Check eligibility for Home Care Services by completing the form provided below.
If the patient cannot complete the form due to age, disability, or medical limitations, a family member or another trusted person may complete it on their behalf.
Are you a patient seeking home care and do not yet have a caregiver?
Submit only the patient details. Our team will contact you for the next steps and your available options.
What happens after you submit?
We review your details promptly, and a team member will reach out to guide you through the enrollment process.
Need assistance submitting the form?
Call 929-660-2391
Email [email protected]
We keep submitted information private and use it solely to determine eligibility for home care programs.
The most accurate way to verify Medicaid eligibility is the patient’s Medicaid Client Identification Number (CIN). You can find the CIN on the front of the New York State Medicaid Benefit (EBT) card, usually labeled as “ID Number” (example: IR12138T). If the CIN is unavailable, you may provide the patient’s Social Security Number (SSN) for verification purposes.