Guardianship vs Conservatorship Massachusetts: Which One Do You Actually Need?

In some states, "guardian" and "conservator" are used interchangeably. Massachusetts is not one of those states. Under the Massachusetts Uniform Probate Code (MUPC, M.G.L. c. 190B, Article V), they are legally distinct appointments with completely different authority, different filing fees, and different ongoing obligations.

Getting this distinction wrong before you file means either requesting authority you do not need or missing authority you do — both of which cost time and money to fix.

What a Guardian Does

A guardian in Massachusetts has authority over the ward's personal and medical decisions:

• Deciding where the ward lives (residential placement)
• Consenting to or refusing medical treatment (except antipsychotic medications, which require separate Rogers authority)
• Managing daily personal care and safety
• Making educational decisions if the ward is still in a school program

A guardian does not have authority over the ward's money, bank accounts, investments, real estate, or contractual obligations. If your adult child receives $994/month in SSI and you need to manage how it is spent, guardianship alone does not give you that power.

Filing fee for guardianship (Form MPC 120): $0.

What a Conservator Does

A conservator has authority over the protected person's financial affairs:

• Managing bank accounts and investments
• Paying bills and managing expenses
• Entering contracts on behalf of the protected person
• Protecting assets from exploitation or dissipation
• Filing taxes and managing government benefit coordination

A conservator does not have authority over the protected person's medical care, housing decisions, or personal safety. If your adult child needs emergency surgery and cannot consent, a conservatorship does not authorize you to consent on their behalf.

Filing fee for conservatorship (Form MPC 130): $240 plus a $15 surcharge, totaling $255.

The Overlap Problem

The confusion arises because many families need authority in both domains. The adult child cannot manage their finances and also cannot make safe medical decisions. In that case, you file both petitions — MPC 120 (guardianship) and MPC 130 (conservatorship) — either simultaneously or sequentially.

Filing both petitions together is more efficient. The court can consolidate the hearings, the clinical evidence (MPC 400 or MPC 402) supports both petitions, and you avoid duplicating the notice-and-service process.

Ongoing Obligations: Where They Diverge Sharply

After appointment, the reporting requirements split:

Guardian's Obligations

• MPC 821 (Guardian's Care Plan Report): File within 60 days of appointment, then annually on the anniversary date. The report covers the ward's living arrangements, medical condition, social activities, and any changes in functional capacity. No filing fee. Can be e-filed.

Conservator's Obligations

• MPC 854/854a (Inventory): File within 90 days of appointment, detailing all real estate, bank accounts, and personal property. No filing fee.
• MPC 853/853a (Annual Account): File annually with a detailed financial accounting — every dollar received, spent, and held. The filing fee for annual accounts escalates by estate value: $0 for estates under $1,000, scaling up to $1,500 for estates over $5 million. Annual accounts cannot be e-filed — they must be submitted in person or by mail. The court also issues a citation for allowance of the account ($15 fee), which the conservator must serve on all interested parties.

The conservator's reporting burden is substantially heavier than the guardian's, especially for estates with significant assets. For many families of adults with disabilities whose primary income is SSI ($994/month), the conservator's annual accounting covers a modest estate — but the paperwork is the same regardless of size.

A Note About Federal Benefits

Neither a guardian nor a conservator automatically manages federal disability benefits. The Social Security Administration operates independently of state courts. To manage SSI or SSDI payments, you must separately apply to become a Representative Payee through the SSA using Form SSA-11-BK. The SSA does not treat a guardianship decree, conservatorship decree, or power of attorney as automatic authority to receive or manage benefit payments.

When You Need Only One

Guardianship alone makes sense when the adult needs support with medical and residential decisions but has minimal financial assets that can be managed through a Representative Payee (for SSI) and an ABLE account (for savings up to $100,000 without affecting SSI eligibility).

Conservatorship alone makes sense when the adult can participate in their own medical and daily care decisions (perhaps with SDM support) but is vulnerable to financial exploitation — taking out predatory loans, giving money to scammers, or making large purchases they cannot afford. This is less common but does arise, particularly for adults with mental health conditions whose cognitive capacity fluctuates.

Deciding What to File

The decision comes down to two questions:

1. Does the adult lack the ability to make safe personal and medical decisions? → Guardianship
2. Does the adult lack the ability to manage money and protect their own financial interests? → Conservatorship

If the answer to both is yes, file both. If the answer to only one is yes, file that one. If the answer to both is "they can handle it with support," explore the alternatives to guardianship first — SDM agreements, health care proxies, durable powers of attorney, and Representative Payee appointments may cover every gap without court supervision.

The Massachusetts Adult Guardianship & Alternatives Guide includes the full comparison framework with a diagnostic worksheet that maps your child's functional capacity to the specific legal tools they need.

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