We open PCA enrollment on October 1 . If you have MassHealth Standard or CommonHealth, a permanent or chronic disability, and need hands on help with two or more daily activities, the PCA program pays for a personal care attendant. The part most families do not know: you choose who that attendant is, and it can be your own son, daughter, or a friend.

Who qualifies?

Three things have to be true at the same time. You are eligible for MassHealth Standard or CommonHealth. You have a permanent or chronic disability. And you need physical assistance with two or more activities of daily living, which means bathing, dressing, eating, mobility and the rest of that list, not errands and not company.

Age is not a factor. This is not a seniors program. Adults and children both qualify.

What can a PCA actually do?

More than most people expect, and more than a privately hired aide. The program covers grooming, bathing and hygiene, mobility and transfers, medication assistance, meal preparation and feeding, grocery shopping, light housekeeping, and transportation to medical appointments.

Note the medication line, because it is a real difference. Our private pay home health aides are trained, background checked and insured, and they are not nurses and do not administer medication. Medication assistance is inside the PCA program's scope. If that is the thing you have been stuck on, this is the route that solves it.

Transfers, bathing, dressing, meals and medication assistance are all inside the PCA program's scope.

Can I pay my daughter, my son, or my friend?

Generally yes, and this is the reason most people apply. A PCA can be a friend, a relative, or an adult child. The exclusions are the ones you would expect: a spouse, your surrogate, and your legal guardian cannot be paid as your PCA. If you are a parent applying on behalf of a child, ask us about your specific situation before you assume either way, because the rules around parents differ depending on the age of the child and who is legally responsible.

If someone in your family has already been doing this work unpaid for years, that is the conversation to have on the phone.

Who is the employer?

You are. This is the part that surprises people, and it is worth understanding before you start rather than after. In the PCA program the consumer is the employer: you hire your attendant, you train them, you set the schedule, you supervise the work, and if it is not working you are the one who ends it. MassHealth pays the attendant. It does not manage them for you.

That is real control and it is also real responsibility. It is why the program includes skills training, and it is why some people choose to pay privately instead. Both are legitimate. We will tell you honestly which one fits you.

What if I cannot manage all that myself?

Then you use a surrogate or an administrative proxy. A surrogate is a person who takes on the employer responsibilities for you, which is how the program works for a child, or for an adult who cannot direct the hiring and scheduling. Naming one does not disqualify you. Not having anybody to name is the thing to talk to us about early.

What are the steps, and how long does it take?

• A letter of medical necessity from your primary care provider.
• A face to face evaluation by a registered nurse, in your home, looking at what you actually need help with and how many hours that comes to.
• Prior authorization. The evaluation goes to MassHealth for approval. This is the step that takes time and it is not one anybody can rush.
• Skills training, so you know how to be the employer: hiring, timesheets, and what to do when your attendant calls out.
• A written service agreement, including a backup plan for coverage. Do not skip the backup plan. It is the difference between a rough week and a hospital admission.

Plan on weeks, not days. Start the doctor's letter now, because it is the step people leave until last and it is the one that is out of your hands.

Who handles the payroll and the taxes?

A fiscal intermediary. Being the employer does not mean you are running a payroll department. The fiscal intermediary processes the timesheets, handles income tax withholding and makes sure the IRS requirements for your attendant are met. You approve the hours. They do the paperwork.

What does it cost you?

MassHealth pays the attendant. That is the whole point of the program, and it is why it is worth the weeks it takes to get through the authorization.

Compare it honestly to the private route. Our home health aide care is $45 an hour, one to eight hours a day, no minimum contract, and it can start this week with no eligibility determination and no prior authorization. It is also money out of your pocket. PCA is free to you and takes longer to start, and you become the employer. Many families do both: hire privately to cover the gap now, and enroll in PCA for the long run.

What do we need from you to start on October 1?

• Whether you have MassHealth Standard or CommonHealth, or neither yet.
• Which daily activities you need physical help with.
• Whether you have somebody in mind to hire, and their relationship to you.
• Whether you will direct the program yourself or need a surrogate.
• Your town, so we know which office covers you.

How to get on the list

Call 781-957-8076 . We work out of Woburn, Brockton and Springfield and cover most of eastern and central Massachusetts. Calling before October 1 puts you at the front of the queue for the nurse evaluation, which is the step that sets everything else in motion.

This page describes the MassHealth PCA program in general terms as of October 2026. Program rules and eligibility are set by MassHealth and can change. We will confirm your specific situation on the phone, and MassHealth Customer Service is 800-841-2900.