY 711). General eligibility, patient-paid amount, and benefit questions.
• MassHealth Estate Recovery Unit, 617-348-5230. Estate-recovery claim questions and hardship-waiver process.
• Mass. Executive Office of Elder Affairs (EOEA), 1-800-AGE-INFO (1-800-243-4636). Statewide elder services, SHINE Medicare counseling referrals.
• SHINE Program (Massachusetts SHIP), 1-800-AGE-INFO option 3. Free Medicare counseling.
• Disability Law Center (DLC), 617-723-8455 or toll-free 1-800-872-9992. 11 Beacon Street, Suite 925, Boston, MA 02108. MA's Protection & Advocacy agency; handles MassHealth, estate recovery, and disability-rights cases.
• Greater Boston Legal Services, Elder, Health and Disability Unit, 617-371-1234. Represents low-income seniors on MassHealth, estate recovery, and nursing home issues.
• MetroWest Legal Services, Regional legal aid covering MetroWest communities.
• Justice Center of Southeast Massachusetts, Regional legal aid covering Southeast Massachusetts.
• Community Legal Aid (Worcester), Regional legal aid covering Central/Western Massachusetts.
• Massachusetts Chapter NAELA, National Academy of Elder Law Attorneys, MA chapter; specialized elder-law referrals for QIT, spend-down, and estate-recovery planning.
• AARP Massachusetts, Senior-policy advocacy and information.
• LeadingAge Massachusetts, Trade association of nonprofit senior-living operators.
• Dignity Alliance Massachusetts, Coalition advocating for PNA increases and senior-resident dignity reforms.
• Massachusetts Senior Care Association (MSCA), Trade association of MA nursing facilities.

Learn More

• MassHealth Programs Overview
• MassHealth Eligibility & Income Limits
• MassHealth Estate Recovery
• MassHealth Spousal Impoverishment
• MassHealth Medically-Needy Spend-Down
• MassHealth SCO & One Care

Find personalized help navigating the Massachusetts Medicaid personal needs allowance at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.