A caregiver smiling and pushing an elderly man in a wheelchair

How To

Be Eligible for PCA services

To be eligible to receive PCA services, you must have:

A woman in a wheelchair being hugged by a young girl and holding the hand of a young woman
  • MassHealth Standard or CommonHealth coverage;
  • a disability that is permanent  and chronic that prevents you from performing your Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs) without physical assistance;
  • Require physical assistance with two or more of the following ADLs:
    • mobility, including transfers;
    • medications;
    • bathing/grooming;
    • dressing/undressing;
    • range of motion exercises;
    • eating
    • toileting
  • a prescription from your physician or nurse practitioner for PCA services; and
  • obtain prior authorization for PCA services from MassHealth

Stavros PCM Agency can provide you with more information about the eligibility criteria, and will assist with submitting your application for PCA services to MassHealth should you meet this criteria.

What are Instrumental Activities of Daily Living (IADLs)?

Individuals who meet the criteria to receive PCA services can also receive physical assistance with IADLs, if authorized by MassHealth.   IADLs include household management tasks, such as laundry, shopping, and housekeeping; meal preparation and clean-up; transportation to medical providers; care and maintenance of adaptive devices, such as wheelchairs; assistance with completing PCA paperwork; and other special needs as determined instrumental to the health care of the individual.

Who decides if I am eligible for PCA Services?

A Registered Nurse (RN) from Stavros PCM Agency will visit you in your home to conduct an Evaluation of your need for PCA services. If this is your first PCA Evaluation, an Occupational Therapist will also conduct a functional assessment.