State Medicaid Waiver Directory
Find your state's Katie Beckett waiver, TEFRA pathway, HCBS programs, and Medicaid eligibility rules for children and adults with disabilities. Each guide covers waitlists, application steps, income limits, and parent caregiver pay options.
For informational purposes only — not legal, medical, or financial advice. Medicaid rules, eligibility, and waitlists change frequently. Always verify with your state's official Medicaid agency before making decisions. Cross-check with Medicaid.gov's official waiver page.
Massachusetts
Program Overview
Overview
Massachusetts has a clearly organized system through MassHealth and the Department of Developmental Services (DDS). The Children's Behavioral Health Initiative (CBHI) and the adult DDS system are key routes.
Katie Beckett or similar pathway
Massachusetts has a TEFRA State Plan Option (SPA) that disregards parental income for children with disabilities who need institutional-level care. Contact MassHealth and ask specifically about the TEFRA or Katie Beckett option for children.
Child-relevant waivers
The DDS Intensive Supports Waiver and Residential Supports Waiver are primary routes for individuals with developmental disabilities. MassHealth also has HCBS waiver programs.
Eligibility
Who qualifies
DDS waivers serve individuals with intellectual disabilities who meet level-of-care criteria. MassHealth HCBS waivers have specific eligibility requirements.
Financial and income rules
MassHealth financial eligibility applies. DDS waiver programs may have separate financial criteria.
Level of care
ICF/ID or nursing-facility level of care may be required depending on the specific program.
Age rules
DDS services begin in childhood. MassHealth CBHI serves children with behavioral health needs.
Getting Started
How to apply
Contact DDS for developmental disability services. Contact MassHealth for medical Medicaid services.
Documents needed
DDS eligibility documentation, medical records, and financial information are typically required.
Waitlist information
DDS waivers in Massachusetts have historically had significant waiting lists.
Practical next step
Contact Massachusetts DDS for developmental disability intake and MassHealth for medical-related HCBS waiver services.
Services & Support
Services available
DDS waivers cover residential services, day supports, supported employment, and family supports. MassHealth covers medical and behavioral health services.
Parent caregiver pay
Massachusetts created a Complex Care Assistant provider type that allows parents and guardians to be paid to care for their children, including personal care plus enhanced services such as tube feedings and oxygen delivery. Parents and guardians who are RNs or LPNs can also be paid to care for their own children.
Equipment exchange & assistive technology
MassMATCH / MassAbility AT Services (mass.gov/massmatch) — free device demonstrations, short-term loans, and device reuse through the REquipment MA program (free refurbished DME delivered statewide).
Mental health and Medicaid coverage
MassHealth covers behavioral health services through managed care plans and the Behavioral Health Community Partners (BH CP) program. The Children's Behavioral Health Initiative (CBHI) provides intensive home-based therapy, in-home behavioral services, family stabilization, and intensive care coordination for children. Covered services include outpatient therapy, psychiatric evaluations, medication management, and crisis services. The Massachusetts Behavioral Health Partnership (MBHP) manages behavioral health benefits. Children can access services through the EPSDT benefit.
Additional notes
DDS waitlists can be long. Starting the eligibility and intake process as soon as a diagnosis is confirmed helps ensure services are in place when they are needed.
State-Specific Resources
Paid family caregiving — Mass Carelink & Tempus Unlimited
Mass Carelink (masscarelink.org) and Tempus Unlimited (tempusunlimited.org) are two organizations that help family members become paid caregivers through the MassHealth Adult Foster Care program. Caregivers receive a tax-free monthly stipend.
Free equipment — REquipment MA
REquipment MA (requipmentma.org) is a statewide program that collects donated durable medical equipment (DME) and assistive technology, refurbishes it, and delivers it free of charge to individuals with disabilities across Massachusetts.
Vocational rehabilitation — MassAbility
MassAbility — formerly the Massachusetts Rehabilitation Commission — offers vocational rehabilitation and independent living services for people with disabilities.
State cash assistance — EAEDC
EAEDC (Emergency Aid to the Elderly, Disabled, and Children) is a state-funded cash assistance program for low-income adults who are elderly or have a disability, as well as certain caregivers and children who do not qualify for other programs.
Family advocacy — MassFamilies
MassFamilies (massfamilies.org) is a statewide grassroots coalition that provides advocacy training and resources on home and community-based services for individuals with disabilities and their families.
Massachusetts — Respite Care Options for Family Caregivers
DDS Family Support (mass.gov/dds-family-support) funds respite care and flexible stipends so families can hire their own respite providers, including family members where allowed. Seven Hills Foundation also coordinates respite through Family Support Centers in Athol, Lowell, Fitchburg, and Sturbridge. See the Provider Directory for more respite and community programs.
Massachusetts — Fitness, Sports, and Community Programs
Greater Boston has dedicated adaptive fitness centers: Inclusive Fitness (Dedham and Burlington, ages 12+) and the YMCA of Greater Boston's Adaptive Fitness program. Special Olympics Massachusetts offers year-round sports statewide. Day programs for adults include Advocates (MetroWest), Communitas (Wakefield, Burlington, Beverly), and MAB Community Services.
Sources
Recent news for Massachusetts
Hoodline · October 16, 2026 · Education, Rights & Law
A mother is advocating for her son's right to an appropriate Individualized Education Program following repeated psychiatric hospitalizations.
AOL · October 13, 2026 · Medicaid & Waivers, Funding & Budget
Families relying on Medicaid-funded meal delivery services are facing potential instability due to looming budget cuts and uncertainty in policy support.
MassLive · October 6, 2026 · Education
A school district is implementing new training and staffing measures following an official state review of their special education services.
The Cool Down on MSN · October 3, 2026 · Medicaid & Waivers, Rights & Law
Massachusetts is moving to end full Medicaid eligibility for thousands of legal immigrants, impacting access to essential health services.
Community Tips & Experience
Comments reflect the personal experiences and opinions of individual community members only. They do not represent the views, positions, or endorsements of National Disability Resource Project or any of its staff, volunteers, or affiliated members. Always verify information with official agencies and qualified professionals before making decisions.
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