How to Pay for In-Home Care
How to Pay for Home Care in New York
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
This directory lists New York-specific and federal payment sources that can pay for, reimburse, offset, or help plan for home care. Some are direct payment sources; others are indirect supports that reduce the amount of private home care a family must buy. New York's strongest state-specific pathways include the Consumer Directed Personal Assistance Program (CDPAP), state-plan Personal Care Services (PCS), Managed Long-Term Care/MAP/PACE, the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) waivers, OPWDD home and community-based services with self-direction, and EISEP and other NYSOFA caregiver supports, and VA benefits are broken out because they can be one of the strongest payment pathways for eligible New York veterans and surviving spouses.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
New York Medicaid / State Plan
Personal Care Services (PCS)
YesHelps pay for: Pays authorized personal care aides for assistance with ADLs/IADLs such as bathing, dressing, grooming, toileting, mobility, meal preparation and household tasks.
Who qualifies: Medicaid eligibility, medical need and NYIA assessment/clinical review. New minimum-needs rules apply to many new applicants age 21+; grandfathering rules protect certain existing recipients.
How to start: Call NYIA for an initial assessment, then work with the LDSS or Medicaid plan on authorization.
Good to know: Family caregiver payment: Generally no - agency workforce
New York Medicaid / Self-Direction
Consumer Directed Personal Assistance Program (CDPAP)
YesHelps pay for: Lets an eligible Medicaid member recruit, hire, train, schedule and supervise a personal assistant for personal care, home-health-aide and certain skilled tasks.
Who qualifies: Medicaid home-care eligibility; capable of self-directing or have a designated representative; NYIA/minimum-needs rules may apply.
How to start: Request CDPAP through the Medicaid plan/LDSS and complete required PPL enrollment.
Good to know: Family caregiver payment: Yes - qualifying family/friends
New York Medicaid / CDPAP / Paid Family
CDPAP Family Member as Personal Assistant
YesHelps pay for: Allows many relatives to be paid personal assistants, including a parent of an adult age 21+, when all program and worker rules are met.
Who qualifies: Cannot be the consumer’s spouse, designated representative, or parent of a consumer under age 21. Other adult relatives may qualify.
How to start: Identify the proposed relative during CDPAP enrollment and verify worker eligibility with PPL/plan.
Good to know: Family caregiver payment: Yes
New York Medicaid / CDPAP / Fiscal Intermediary
CDPAP Statewide Fiscal Intermediary - PPL
Administrative supportHelps pay for: PPL processes payroll, tax withholding and employment records for CDPAP personal assistants statewide.
Who qualifies: Public Partnerships LLC (PPL) is the statewide fiscal intermediary; effective April 1, 2025 it is the only entity authorized to provide CDPAP fiscal-intermediary services.
How to start: All CDPAP consumers and personal assistants must use PPL for fiscal-intermediary functions.
Good to know: Family caregiver payment: Supports caregiver payroll
New York Medicaid / Long-Term Care
Managed Long Term Care - Partial Capitation (MLTCP)
YesHelps pay for: Coordinates and pays for long-term services such as personal care, home health, adult day health, therapies, PERS and other covered community-based LTSS.
Who qualifies: Generally for Medicaid members with ongoing long-term-care needs who meet program and enrollment criteria; service area and plan availability apply.
How to start: Complete required assessment/enrollment steps and compare approved MLTC plans in the county.
Good to know: Family caregiver payment: CDPAP may allow it
New York Medicaid / MLTC / Home Care
MLTC Personal Care & Home Health Services
YesHelps pay for: MLTC plans can authorize personal care, home health aide, nursing and therapy in the home when medically necessary and included in the plan of care.
Who qualifies: MLTC enrollment and assessed need; authorization and provider-network requirements apply.
How to start: Ask the MLTC care manager to assess and authorize appropriate home services.
Good to know: Family caregiver payment: Through CDPAP if elected
New York Medicaid / MLTC / Self-Direction
MLTC Consumer Directed Personal Assistance Services
YesHelps pay for: Eligible MLTC members can receive CDPAP through the plan while directing their own personal assistants.
Who qualifies: MLTC membership plus CDPAP eligibility; PPL is used for statewide fiscal-intermediary services.
How to start: Tell the MLTC care manager you want CDPAP and complete PPL requirements.
Good to know: Family caregiver payment: Yes - CDPAP rules
New York Medicaid / MLTC / Safety
MLTC Personal Emergency Response System (PERS)
Offsets care costHelps pay for: Can cover an emergency-response system that supports independent living and may reduce the need for constant paid supervision.
Who qualifies: Must be medically necessary/covered under the MLTC plan and authorized.
How to start: Ask the MLTC care manager about PERS.
Good to know: Family caregiver payment: No
New York Medicaid + Medicare / Integrated Care
Medicaid Advantage Plus (MAP)
YesHelps pay for: Integrated Medicare/Medicaid managed-care option that combines acute care and long-term services and supports for eligible dual-eligible members.
Who qualifies: Medicare + Medicaid eligibility, long-term-care need, service area and plan rules apply.
How to start: Compare MAP plans available in the county and complete required eligibility assessment.
Good to know: Family caregiver payment: CDPAP may allow it
PACE
YesHelps pay for: Program of All-Inclusive Care for the Elderly integrates medical care, home care, personal care, therapies, transportation, meals and other services needed to keep eligible participants in the community.
Who qualifies: Age 55+; nursing-home level of care; live in a PACE service area; able to live safely in the community with PACE services.
How to start: Contact a local PACE organization or NYIA/NY Medicaid Choice to explore eligibility.
Good to know: Family caregiver payment: No direct cash
New York Medicaid / HCBS State Plan
Community First Choice Option (CFCO)
Yes / partialHelps pay for: Adds person-centered home- and community-based supports for Medicaid members who meet institutional level-of-care and other CFCO criteria.
Who qualifies: Medicaid eligibility, institutional level of care and assessed need; services must be in an HCBS-compliant setting and included in the plan of care.
How to start: Ask the Medicaid plan/LDSS/care manager whether CFCO applies to assessed needs.
Good to know: Family caregiver payment: Depends on underlying service
New York Medicaid / CFCO / Equipment
CFCO Assistive Technology
Offsets care costHelps pay for: Can fund approved devices/equipment that increase independence with ADLs/IADLs and reduce reliance on human assistance.
Who qualifies: CFCO eligibility and assessed need; prior authorization and program limits apply.
How to start: Request AT through the care manager/plan/LDSS with supporting assessment.
Good to know: Family caregiver payment: No
New York Medicaid / CFCO / Accessibility
CFCO Environmental & Vehicle Modifications
Offsets care costHelps pay for: Can fund qualifying home or vehicle adaptations needed for safety, independence and community living.
Who qualifies: CFCO eligibility; modification tied to assessed ADL/IADL/health-related need; authorization/property rules apply.
How to start: Ask care manager/plan/LDSS for E-Mod/V-Mod authorization before work begins.
Good to know: Family caregiver payment: No
New York Medicaid / CFCO / Safety
CFCO Personal Emergency Response System
Offsets care costHelps pay for: Can cover PERS for eligible members when it supports safe community living.
Who qualifies: CFCO eligibility, assessed need and authorization.
How to start: Ask the plan/LDSS about PERS under CFCO.
Good to know: Family caregiver payment: No
New York Medicaid / CFCO / Nutrition
CFCO Home-Delivered or Congregate Meals
Offsets care costHelps pay for: Can provide approved meals when the service addresses assessed functional needs and may substitute for more costly hands-on assistance.
Who qualifies: CFCO eligibility and person-centered plan authorization.
How to start: Ask the care manager whether meal services can be added to the plan.
Good to know: Family caregiver payment: No
New York Medicaid / CFCO / Transition
CFCO Community Transitional Services & Moving Assistance
Offsets transition costHelps pay for: Can cover certain one-time costs and moving assistance needed to establish a community residence after institutional care.
Who qualifies: Must meet CFCO/transition criteria; expenses must be allowable and authorized before purchase.
How to start: Coordinate through care manager/LDSS/plan before incurring costs.
Good to know: Family caregiver payment: No
New York Medicaid / 1915(c) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
YesHelps pay for: HCBS waiver helping Medicaid-eligible seniors and adults with physical disabilities avoid or leave nursing-home care through individualized community supports.
Who qualifies: Medicaid coverage that supports community LTSS; nursing-facility level of care; community residence and waiver eligibility/service-plan requirements.
How to start: Contact an NHTD Regional Resource Development Center or Open Doors.
Good to know: Family caregiver payment: No direct caregiver wage generally
Traumatic Brain Injury (TBI) Waiver
YesHelps pay for: HCBS waiver for qualifying adults with TBI or similar acquired brain injury who need nursing-home level of care and can be safely served in the community.
Who qualifies: Medicaid coverage for community LTSS; qualifying brain injury; generally age 18-64 at application; nursing-home level of care.
How to start: Contact the TBI Regional Resource Development Center for the county.
Good to know: Family caregiver payment: No direct caregiver wage generally
New York Medicaid / NHTD / Home Care
NHTD Home and Community Support Services (HCSS)
YesHelps pay for: Can provide oversight, supervision and assistance with personal/household tasks needed to maintain the participant safely in the community.
Who qualifies: NHTD enrollment, assessed need and service-plan authorization.
How to start: Ask the NHTD service coordinator about HCSS.
Good to know: Family caregiver payment: Generally through approved provider
New York Medicaid / NHTD / Respite
NHTD Respite Services
Yes - respiteHelps pay for: Provides scheduled relief for informal unpaid primary supports; NHTD guidance describes respite in 24-hour blocks, subject to program limits and plan approval.
Who qualifies: NHTD enrollment; unpaid primary support; respite must be authorized in the service plan.
How to start: Ask the NHTD service coordinator to assess respite needs.
Good to know: Family caregiver payment: No continuous caregiver wage
New York Medicaid / NHTD / Equipment
NHTD Assistive Technology & Environmental Modifications
Offsets care costHelps pay for: Can fund approved assistive technology and home/vehicle modifications that increase independence, access and safety.
Who qualifies: NHTD enrollment; Medicaid State Plan/other resources used first where required; project approval applies.
How to start: Coordinate AT/E-Mod request through the NHTD service coordinator.
Good to know: Family caregiver payment: No
New York Medicaid / NHTD / Transition
NHTD Community Transitional Services & Moving Assistance
Offsets transition costHelps pay for: Can help with allowable one-time costs such as essential furnishings, setup fees and moving expenses when establishing community living.
Who qualifies: NHTD transition/service-plan eligibility and prior authorization; allowable-cost rules apply.
How to start: Work with service coordinator/Open Doors before purchases or move.
Good to know: Family caregiver payment: No
New York Medicaid / TBI / Home Care
TBI Home and Community Support Services
YesHelps pay for: Provides approved hands-on/supportive assistance and supervision to help a TBI waiver participant remain safely in the community.
Who qualifies: TBI waiver enrollment, assessed need and service-plan authorization.
How to start: Ask the TBI service coordinator about HCSS.
Good to know: Family caregiver payment: Generally through approved provider
New York Medicaid / TBI / Respite
TBI Waiver Respite
Yes - respiteHelps pay for: Can provide temporary relief to informal unpaid supports who provide primary care to a waiver participant.
Who qualifies: TBI waiver enrollment and service-plan authorization.
How to start: Request respite through the TBI service coordinator.
Good to know: Family caregiver payment: No continuous caregiver wage
New York Medicaid / TBI / Supports
TBI Assistive Technology, E-Mods & Waiver Transportation
Offsets care costHelps pay for: Can fund approved technology, home/vehicle modifications and non-medical waiver transportation that support independence and community integration.
Who qualifies: TBI waiver eligibility; service must be allowable, necessary and authorized after other applicable resources are considered.
How to start: Coordinate requests through the TBI service coordinator/RRDC.
Good to know: Family caregiver payment: No
New York Medicaid / OPWDD
OPWDD Comprehensive HCBS Waiver
Yes / supportiveHelps pay for: Medicaid-funded developmental-disability supports including community habilitation, respite, residential/community supports, employment services and other HCBS.
Who qualifies: OPWDD eligibility plus Medicaid and HCBS Waiver enrollment for waiver-funded services; Life Plan/service authorization required.
How to start: Start through OPWDD Front Door and a Care Coordination Organization.
Good to know: Family caregiver payment: Sometimes under self-direction
New York Medicaid / OPWDD / Self-Direction
OPWDD Self-Direction
Yes / supportiveHelps pay for: Allows eligible OPWDD waiver participants to choose supports, staff and schedules and, with employer/budget authority, self-hire staff and manage an individualized budget.
Who qualifies: OPWDD eligibility, Medicaid HCBS Waiver enrollment and approved self-direction plan/budget; fiscal intermediary and broker requirements apply.
How to start: Ask the care manager to begin OPWDD Self-Direction planning.
Good to know: Family caregiver payment: Potentially - service-specific rules
New York Medicaid / OPWDD / Home Support
OPWDD Community Habilitation
Yes / supportiveHelps pay for: One-on-one support/training in the home and community to build or maintain skills for independent living and personal goals.
Who qualifies: OPWDD eligibility; authorized in the Life Plan; Medicaid/waiver and provider/self-direction rules apply.
How to start: Ask the care manager about Community Habilitation.
Good to know: Family caregiver payment: May be self-hired in self-direction
New York Medicaid / OPWDD / Respite
OPWDD Respite Services
Yes - respiteHelps pay for: In-home or out-of-home temporary relief for family members and other primary caregivers of people with developmental disabilities.
Who qualifies: OPWDD eligibility and authorization; waiver/non-waiver/FSS funding pathway depends on the individual.
How to start: Ask the care manager about respite options and funding stream.
Good to know: Family caregiver payment: Self-hired staff possible in self-direction
New York Medicaid / OPWDD / Live-In Support
OPWDD Live-In Caregiver
Offsets caregiver housing / supportHelps pay for: Reimburses housing-related support for a caregiver who lives with and assists a self-directing participant in exchange for daily support.
Who qualifies: Available only through OPWDD Self-Direction; must be in the approved self-directed plan and meet service rules.
How to start: Discuss Live-In Caregiver with the care manager, broker and fiscal intermediary.
Good to know: Family caregiver payment: Indirect caregiver benefit
New York OPWDD / Self-Direction / Backup
OPWDD Paid Neighbor
Support / backupHelps pay for: Provides a monthly stipend to an on-call neighbor who fills gaps in the participant’s support network for tasks such as personal hygiene or community needs.
Who qualifies: Available only through Self-Direction; responsibilities and payment must be in the approved plan/budget.
How to start: Ask the self-direction team whether Paid Neighbor fits the support plan.
Good to know: Family caregiver payment: Yes - approved paid neighbor
New York OPWDD / Family Support
OPWDD Family Support Services / Family Reimbursement
Partial / respiteHelps pay for: State-funded supports for people with developmental disabilities living at home with family, including respite, family reimbursement, equipment, home modifications and transportation depending on region/funding.
Who qualifies: OPWDD eligibility; FSS generally requires living at home with non-paid family/caregiver, with special rules when a co-resident family member is paid through CDPAP.
How to start: Ask the care manager or regional FSS provider about current reimbursement/respite options.
Good to know: Family caregiver payment: Reimbursement, not ongoing wage
New York Medicaid / Medical
Medicaid Home Health
Yes - skilled careHelps pay for: Can cover medically necessary nursing, therapy, home health aide and other home-health services through certified providers.
Who qualifies: Medicaid eligibility, medical necessity and provider/authorization rules.
How to start: Ask the treating clinician and Medicaid plan/LDSS for a home-health referral/authorization.
Good to know: Family caregiver payment: No
New York Medicaid / Skilled Nursing
Medicaid Private Duty Nursing
Yes - skilled nursingHelps pay for: Can cover medically necessary continuous or extended skilled nursing in the home for qualifying members when program requirements are met.
Who qualifies: Medicaid eligibility; documented skilled need; provider enrollment/prior authorization rules apply.
How to start: Ask the treating clinician and Medicaid plan/LDSS about private-duty nursing.
Good to know: Family caregiver payment: No
New York Medicaid / End-of-Life
Medicaid Hospice
Yes - hospiceHelps pay for: Can cover hospice and related palliative/end-of-life services for eligible Medicaid members who elect hospice and meet clinical requirements.
Who qualifies: Medicaid eligibility and hospice certification/election requirements.
How to start: Ask clinician/Medicaid plan for hospice evaluation.
Good to know: Family caregiver payment: No
New York Medicaid / Transition
Money Follows the Person / Open Doors
Offsets transition costHelps pay for: Helps people in nursing homes and certain institutions plan a move back to the community and connect with HCBS, housing and transition supports.
Who qualifies: Institutional residence and MFP/Open Doors criteria; transition plan and community supports must be feasible.
How to start: Request an Open Doors Transition Specialist.
Good to know: Family caregiver payment: No
New York Medicaid / Working with Disability
Medicaid Buy-In for Working People with Disabilities (MBI-WPD)
Indirect / enables coverageHelps pay for: Allows qualifying working people with disabilities to retain Medicaid at income levels above regular Medicaid limits, preserving access to covered health and LTSS benefits.
Who qualifies: Working person with a qualifying disability; program income/resource and other eligibility rules apply.
How to start: Apply through the appropriate Medicaid eligibility channel and request MBI-WPD screening.
Good to know: Family caregiver payment: Depends on covered service
New York Medicaid / Eligibility Strategy
Medicaid Excess Income (Spenddown / Surplus Income)
Indirect / enables coverageHelps pay for: Lets some people with income above the Medicaid level qualify after meeting a spenddown; community long-term care such as home care may be covered once eligibility is established.
Who qualifies: Must otherwise qualify for Medicaid and meet spenddown rules; documentation/payment methods vary by eligibility category and locality.
How to start: Ask LDSS/HRA or a benefits counselor to calculate the spenddown and acceptable medical expenses.
Good to know: Family caregiver payment: Depends on service
New York Aging / Non-Medicaid HCBS
Expanded In-home Services for the Elderly Program (EISEP)
Yes / subsidizedHelps pay for: Coordinated nonmedical supports for adults 60+ who are not eligible for the same services under Medicaid, including case management, in-home help, respite and ancillary services.
Who qualifies: Age 60+; need help with at least 1 ADL or 2 IADLs; safe at home; not eligible for the same services under Medicaid. Cost sharing may apply.
How to start: Contact local AAA or NY Connects for EISEP assessment/referral.
Good to know: Family caregiver payment: Some local consumer-directed models
New York Aging / EISEP / Home Care
EISEP Personal Care I
Yes / subsidizedHelps pay for: Can provide help with housekeeping, cooking, shopping and other IADLs through local aging programs.
Who qualifies: EISEP eligibility and local funding/assessment; service delivery varies by county.
How to start: Ask the EISEP case manager about Personal Care I.
Good to know: Family caregiver payment: Varies by local delivery model
EISEP Personal Care II
Yes / subsidizedHelps pay for: Includes Personal Care I plus hands-on ADL assistance such as bathing, dressing and grooming.
Who qualifies: EISEP eligibility, functional need and local funding/assessment.
How to start: Ask the EISEP case manager about Personal Care II.
Good to know: Family caregiver payment: Varies by local delivery model
New York Aging / EISEP / Self-Direction
EISEP Consumer-Directed / Direct-Hire In-Home Services
Yes / subsidizedHelps pay for: Some Area Agencies on Aging offer consumer-directed or direct-hire models for EISEP in-home assistance rather than only licensed-agency delivery.
Who qualifies: EISEP eligibility; model is not available everywhere and worker/family rules depend on the local AAA program.
How to start: Ask the local AAA specifically whether consumer-directed/direct-hire EISEP is offered.
Good to know: Family caregiver payment: Potentially - local rules
New York Aging / EISEP / Respite
EISEP Noninstitutional Respite
Yes - respiteHelps pay for: Provides in-home personal care or social-day services that give an unpaid primary caregiver temporary relief.
Who qualifies: EISEP client must have at least one informal caregiver providing ongoing care; local availability/funding applies.
How to start: Ask the EISEP case manager about respite.
Good to know: Family caregiver payment: No continuous caregiver wage
New York Aging / Caregiver Support
State Respite Program
Yes - respiteHelps pay for: State-funded respite supports temporary substitute care or supervision for an adult who needs help, giving an unpaid caregiver time away.
Who qualifies: Caregiver must be an unpaid family/other caregiver; care receiver has impairment requiring daily help/supervision; priority rules and local funding apply.
How to start: Contact NY Connects/local AAA for the State Respite provider serving the county.
Good to know: Family caregiver payment: No continuous caregiver wage
National Family Caregiver Support Program (NFCSP)
Partial / respiteHelps pay for: Provides caregiver information, counseling/training, respite and limited supplemental services through local aging agencies.
Who qualifies: Older Americans Act caregiver categories apply; local funding and service availability vary.
How to start: Contact local AAA or NY Connects caregiver-support staff.
Good to know: Family caregiver payment: No continuous caregiver wage
New York Aging / Nutrition
Home-Delivered Meals
Offsets care costHelps pay for: Provides nutritious meals to eligible older adults who cannot prepare meals, reducing food spending and caregiver meal-preparation burden.
Who qualifies: Generally based on age, functional/homebound need and local program assessment; contribution policies vary.
How to start: Contact local Office for the Aging/AAA or NY Connects.
Good to know: Family caregiver payment: No
New York Aging / Transportation
AAA / Older Adult Transportation Services
Offsets care costHelps pay for: Local aging programs may provide or coordinate transportation to medical care, meals, shopping and community activities.
Who qualifies: Age/location/program rules and local funding vary.
How to start: Ask the local AAA about transportation programs and eligibility.
Good to know: Family caregiver payment: No
New York Aging / Adult Day
Social Adult Day Services (SADS)
Offsets care costHelps pay for: Provides supervised social activities, meals, caregiver services and transportation coordination; can reduce hours of in-home supervision for appropriate older adults.
Who qualifies: Program-specific eligibility, funding/cost share and local availability.
How to start: Contact local AAA/NY Connects or an approved SADS program.
Good to know: Family caregiver payment: No
New York Aging / Aging in Place
Naturally Occurring Retirement Community (NORC) Supportive Services
Partial / localHelps pay for: NYS-funded NORCs coordinate case management, health monitoring and other supports; optional services may include transportation, personal care and counseling.
Who qualifies: Generally age 60+ and must live in a participating NORC catchment area; exact services depend on the local program.
How to start: Check whether the residence is served by a NYS- or locally funded NORC.
Good to know: Family caregiver payment: No
New York Medicaid / Transportation
Medicaid Non-Emergency Medical Transportation (NEMT)
Offsets care costHelps pay for: Pays or arranges qualifying transportation to Medicaid-covered medical services, reducing caregiver driving and transportation costs.
Who qualifies: Medicaid eligibility; trip must meet transportation program rules and be arranged through the appropriate broker/process.
How to start: Use the Medicaid transportation process/broker for the county before the trip when required.
Good to know: Family caregiver payment: No
Medicare
Medicare Home Health Benefit
Yes - skilled/limitedHelps pay for: Can cover intermittent skilled nursing, therapy and limited home health aide services when Medicare home-health eligibility requirements are met.
Who qualifies: Must meet Medicare home-health criteria, including qualifying skilled need and certified plan of care; not a general long-term custodial-care benefit.
How to start: Ask the treating clinician for a Medicare-certified home health referral.
Good to know: Family caregiver payment: No
Medicare / Dementia
CMS GUIDE Dementia Model
Partial / respiteHelps pay for: Participating GUIDE organizations can provide dementia care coordination, caregiver education/support and respite services for eligible Medicare beneficiaries.
Who qualifies: Dementia diagnosis, Medicare eligibility and participating GUIDE provider/service area requirements apply.
How to start: Use CMS GUIDE resources or ask the clinician/health system about local participants.
Good to know: Family caregiver payment: No continuous wage
Medicare / Caregiver Training
Medicare Caregiver Training Services
Offsets training costHelps pay for: Medicare may cover caregiver training ordered as part of a patient’s treatment when the caregiver needs training to help carry out the treatment plan.
Who qualifies: Must meet Medicare coverage criteria and be furnished by an eligible practitioner/provider in connection with the patient’s care.
How to start: Ask the treating clinician whether covered caregiver training is appropriate.
Good to know: Family caregiver payment: No wage
Medicare Cost Reduction
Medicare Savings Programs + HIICAP
Offsets household/medical costHelps pay for: MSP can help pay Medicare premiums and certain cost-sharing for eligible beneficiaries; HIICAP provides free application and Medicare counseling help.
Who qualifies: Medicare beneficiary plus current income/program eligibility.
How to start: Call HIICAP for screening and application assistance.
Good to know: Family caregiver payment: No
Prescription Cost Reduction
Elderly Pharmaceutical Insurance Coverage (EPIC)
Offsets household/medical costHelps pay for: New York program that supplements Medicare Part D for eligible seniors and can reduce prescription costs, preserving income for home care.
Who qualifies: New York resident age 65+ meeting EPIC income and Medicare Part D eligibility/enrollment rules.
How to start: Apply through EPIC or call the EPIC helpline.
Good to know: Family caregiver payment: No
Food Assistance
New York SNAP
Offsets household costHelps pay for: Monthly nutrition assistance can reduce food expenses and preserve income for home-care needs.
Who qualifies: Household income/eligibility rules apply; older adults and people with disabilities may have special deduction considerations.
How to start: Apply through myBenefits/LDSS or seek SNAP outreach assistance.
Good to know: Family caregiver payment: No
Utility Assistance
Home Energy Assistance Program (HEAP)
Offsets household costHelps pay for: Helps eligible households pay heating/cooling costs and may provide emergency benefits, preserving funds for care.
Who qualifies: Income, household and program-year rules apply; benefits/funding are seasonal.
How to start: Apply through local HEAP district/myBenefits as directed.
Good to know: Family caregiver payment: No
Home Cost Reduction
Weatherization Assistance Program
Offsets household costHelps pay for: Provides free energy-efficiency and health/safety improvements for income-eligible homes, lowering ongoing utility costs.
Who qualifies: Income and property/program requirements apply; local weatherization provider completes assessment/work.
How to start: Contact the local HCR Weatherization Assistance provider.
Good to know: Family caregiver payment: No
Tax Relief
Senior Citizens Property Tax Exemption
Offsets household costHelps pay for: Local-option partial property-tax exemption for qualifying older homeowners can preserve income for care expenses.
Who qualifies: Generally age 65+ with local income/ownership/residency rules; locality must adopt the exemption.
How to start: Ask the local assessor about RPTL 467 and filing deadlines.
Good to know: Family caregiver payment: No
STAR / Enhanced STAR
Offsets household costHelps pay for: School property-tax relief for eligible owner-occupied primary residences; Enhanced STAR provides greater relief for qualifying seniors.
Who qualifies: STAR credit/exemption and Enhanced STAR age/income rules apply; 2026 administration changes affect some existing exemption recipients.
How to start: Register/check status with NYS Tax and ask local assessor when applicable.
Good to know: Family caregiver payment: No
Private Insurance
Long-Term Care Insurance
Yes / policy-dependentHelps pay for: Private LTC insurance may reimburse qualifying home care, personal care, respite or other covered services depending on the policy.
Who qualifies: Coverage, elimination period, benefit triggers, daily/monthly limits and caregiver/provider restrictions are policy-specific.
How to start: Review the policy and request a written benefit determination before hiring care.
Good to know: Family caregiver payment: Sometimes - policy-dependent
Private Insurance / Medicaid Planning
New York State Partnership for Long-Term Care
Yes / policy-dependentHelps pay for: Qualified Partnership LTC insurance can provide private benefits and, if requirements are met, asset-protection advantages when later qualifying for Medicaid Extended Coverage.
Who qualifies: Must own/maintain a qualifying Partnership policy and meet Medicaid Extended Coverage rules when private benefits are exhausted/requirements met.
How to start: Contact the NYS Partnership or participating insurer before purchase/claim planning.
Good to know: Family caregiver payment: Policy-dependent
VA Benefits
VA Homemaker & Home Health Aide
YesHelps pay for: VA may pay an authorized community aide to help an eligible Veteran with ADLs and selected daily tasks.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local availability; copay may apply.
How to start: Ask VA primary care/social work for assessment and authorization.
Good to know: Family caregiver payment: No
VA Homemaker & Home Health Aide
YesHelps pay for: VA may pay an authorized community aide to help an eligible Veteran with ADLs and selected daily tasks.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local availability; copay may apply. Ask VA primary care/social work for assessment and authorization.
How to start: Ask the VA social worker or care team about VA Homemaker & Home Health Aide.
Good to know: Family caregiver payment: No
Veteran-Directed Care (VDC)
YesHelps pay for: Provides a flexible self-directed budget for eligible Veterans who need personal care and help with daily activities; workers may include family or neighbors under local program rules.
Who qualifies: Enrolled Veteran; community-care eligibility; clinical need and local VDC availability. Ask the VA social worker whether VDC is available through the local VA/AAA partnership.
How to start: Ask the VA social worker or care team about Veteran-Directed Care (VDC).
Good to know: Family caregiver payment: Yes
VA Skilled Home Health
Yes - skilled careHelps pay for: VA may purchase skilled nursing, therapy and related home-health services from community providers for eligible Veterans.
Who qualifies: Clinical need, VA eligibility and authorization/local availability. Ask the VA care team for skilled home-health assessment/referral.
How to start: Ask the VA social worker or care team about VA Skilled Home Health.
Good to know: Family caregiver payment: No
VA Respite Care
Yes - respiteHelps pay for: VA may arrange in-home, adult-day or nursing-home respite to give eligible caregivers a break.
Who qualifies: Clinical need, enrollment and local availability; community-care authorization may apply. Ask the VA caregiver support coordinator/social worker.
How to start: Ask the VA social worker or care team about VA Respite Care.
Good to know: Family caregiver payment: No
VA Aid & Attendance
Cash / indirectHelps pay for: Extra pension amount for a qualifying Veteran/survivor who needs help with ADLs, is bedridden, has severe vision impairment or meets other criteria.
Who qualifies: Must qualify for VA pension and Aid & Attendance medical/financial criteria. Apply through VA or an accredited representative.
How to start: Ask the VA social worker or care team about VA Aid & Attendance.
Good to know: Family caregiver payment: Yes, indirectly
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Direct caregiver stipendHelps pay for: Monthly stipend and additional supports for an approved primary family caregiver of an eligible Veteran.
Who qualifies: Veteran and caregiver must meet PCAFC eligibility and complete VA assessment/enrollment. Apply jointly through VA Caregiver Support.
How to start: Ask the VA social worker or care team about Program of Comprehensive Assistance for Family Caregivers (PCAFC).
Good to know: Family caregiver payment: Yes
VA Community Care Network - Region 1
Pays authorized providerHelps pay for: VA-authorized community care can include home health and other approved services. New York is in CCN Region 1, administered by Optum.
Who qualifies: VA referral/authorization and community-care eligibility generally apply. Do not assume reimbursement after privately hiring care. Obtain VA authorization before routine community care; use emergency/urgent-care rules when applicable.
How to start: Ask the VA social worker or care team about VA Community Care Network - Region 1.
Good to know: Family caregiver payment: No
VA Pension
Cash / indirectHelps pay for: Needs-based monthly cash benefit for qualifying wartime Veterans or survivors; can be used toward living and care expenses.
Who qualifies: Wartime service plus age/disability and net-worth/income rules. Apply through VA or an accredited representative.
How to start: Ask the VA social worker or care team about VA Pension.
Good to know: Family caregiver payment: Yes, indirectly
Housebound Pension Add-On
Cash / indirectHelps pay for: Additional pension amount for some pension-eligible Veterans substantially confined to the home because of permanent disability.
Who qualifies: Must qualify for pension plus housebound criteria; cannot generally receive both A&A and housebound add-ons. Apply with pension/A&A-housebound forms and medical evidence.
How to start: Ask the VA social worker or care team about Housebound Pension Add-On.
Good to know: Family caregiver payment: Yes, indirectly
Home Improvements and Structural Alterations (HISA)
Offsets care costHelps pay for: Grant for medically necessary home improvements/structural alterations such as accessibility changes.
Who qualifies: Veteran must meet HISA clinical/eligibility rules; prescribed improvement and approval required. Ask VA prosthetics/rehabilitation or care team before starting work.
How to start: Ask the VA social worker or care team about Home Improvements and Structural Alterations (HISA).
Good to know: Family caregiver payment: No
VA Adult Day Health Care
Offsets care cost / day careHelps pay for: Therapeutic daytime health, rehabilitation and social services can reduce in-home supervision needs for eligible Veterans.
Who qualifies: Clinical need, enrollment/eligibility and local availability. Ask the VA social worker about adult day health care.
How to start: Ask the VA social worker or care team about VA Adult Day Health Care.
Good to know: Family caregiver payment: No
VA Hospice Care
Yes - hospiceHelps pay for: VA can arrange hospice/palliative services, often including home-based support, for eligible Veterans with advanced illness.
Who qualifies: Clinical eligibility and VA/hospice authorization requirements. Ask VA care team for hospice/palliative consultation.
How to start: Ask the VA social worker or care team about VA Hospice Care.
Good to know: Family caregiver payment: No
VA Benefits / Self-Direction
Veteran-Directed Care (VDC)
YesHelps pay for: Provides a flexible self-directed budget for eligible Veterans needing personal care; workers may include family or neighbors under local program rules.
Who qualifies: Enrolled Veteran; community-care eligibility; clinical criteria; local VDC availability.
How to start: Ask VA social work whether VDC is available locally.
Good to know: Family caregiver payment: Yes
VA Benefits / Cash
VA Aid & Attendance Pension Add-On
Cash / indirectHelps pay for: Additional monthly VA pension payment for qualifying Veterans/survivors who need help with daily activities or meet other criteria; cash can be used toward care.
Who qualifies: Must qualify for VA pension plus Aid & Attendance criteria; medical and financial rules apply.
How to start: Use VA or an accredited representative to apply.
Good to know: Family caregiver payment: Yes, indirectly
Where New York Families Can Start
Not sure where to begin? Match your situation to a contact below.
Best statewide first stop for long-term services/supports, EISEP, caregiver respite, meals, transportation and local aging/disability resources
NY Connects
Medicaid eligibility, benefits and general program questions
New York State Medicaid Helpline
Initial assessments for PCS, CDPAP and many MLTC eligibility pathways
New York Independent Assessor (NYIA)
Statewide fiscal intermediary enrollment, personal-assistant payroll and CDPAP operational help
CDPAP / Public Partnerships LLC (PPL)
MLTC/MAP plan enrollment and plan-choice assistance
New York Medicaid Choice
Nursing-home/institution transition help; MFP and NHTD referrals/navigation
Open Doors Transition Center
Developmental-disability eligibility, HCBS waiver, respite, community habilitation and Self-Direction entry point
OPWDD Front Door
Free unbiased Medicare, Medicare Savings Program and insurance counseling
HIICAP
New York prescription-cost assistance for eligible seniors with Medicare Part D
EPIC
Partnership LTC insurance and Medicaid Extended Coverage questions
NYS Partnership for Long-Term Care
Medicare home health, caregiver training, GUIDE and coverage questions
Medicare
VA health benefits, caregiver/home-care programs and general VA assistance
U.S. Department of Veterans Affairs
Before You Rely on Any Payment Source
Planning Point
Why It Matters
CDPAP is New York’s clearest paid-family-caregiver route
A CDPAP personal assistant may be a friend or family member, including the parent of an adult consumer age 21+, but may not be the consumer’s spouse, designated representative, or parent of a consumer under 21.
PPL is now the sole statewide CDPAP fiscal intermediary
Effective April 1, 2025, PPL is the only authorized fiscal intermediary for CDPAP. Consumers and personal assistants should use current PPL enrollment/payroll procedures rather than relying on old local-FI instructions.
New minimum-needs rules affect new PCS/CDPAP/MLTC applicants
New York implemented minimum-needs requirements beginning September 1, 2025 for many new applicants age 21+ seeking PCS/CDPAS and for certain MLTC enrollment pathways. Existing recipients continuously authorized/enrolled by the applicable date may be protected under prior criteria.
NYIA is a key gatekeeper for many home-care pathways
Initial PCS/CDPAP assessments and many MLTC eligibility assessments use the New York Independent Assessor. Families should call NYIA early when seeking Medicaid home care.
MLTC, MAP and PACE are different products
MLTCP focuses on long-term services; MAP integrates Medicare and Medicaid for eligible duals; PACE is an all-inclusive model for people age 55+ who meet nursing-home level of care and live in a service area.
NHTD and TBI waivers are specialized alternatives to managed LTC
NHTD targets seniors/adults with physical disabilities who need nursing-home level of care; TBI targets qualifying adults with acquired brain injury, generally ages 18-64 at application. Both use regional waiver infrastructure and individualized service plans.
OPWDD self-direction is broader than a single personal-care benefit
OPWDD participants may self-hire staff and direct budgets for approved services. Live-In Caregiver and Paid Neighbor are distinct supports; service-specific family/payment restrictions still need to be checked with the care manager, broker and fiscal intermediary.
EISEP fills an important non-Medicaid gap
EISEP is for adults 60+ who need help at home but are not eligible for the same services under Medicaid. It can include Personal Care I/II, respite and ancillary supports, and some AAAs offer consumer-directed or direct-hire delivery.
Respite has multiple New York funding streams
Caregiver respite may come through State Respite, NFCSP, EISEP, NHTD/TBI, OPWDD, VA, GUIDE or private insurance. Eligibility and whether the regular family caregiver can also be paid are separate questions.
Medicaid spenddown and MBI-WPD can preserve access to home care
People who appear over ordinary Medicaid income limits may still qualify through the Excess Income/Spenddown program or, if working with a disability, MBI-WPD. Benefits counseling can materially change the available home-care pathways.
Medicare is not a general custodial home-care benefit
Medicare home health is tied to qualifying skilled/intermittent needs and other eligibility rules. GUIDE and caregiver training can add targeted caregiver support, but ongoing custodial assistance usually requires Medicaid, VA, LTC insurance or private pay.
New York cost varies dramatically by county and city
CareScout’s 2025 statewide median is $80,080 for 44 hours/week of non-medical caregiving, but New York City, Long Island, Hudson Valley, upstate metros and rural markets can differ substantially. Use local quotes for planning.
Program rules, income limits, and availability change over time and can vary by county. Confirm current details with the program directly, or ask a home care provider in New York to help you navigate the application process.
← Back to How to Pay for In-Home CareHome Care Providers in New York
These providers serve families in New York and can help you apply what you've learned above to your specific situation.
Artful Home Care
Serving New York
Artful Home Care provides home care services in the communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Long Island, Southampton
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Help at Home, Inc.
Serving New York
Help at Home, Inc. provides home care services in Islip, NY and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Babylon, Brookhaven, Hempstead and surrounding areas
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Star Multi Care Services
Serving New York
Star Multi Care Services is an accredited home health care agency based in Melville, NY, providing skilled and non-medical home care across Long Island, Nassau County, Suffolk County, and Queens.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Skilled Nursing Care at Home • In-Home Rehabilitation • Dementia & Alzheimer's Care • Hospice Supportive Care • Hospital-to-Home Care • Client Advocacy Services • Healthcare Staffing • Snowbird Services
Communities Served
Melville, Dix Hills, Floral Park and surrounding areas
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