New York Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in New York.
7.6 million Medicaid long-term care recipients nationwide
New York State Department of Health
Processing Time
45-90 days standard, expedited processing available for nursing facility applications
New York Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in New York, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). New York follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$1,732/month (community Medicaid)
Married Couple (One Applying)
$2,268/month (community Medicaid)
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$31,175
Community Spouse (At-Home Spouse)
$49,900
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
New York Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $14,500/month average (varies significantly by region) (the average monthly nursing home cost in New York).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in New York
Nursing Home Care
Medicaid pays 100% of nursing home costs in New York once eligibility is established. The average monthly cost is $14,500/month average (varies significantly by region). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Assisted Living Program (ALP): New York's ALP is unique in that it does cover room, board, personal care, and services. This makes it one of the few state programs that provides comprehensive assisted living coverage including housing costs. Covers up to $3,800/month average.
Important: New York is one of the few states where Medicaid covers both care services AND room and board in assisted living facilities.
Home and Community-Based Services (HCBS) Waivers
New York offers 3 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Assisted Living Program (ALP)
Serves approximately 4,200 individuals in licensed assisted living residences. Covers room, board, personal care, and case management services.
Program Details →Long Term Home Health Care Program (LTHHCP)
Provides nursing, personal care, and other services in the home for individuals who would otherwise require nursing facility care.
Program Details →Traumatic Brain Injury (TBI) Waiver
Serves individuals with traumatic brain injury who require nursing facility level of care.
Program Details →How to Apply for Medicaid in New York
New York Medicaid applications typically take 45-90 days standard, expedited processing available for nursing facility applications. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in New York through:
- Online through NY State of Health
- Mail to local Department of Social Services
- In-person at local Medicaid office
- Through facilitated enroller
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in New York from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
New York-Specific Programs and Resources
Medicaid Buy-In Program
Allows working individuals with disabilities to buy into Medicaid coverage with higher income and asset limits than standard Medicaid.
Learn MorePartnership for Long-Term Care
Long-term care insurance policies that provide dollar-for-dollar asset protection from Medicaid spend-down.
Learn MoreNeed Help with New York Medicaid?
Contact New York State Department of Health for specific questions about eligibility, application status, or covered services.
Main Office Phone
1-800-541-2831Application Helpline
1-855-355-5777