Medicaid Long-Term Care Guide in New York
Long-term care eligibility, benefits, and how to apply through the New York Department of Health (DOH) in conjunction with local Departments of Social Services (DSS).
What makes New York Medicaid different
Medicaid in New York is sometimes called Medicaid Managed Care. Medicaid for the Disabled, Aged 65+ or Blind (DAB) is also called NON-MAGI Medicaid. NY Medicaid is state and federally funded and administered by the state under federally set parameters. In addition to nursing home care, NY Medicaid pays for non-medical services and supports to help frail seniors remain living at home or in the community.
Administered by the New York Department of Health (DOH) in conjunction with local Departments of Social Services (DSS).
Program Types
Institutional / Nursing Home Medicaid
An entitlement; anyone who is eligible will receive assistance. Care is provided only in Medicaid-certified nursing homes.
Level of care: Nursing Home
Medicaid Waivers / Home and Community Based Services (HCBS)
Not an entitlement; there are a limited number of participant slots and waiting lists may exist. Intended to delay nursing home admissions, services are provided at home, the home of a loved one, adult day care, or in assisted living.
Level of care: Nursing Home
Regular Medicaid / Disabled, Aged 65+ or Blind (DAB)
An entitlement; anyone who is eligible will receive assistance. While Regular Medicaid is not Long-Term Care Medicaid, some long-term care services, such as personal care assistance or adult day care, may be available.
Level of care: Help with ADLs
2026 New York Medicaid Long-Term Care Eligibility for Seniors
Institutional / Nursing Home Medicaid*
Medicaid Waivers / Home and Community Based Services†
Regular Medicaid / Aged Blind and Disabled‡
*All of a recipient's monthly income, with the exception of a Personal Needs Allowance of $50 / month, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse, must go towards nursing home costs. This is called a Patient Liability.
†Based on one's living setting, a program beneficiary may not be able to keep monthly income up to this level.
‡Another pathway to Medicaid eligibility is through SSI. In New York, persons who are determined eligible for SSI are automatically approved for Regular Medicaid, including long-term services and supports, given one meets the functional criteria.
Explore New York Medicaid Programs
Compare programs, see caregiver pay rates, get step-by-step application guidance, and check your eligibility — all specific to New York.
Long-term care Medicaid guide
Eligibility · Caregiver pay · How to apply · 2026 data
Important: Rates vary — contact your state Medicaid office for current figures. This tool provides general guidance, not legal or financial advice.
Compare Medicaid Programs — New York
How the main LTC programs available in New York compare side by side.
| Program | Pay | Pay type | Tax-free? | Spouse OK? | Waitlist? |
|---|---|---|---|---|---|
| Consumer-directed HCBS | $18–22/hr | Hourly wage | No | Yes | No |
| Structured Family Caregiving (SFC) | Not in New York | Daily stipend | Yes | Usually no | No |
| Personal Care Agreement | Market rate (from assets) | Private pay | No | Yes | No |
| VA Aid & Attendance | Up to $2,874/mo | Monthly pension | Yes | Yes | No |
New York Medicaid programs
CDPAP (Consumer Directed Personal Assistance)
MLTC
Sources: KFF (Jan 2026), medicaidplanningassistance.org (Feb 2026). Programs and rates change — verify with your state Medicaid office.
How Family Caregivers Get Paid Through Medicaid in New York
If you're a family member providing care, you may be able to get paid through Medicaid — often at rates comparable to a home care agency.
Consumer-directed care — hourly pay
Available in New YorkHow it works: The person receiving care becomes the "employer" — they hire you and a fiscal intermediary handles payroll, taxes, and paperwork on their behalf. You receive a paycheck just like a regular job.
How to apply: Local LDSS · health.ny.gov/cdpap — FreedomCare for enrollment
Personal Care Agreement — private pay from assets
Available to any familySources: KFF Medicaid Home Care Survey 2025 (Jan 2026), Careforth FAQ (Jan 2026), IRS Notice 2014-7.
How to Apply for Medicaid Long-Term Care in New York
What to expect when applying for LTC Medicaid and getting family caregiver pay set up in New York. The process typically takes 45–90 days from application to first paycheck.
Apply in New York: Local LDSS · health.ny.gov/cdpap — FreedomCare for enrollment
Medicaid Eligibility Screener — New York
Answer 7 quick questions — we'll check the financial and care requirements for New York and explain what each one means.
What is the marital status of the person who needs care?
Medicaid looks at only the applicant's income and assets — but being married triggers special protections that let the healthy spouse keep significantly more money.
Sources
- CMS Medicaid — eligibility, HCBS waivers, and long-term services medicaid.gov/medicaid/eligibility
- CMS Medicaid — Home & Community-Based Services (HCBS) medicaid.gov/medicaid/home-community-based-services
- Social Security Administration — SSI Federal Benefit Rate (2026 figures) ssa.gov/oact/cola/SSI.html
- CMS — Spousal Impoverishment standards (CSRA & MMMNA) medicaid.gov/medicaid/eligibility/spousal-impoverishment
- CMS — Estate Recovery and the 5-year lookback period medicaid.gov/medicaid/eligibility/estate-recovery
- IRS Notice 2014-7 — Tax treatment of Medicaid caregiver payments irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Educational guidance only — not legal or financial advice. Your state Medicaid office determines actual eligibility.
Key Rules at a Glance
- Nearly all sources of income are counted, including employment wages, alimony, pensions, SSDI, SSI, gifts, annuity payments, and IRA distributions.
- Nationally, Holocaust restitution payments are not counted as income.
- In NY, the VA Aid and Attendance, which is above and beyond the Basic VA Pension, does not count.
- When only one spouse applies for Nursing Home Medicaid or a HCBS Waiver, the non-applicant spouse's income is disregarded.
- The Community Spouse Monthly Income Allowance (CSMIA) is $4,066.50 (2026). If the non-applicant spouse has income under this amount, income can be transferred from the applicant spouse.
- If the non-applicant spouse has income over $4,066.50 / month, Medicaid will request 25% of the 'excess' income go towards the applicant's care costs. An applicant can institute Spousal Refusal in this situation.
- For Regular Medicaid, both spouses' income is counted. There is no CSMIA for a non-applicant spouse.
- In New York, persons determined eligible for SSI are automatically approved for Regular Medicaid.
- Countable assets include cash, stocks, bonds, investments, cryptocurrency, vacation homes, and bank accounts (checking, savings, money market).
- In New York, IRAs and 401Ks in payout status are exempt. This means one's required minimum distribution (RMD) is being withdrawn.
- Non-countable (exempt) assets include one's primary home, personal belongings, household items, a vehicle, burial funds up to $1,500 or a life insurance policy with cash value up to $1,500, and non-refundable pre-paid funeral agreements.
- All assets of a married couple are considered jointly owned regardless of the Medicaid program.
- The CSRA allows the non-applicant spouse to keep 50% of the couple's assets, up to $162,660 (2026). If 50% is under $74,820, the non-applicant can keep 100% of assets up to $74,820.
- There is no CSRA for Regular Medicaid.
- The home is automatically exempt if the applicant's spouse, child under 21, or permanently blind or disabled child (of any age) lives in it.
- If this is not the case, there is a home equity interest limit of $1,097,000 (in 2026).
- Home equity is the value of the home minus any outstanding debt. Equity interest is the amount of equity owned by the applicant.
- If neither the applicant nor qualifying family live in the home, the applicant must have Intent to Return.
- There is no home equity interest limit for Regular Medicaid.
- The home is NOT exempt from Medicaid's Estate Recovery Program. After a beneficiary's death, the NY Medicaid agency attempts reimbursement of care costs through the deceased's estate.
- New York has a 60-month Look-Back Period for Institutional (Nursing Home) Medicaid only.
- The Look-Back Period does NOT currently apply to Regular Medicaid or Home and Community Based Services (Community Medicaid).
- However, the state plans to implement a 30-month Look-Back Period for Community Medicaid. The implementation date is currently unknown.
- Medicaid scrutinizes all asset transfers, including those by a spouse, to ensure none were gifted or sold under fair market value.
- Violations result in a Penalty Period of Medicaid ineligibility.
- The U.S. Federal Gift Tax Rule ($19,000 per recipient in 2026) does not extend to Medicaid eligibility — gifting under this rule violates the Look-Back Period.
- MMMNA: $4,066.50 · CSRA: $162,660 · CSRA Min: $74,820
- When only one spouse applies for Nursing Home Medicaid or a Waiver, the non-applicant spouse's income is disregarded.
- The CSMIA (Community Spouse Monthly Income Allowance) is $4,066.50 (2026), the federal maximum. Income can be transferred from the applicant spouse if the non-applicant's income is below this level.
- If the non-applicant's income exceeds $4,066.50 / month, Medicaid requests 25% of excess income go towards care costs. Spousal Refusal can be instituted.
- The CSRA allows the non-applicant spouse to keep 50% of assets up to $162,660. If 50% is under $74,820, up to $74,820 can be retained.
- For Regular Medicaid, both spouses' income is counted and there is no CSMIA or CSRA.
- Medically Needy Pathway — New York has a Medicaid Excess Income Program (Spenddown / Surplus Income Program). The medically needy income level is $1,836 / month (single) and $2,489 / month (couple) eff. 1/1/26. The spend-down amount is the difference between income and the medically needy level. Medical expenses (supplies, prescriptions, doctor visits) can be used. The medically needy asset limit is $33,038 (individual) and $44,796 (couple).
- Pooled Income Trusts — Persons who are disabled and have income over Medicaid's limit can deposit 'excess' income into a Pooled Income Trust. A type of Supplemental Needs Trust, this can eliminate the need for income spend-down. Trust funds can only be used for limited purposes such as paying the recipient's bills.
- Asset Spend-Down — Spend excess assets on non-countable items such as past-due medical bills (within 6 years), in-home care, home modifications (wheelchair ramps, stair lifts, wheelchair-accessible bathrooms), prepaying funeral/burial expenses, and paying off debt. Keep documentation as proof the Look-Back Rule was not violated.
- Medicaid Planning — Work with a Medicaid Planning Professional to employ strategies to become eligible and protect your home from Medicaid's Estate Recovery Program.
New York does not use Qualified Income Trusts (Miller Trusts). Instead, Pooled Income Trusts and the Medicaid Excess Income Program (Spenddown) are available. Notably, the Look-Back Period currently applies only to Nursing Home Medicaid, not Community Medicaid / HCBS.
New York Medicaid Programs
Managed Long Term Care (MLTC) Program Waiver
Intended for seniors who require a Nursing Facility Level of Care but do not want to be institutionalized. Supports include personal care assistance, adult day care, meal delivery, and home modifications. The Consumer Directed Personal Assistance Program (CDPAP) allows hiring the personal care assistant of one's choosing, including select relatives such as one's adult child.
Community First Choice Option (CFCO)
Allows elderly individuals to receive long-term Home and Community Based Services under the state Medicaid plan, including assistance with daily living activities, home health aides, and assistive technology. The consumer-directed option (CDPAP) is available.
Assisted Living Program (ALP)
Pays for services in adult care facilities for seniors who require a Nursing Home Level of Care. Services may include skilled nursing, personal care, personal emergency response systems, and housecleaning.
Nursing Home Transition and Diversion (NHTD) Waiver
Helps nursing home residents transition back to community living by providing assistance with security deposits, utility set-up fees, and essential home furnishings. Long-term supports include assistive technology, home modifications, personal care assistance, and homemaker services.
State Plan Personal Care Services (PCS) Program
For New Yorkers who are elderly or disabled with a medical need for assistance with daily living activities. Services include help with bathing, dressing, toileting, meal preparation, laundry, grocery shopping, and light housecleaning.
Program of All-Inclusive Care for the Elderly (PACE)
Combines the benefits of Medicaid, including long-term care, and Medicare into a single program. Additional benefits, such as dental and eye care, may be available.
Money Follows the Person (Open Doors)
A federal program that helps institutionalized persons who are eligible for Medicaid to transition back home or into the community. Called Open Doors in New York.
How to Apply
- Apply in person at a Local Department of Social Services (LDSS) office
- Call a local LDSS office to apply by phone
- Download the Medicaid Application for Non-MAGI Eligibility Group and Supplement A form
- Call the Medicaid Helpline at 1-800-541-2831 for program questions or application assistance
- Contact a local Area Agency on Aging office or a Facilitated Enroller for the Aged, Blind and Disabled
There is no online application option for New Yorkers 65+ years old. Applicants should be certain all eligibility requirements are met prior to applying. Medicaid Planning can be invaluable for those over the income and/or asset limits.
More New York Long-Term Care Resources
Take the Next Step for New York Medicaid
Find out if you qualify or see how Medicaid fits into your overall long-term care plan.
Sources & references
Verified May 2026- Centers for Medicare & Medicaid Services — Long-Term Services & Supports
- Administration for Community Living — State Medicaid Agencies
- Centers for Medicare & Medicaid Services — Medicaid Eligibility
- American Council on Aging — About Medicaid Planning Assistance
- New York Department of Health (DOH) in conjunction with local Departments of Social Services (DSS) — New York Medicaid — Official site