Medicaid Home Care in the Bronx: Eligibility, Services, and How to Apply

If you are caring for an aging parent, an adult with a disability, or someone who needs help with daily activities, you may be wondering whether New York Medicaid can help pay for care at home.

New York Medicaid covers several types of home care services for people who meet the program’s financial, medical, and functional requirements. Depending on the individual’s circumstances, available services can include personal care, home health care, and Consumer Directed Personal Assistance Services (CDPAS). Eligibility and service authorization depend on the individual’s circumstances and an assessment of their care needs.

What Is Medicaid Home Care in New York?

“Home care” is not one single Medicaid service. New York Medicaid has several programs and service arrangements designed to help eligible people receive care in their homes.

Depending on your circumstances, you may encounter:

Personal Care Services

Personal Care Services can provide assistance with activities of daily living and other approved personal care tasks.

The amount and type of care authorized depend on the individual’s assessed needs and Medicaid eligibility.

Consumer Directed Personal Assistance Program

The Consumer Directed Personal Assistance Program (CDPAP) gives eligible Medicaid recipients greater control over who provides their care.

A consumer can recruit, hire, train, supervise, and terminate their personal assistants. Eligible family members or friends may be able to serve as the personal assistant, subject to program rules. A consumer’s spouse, designated representative, and certain other individuals are excluded under the program’s rules.

There has also been a major change to CDPAP.

Since April 1, 2025, Public Partnerships LLC (PPL) has been New York’s statewide fiscal intermediary for CDPAP. All CDPAP recipients are required to work with PPL as the fiscal intermediary.

Managed Long-Term Care

Some Medicaid recipients who need ongoing long-term care services may receive those services through a Managed Long-Term Care plan.

Whether MLTC enrollment applies depends on the person’s age, eligibility, care needs, and other circumstances.

Home Health Care

Medicaid also covers certain home health services for eligible individuals when the applicable requirements are met.

These services can include skilled nursing and certain therapy services. Coverage depends on medical necessity and the specific Medicaid rules applicable to the individual.

Who Can Qualify for Medicaid Home Care?

Medicaid home care eligibility involves more than income.

A person generally must first qualify for the applicable Medicaid program. They must also meet the requirements for the particular home care service they are seeking.

New York has changed the eligibility rules for Personal Care Services and CDPAS.

As of September 1, 2025, new Minimum Needs Requirements apply to certain Medicaid recipients age 21 and older seeking Personal Care Services or CDPAS. Under the current rules, an individual generally must be assessed as needing at least limited assistance with physical maneuvering with more than two activities of daily living, or, for individuals with Alzheimer’s disease or dementia, at least supervision with more than one activity of daily living. Certain people who were already receiving services or continuously enrolled in an MLTC plan before September 1, 2025 are subject to transition provisions.

Because these rules can be complicated, do not assume that being slightly above or below a particular income figure automatically determines whether you qualify for home care.

Medicaid Income and Asset Rules

Financial eligibility depends on the Medicaid category involved.

The rules are different for adults applying under MAGI-based Medicaid compared with people applying under aged, blind, or disabled Medicaid categories.

Income and resource limits can also change from year to year.

For that reason, avoid relying on an old income table when deciding whether to apply. A person who appears to be over a basic limit may have other eligibility pathways depending on their circumstances.

New York Medicaid also has programs and rules involving excess income and other financial eligibility mechanisms. A qualified Medicaid enrollment professional or New York State Medicaid representative can help determine which rules apply to your situation.

Do You Need a Medical or Functional Need?

Yes.

Financial eligibility alone does not automatically qualify someone for Medicaid-funded personal care or CDPAS.

The individual must have an assessed need for the services being requested. New York uses state-approved assessment processes to evaluate an individual’s functional needs.

The current Minimum Needs Requirements are particularly important for people seeking Personal Care Services or CDPAS for the first time.

When preparing for an assessment, be ready to explain what the person can and cannot safely do on their own.

This can include difficulties with:

• Bathing
• Dressing
• Eating
• Toileting
• Transferring
• Walking or mobility
• Other activities of daily living

Be specific about the person’s actual daily limitations rather than simply describing their medical diagnosis.

What Does Medicaid Home Care Cover?

Covered services depend on the Medicaid program and the individual’s authorization.

Depending on eligibility and the applicable program, Medicaid home care can include:

• Personal care assistance
• Consumer-directed personal assistance
• Home health services
• Skilled nursing services
• Certain therapy services
• Other authorized home and community-based services

New York Medicaid confirms that home health and personal care are among services Medicaid may cover, although coverage is subject to program rules and individual eligibility.

Not every service is automatically available to every Medicaid recipient.

The number of authorized hours, the type of service, and the delivery method depend on the individual’s assessment and care plan.

How Does CDPAP Work?

CDPAP is different from traditional agency-based home care because the Medicaid consumer has substantially more control over the caregiver relationship.

The consumer or their designated representative is responsible for recruiting, hiring, training, supervising, and terminating personal assistants.

The statewide fiscal intermediary handles administrative functions such as payroll, required wage withholdings, benefits, and employment records.

Can a Family Member Be a CDPAP Caregiver?

In many situations, yes.

New York Medicaid allows eligible consumers to choose certain family members or friends as personal assistants.

However, there are exclusions. For example, a consumer’s spouse cannot serve as the personal assistant under CDPAP, and other restrictions apply depending on the consumer’s circumstances.

If you want a family member to provide care, confirm that the person meets the current program requirements before making arrangements.

How Do You Apply for Medicaid Home Care in the Bronx?

The exact process depends on whether you already have Medicaid and which home care program may apply.

Step 1: Determine Your Medicaid Status

First, determine whether the person already has active New York Medicaid coverage.

If Medicaid is already active, the next step may involve requesting an assessment for home care rather than starting a new Medicaid application.

Step 2: Determine Which Home Care Program Applies

The appropriate pathway depends on the person’s age, Medicaid status, care needs, and other circumstances.

Someone seeking personal care or CDPAS may be subject to the current assessment and Minimum Needs Requirements.

Step 3: Complete the Required Assessment

The state uses an approved assessment process to evaluate the individual’s functional needs.

Be prepared to describe the person’s normal day and the specific activities where assistance is required.

Step 4: Review the Service Authorization

If the person qualifies, the appropriate program or plan determines the services and amount of care that can be authorized.

Do not assume that a particular number of weekly hours is guaranteed.

Authorized care depends on the person’s assessed needs and the applicable Medicaid rules.

Step 5: Choose and Coordinate Care

For traditional agency-based services, the care arrangement is coordinated through the applicable Medicaid program or managed care plan.

For CDPAP, the consumer has responsibility for choosing and managing personal assistants while PPL handles the statewide fiscal intermediary functions.

How Much Does Medicaid Home Care Cost?

For eligible Medicaid recipients, covered home care services are generally paid through Medicaid rather than as a standard private-pay hourly expense.

New York Medicaid states that home health and personal care are covered services under Medicaid, and its current benefits information states that there is no copayment for home health services or personal care services.

However, Medicaid eligibility and service authorization are separate questions.

Being enrolled in Medicaid does not automatically mean that every type or amount of home care is covered.

What If You Are Over the Income Limit?

Do not automatically assume that being over an initial income threshold means you cannot receive Medicaid.

New York has different eligibility categories and financial rules, including pathways involving excess income for certain applicants.

Because the rules can vary significantly based on age, disability status, household circumstances, and the Medicaid category involved, financial eligibility should be reviewed individually.

Do not transfer assets or make other financial changes solely to try to qualify without first getting qualified advice.

What If You Need More Care Than Medicaid Authorizes?

If you believe the authorized services do not adequately address the person’s needs, ask about your rights to challenge or appeal the determination.

Keep copies of notices, assessments, care plans, and correspondence.

A Medicaid enrollment specialist, care manager, patient advocate, or appropriate legal services organization may be able to explain the available appeal process.

Language Assistance Is Available

Language should not prevent someone from seeking Medicaid information or services.

New York State provides Medicaid information in multiple languages, and applicants or recipients can request language assistance when interacting with government agencies and participating organizations.

If the person receiving care is more comfortable communicating in Spanish, Bengali, Haitian Creole, or another language, ask what language assistance or interpretation services are available.

Important Changes to CDPAP

Families who previously used CDPAP should be aware of the statewide fiscal intermediary change.

PPL became New York’s sole statewide fiscal intermediary on April 1, 2025. The New York State Department of Health confirms that PPL is the statewide fiscal intermediary and that CDPAP recipients are required to work with PPL for fiscal intermediary services.

This means older articles that list multiple fiscal intermediaries may no longer be accurate.

If you are currently enrolled in CDPAP, verify current procedures directly with your plan, facilitator, or PPL.

Frequently Asked Questions

Can my adult son be my CDPAP caregiver?

An adult child can generally serve as a CDPAP personal assistant for an eligible parent, provided the person meets program requirements and is not otherwise excluded. New York Medicaid specifically allows certain family members to serve as personal assistants.

Can my spouse be my CDPAP caregiver?

No. New York Medicaid’s CDPAP rules exclude the consumer’s spouse from serving as the personal assistant.

How many hours of home care can Medicaid provide?

There is no single number that applies to everyone. The amount of authorized care depends on the person’s assessed needs, eligibility, and applicable program rules.

Do I automatically get home care if I have Medicaid?

No. Medicaid enrollment does not automatically guarantee personal care or CDPAS. The individual must meet the applicable home care eligibility and assessment requirements.

Is CDPAP still available in New York?

Yes. CDPAP remains a New York Medicaid program. However, the statewide fiscal intermediary structure changed in 2025, with PPL becoming the statewide fiscal intermediary.

Get Help Understanding Medicaid Home Care in the Bronx

Medicaid home care rules can be difficult to navigate, especially when eligibility requirements and program policies change.

If you or a family member in the Bronx needs help understanding the available home care options, start by confirming your current Medicaid status and determining which program may apply.

HomeCareMedicaidNY.com offers eligibility screening and guidance for Bronx families seeking Medicaid home care services.

Contact the team to discuss your situation, understand the next steps, and determine what documentation or assessment may be needed.

Related: Telehealth Medicaid Therapy Services — learn how virtual sessions are covered under New York Medicaid.

Related from Home Care Medicaid NY: Medicaid Home Care in New York · Medicaid Home Care New York