My Senior Solutions

For Massachusetts families, from one caregiver to another

A little help for the people who do it all.

When you’re caring for a parent, the questions never stop. Let’s make the next step a little clearer—with real-life guidance, useful answers, and no jargon.

Find a place to start Meet Heidi
“

You don’t have to figure out every part of this today. Let’s take one thing at a time.

An adult daughter and her older mother talking together at a kitchen table at home
Caregiving is personal.
The help should be, too.
East Boston, MA Neighbors helping neighbors
Clear answersPractical next stepsMade for Massachusetts

If you're not sure where to begin

Start with what’s
weighing on you.

There’s a lot to navigate. Choose the question closest to yours, and we’ll help you find the next right step.

01

“They worked their whole life. Why can’t they get help?”

Make sense of Medicare, MassHealth, and the gap between them.

 02

“The prescription is stuck. Now what?”

Find out who to call, what to ask, and when a delay needs action.

 03

“Can I be paid to care for my parent?”

Understand the basics of Massachusetts Adult Foster Care.

From one caregiver
to another

EAST BOSTON · MASSACHUSETTS

Hi, I’m Heidi

I didn’t set out to become an expert. I just needed to help my parents.

My parents are in their 80s. Like so many families, ours has been learning the system as we go—making calls, comparing answers, and trying to understand what help is actually available.

I started My Senior Solutions because I wished someone had explained it all in plain English when we began. Not a sales pitch. Not a stack of acronyms. Just honest information from someone who knows how heavy—and how loving—this work can be.

If you’re juggling a job, your own family, and the needs of a parent, you’re not alone here. We’ll sort through the next step together.

With care, Heidi

The coverage puzzle

“My mom worked her whole life. Why can’t she get help?”

A question I hear—and have asked—more than once. The short answer is that Medicare and MassHealth do different jobs.

A starting point, not a verdict.
Eligibility depends on the person, the service, and current program rules. A SHINE counselor or MassHealth can help you look at a specific situation.

Medicare covers health care. It usually isn’t long-term care.

Medicare is federal health insurance for people 65 and older and some younger people with disabilities. It can help pay for hospital care, doctor visits, and certain limited skilled care at home or in a facility. It generally does not pay for ongoing, hands-on help with everyday activities—like bathing, dressing, or staying safe at home—when that is the only care needed.

That distinction can feel startling when a parent has paid into the system for decades. Medicare eligibility is not a promise that every kind of support will be covered.

MassHealth may cover more long-term supports—but has its own rules.

MassHealth is Massachusetts’ Medicaid program. For people who qualify, it can cover services Medicare generally doesn’t, including certain long-term services and supports. Eligibility can depend on the specific MassHealth coverage type, income, assets, and care needs. Rules and limits can vary by program and can change.

Some people have both Medicare and MassHealth. In that case, Medicare is generally the primary payer for Medicare-covered services, and MassHealth may help with costs and services for which the person qualifies.

Why can a “working senior” still face a wall?

Work history by itself doesn’t decide whether someone qualifies for needs-based help. A person can have retirement income, savings, or a home and still have care needs—but may need a careful eligibility review to learn which programs fit. Having a Medicare card does not automatically open the door to MassHealth-funded home care.

Before making financial decisions or moving money, get guidance from a qualified benefits counselor or elder-law professional. Transfers and disclosures can affect eligibility; there isn’t one safe answer for every family.

The uncomfortable part: sharing financial information

Applying for means-tested benefits can involve providing financial records. Families can worry about privacy, family assets, or whether they are being asked for something legitimate. It’s reasonable to ask why information is needed, who will see it, how it will be used, and what documents are required.

Use official MassHealth channels or a trusted counselor. Don’t guess, hide information, or give away assets to “qualify” without individualized legal advice. Explain the concern openly and ask for help understanding the options.

Try this next: Call SHINE at 1-800-243-4636 and ask for a free, unbiased conversation about Medicare coverage and where to check MassHealth eligibility.

When a medicine is delayed

“Her prescription sat in prior authorization for a month.”

That wait is stressful. The first move is to find out exactly where the request is stuck—then make sure someone owns the next step.

A practical call plan

  1. 1
    Ask the pharmacy what the rejection says.

    Is the prescription waiting for prior authorization, a refill-too-soon date, a quantity limit, or something else? Ask if the prescriber has been notified, and when.

  2. 2
    Call the prescriber’s office with specifics.

    Ask whether the request was sent, on what date, and to which insurer or plan. If it was sent, ask for the tracking or reference number and what is still needed.

  3. 3
    Ask the plan what happens next.

    Confirm whether they received it, whether it is complete, and the decision deadline. Ask if the doctor can request an expedited review when a delay could seriously jeopardize health.

  4. 4
    Make a safe plan for the gap.

    Ask the pharmacist and prescriber whether an emergency supply, clinically appropriate alternative, or other bridge is available. Don’t change a dose or stop a medication without clinical advice.

Words you can use

“Can you tell me the exact reason it hasn’t been filled, who has the next action, and when I should call back if it isn’t resolved?”

New program to know about

Medicare GLP-1 Bridge: who should ask?

CMS’s temporary Medicare GLP-1 Bridge began July 1, 2026 and is scheduled to run through December 31, 2027. It may help some people with eligible Medicare Part D coverage get certain GLP-1 medicines for weight management, outside their Part D plan, for a $50 copay. It is not for everyone: a prescriber must submit a prior-authorization request and the person must meet the program’s plan and clinical criteria.

Among the current criteria: at least age 18, a weight-management prescription, and BMI at therapy start of 35 or more, or lower BMI with specified health conditions. People using GLP-1s for eligible Part D conditions such as type 2 diabetes should work through their Part D plan instead; the Bridge is not a shortcut around diabetes coverage or an individual plan’s rules. Covered products and eligibility details can change.

Check CMS’s current GLP-1 Bridge guidance

Care at home

“Can I get paid to take care of my own parent?”

Sometimes, yes. In Massachusetts, Adult Foster Care (AFC) can pay a qualified live-in caregiver—including an adult child—for eligible care. It is a structured MassHealth program, not a paycheck for every family caregiver.

See MassHealth’s AFC guide

An adult child may qualify as the caregiver

MassHealth says a family member can serve as the caregiver, with exclusions including a spouse or legal guardian. The caregiver must live with the member, meet program qualifications, and be willing and able to provide daily care. A MassHealth AFC provider—not the family directly—pays the caregiver.

The parent needs to meet AFC eligibility

The member generally must be 16 or older, have an eligible MassHealth coverage type (or qualifying integrated-care enrollment), need physical assistance or cueing/supervision with at least one activity of daily living, and be able to live safely at home with caregiver support. The care must be ordered and assessed.

AFC comes with a care team

An approved AFC provider coordinates assessment, a written plan of care, nursing oversight, and care management. The caregiver lives in the same home and provides hands-on daily support. The provider confirms clinical eligibility and handles prior authorization.

Spouses cannot be paid as the AFC caregiver

A spouse is excluded from serving as the paid AFC caregiver. Adult children are not excluded just for being the member’s child, but they still have to meet the provider’s and MassHealth’s requirements. Always confirm the current rules with an AFC provider.

Good first question: Call MassHealth or an AFC provider and ask, “Could my parent meet AFC clinical criteria, and can an adult child who lives with them be the caregiver?”

Keep these close

People who can help
you sort it out.

These are reliable places to ask questions and get connected. You don’t have to arrive with all the right words.

SHINE

Free, unbiased Medicare counseling for Massachusetts residents. Ask about coverage, plan choices, bills, and appeals.

800-243-4636Visit SHINE ↗

MassOptions is generally available Monday–Friday. Check the service website for the latest hours and ways to connect.

Let’s take the next step

One question is enough to start.

Tell me what you’re trying to figure out. I’ll do my best to point you toward a helpful next step or a trusted resource.

A quick note: Please don’t include Social Security numbers, Medicare numbers, or private medical records in your message.

Your message is for an initial inquiry—not for urgent or emergency medical questions.