Free In-Home Help for Seniors with Disabilities in New York

If an older family member or an adult with a disability is struggling to live safely at home, private Home Care can become expensive very quickly. The good news is that New York has Medicaid-funded Home Care programs and other public programs that can help eligible people receive assistance at home without paying the full cost of private care themselves.

The right program depends on the person’s age, disability, Medicaid and Medicare status, functional needs, income, and the level of assistance they require.

Some services can be fully covered through Medicaid for eligible individuals. Other programs, such as EISEP, operate outside Medicaid and may use income-based cost sharing. Here are the main options New York families should know about.

Quick Answer: Can Seniors Get Free In-Home Help in New York?

Yes, eligible seniors and adults with disabilities may qualify for Medicaid-funded in-home assistance in New York. Depending on the person’s situation, possible options include:

• PCA Home Care
• Home Health Aide services
• Managed Long-Term Care
• Medicaid Advantage Plus
• PACE for certain adults aged 55 and older
• EISEP for some older adults who are not Medicaid recipients

These programs do not all have the same eligibility rules, and qualifying for Medicaid does not automatically mean a particular number of Home Care hours will be approved.

PCA Home Care for Seniors and Adults With Disabilities

For many adults who need ongoing assistance at home, PCA Home Care is one of the first options to review.

Personal Care Aides can assist an eligible person with authorized activities such as:

• Bathing and personal hygiene
• Dressing and grooming
• Toileting
• Walking and mobility
• Transfers
• Meal preparation
• Other approved daily living activities

The person receiving care generally must have Medicaid and meet the functional eligibility requirements for Personal Care Services.

New York’s Minimum Needs Requirements for PCA Home Care

New York changed the minimum functional requirements for many people seeking Personal Care Services beginning September 1, 2025.

For applicable cases, a person generally must be assessed as needing at least limited assistance with physical maneuvering in more than two activities of daily living.

For an individual with a diagnosis of dementia or Alzheimer’s disease, a different standard applies: the person may qualify when assessed as needing at least supervision with more than one activity of daily living.

You can review the current requirements through the New York State Department of Health Minimum Needs Requirements.

What Is Managed Long-Term Care?

Managed Long-Term Care, commonly called MLTC, is not simply another name for a Home Care aide. It is a managed-care system that coordinates long-term services and supports for eligible New Yorkers with chronic illnesses or disabilities who want to remain in their homes and communities.

Depending on the plan and the person’s authorization, covered services can include Personal Care, Home Health Aide services, nursing, therapies, adult day health care, medical equipment, and other long-term supports.

For many people who have both Medicare and Medicaid and need community-based long-term services on an ongoing basis, MLTC becomes an important part of how their Home Care is coordinated.

New York provides current information through its Managed Long-Term Care program.

Medicaid Advantage Plus for Medicare and Medicaid Members

Medicaid Advantage Plus, commonly called MAP, is an integrated option for eligible adults who have both Medicare and Medicaid.

MAP can coordinate Medicare health care, Medicaid benefits, prescription coverage, and long-term services and supports through an integrated arrangement.

For someone who needs ongoing Home Care and is already dealing with both Medicare and Medicaid, this can reduce some of the fragmentation that comes from managing the programs separately.

MAP eligibility starts at age 18 and includes additional functional and program requirements. It is not limited only to seniors.

PACE for Seniors With Higher Care Needs

The Program of All-Inclusive Care for the Elderly, or PACE, is another option for people with significant long-term care needs.

PACE is available to qualifying people aged 55 or older who meet nursing-home-level-of-care requirements and can remain safely in the community with appropriate services.

Participants may have Medicare, Medicaid, or both, depending on their individual eligibility.

PACE can coordinate a broad package of medical care and long-term services, including services that help an eligible person remain at home rather than enter a nursing facility.

What If the Senior Does Not Have Medicaid?

Not having Medicaid today does not automatically mean there are no options.

Medicaid eligibility should be reviewed before assuming that a senior or disabled adult cannot qualify. Income, resources, age, disability status, Medicare enrollment, and other factors can affect eligibility.

New York also provides official information about how to apply for Medicaid.

For qualified Home Care cases, Medicaid enrollment or coverage issues can often be addressed when determining the appropriate next steps. Available assistance depends on the case and the licensed agency involved.

EISEP: In-Home Help for Seniors Who Are Not on Medicaid

Medicaid is not the only possible source of in-home assistance for older New Yorkers.

The Expanded In-Home Services for the Elderly Program, known as EISEP, is administered through local Area Agencies on Aging and is specifically designed for qualifying older adults who are not Medicaid recipients.

EISEP eligibility generally begins at age 60. An individual must need assistance with at least one activity of daily living or two instrumental activities of daily living and be able to remain safely at home.

Services can include case management, in-home assistance, respite, and other non-medical supports.

Unlike Medicaid Home Care, EISEP should not automatically be described as completely free. Depending on income and other program rules, a participant may have a cost-sharing responsibility.

Learn more through the New York State Office for the Aging EISEP page.

PCA or HHA: What Kind of In-Home Help Does the Person Need?

Another important question is the level of care the person actually needs.

Many patients need PCA Home Care for assistance with ordinary daily activities. A Personal Care Aide can provide hands-on assistance with approved personal care and household tasks as outlined in the person’s plan of care.

Other patients need Home Health Aide-level services because their care plans include health-related tasks that require an HHA working under appropriate professional supervision.

For qualified patients, we refer only to top, vetted, licensed Home Care agencies that can determine whether PCA or HHA Home Care is the appropriate level of service.

Can a Family Member Provide the Home Care?

In some qualifying PCA Home Care cases, certain extended relatives or trusted individuals may be considered for employment as caregivers through the licensed agency pathway we support.

Possible relationships may include siblings, grandchildren, cousins, nieces, nephews, other qualifying extended relatives, and trusted family friends.

Spouses, adult sons or daughters caring for a parent, in-laws, and legal guardians are not eligible caregivers through the PCA pathway we support.

The patient’s eligibility for Home Care and the proposed caregiver’s eligibility for employment are separate questions, which is why the relationship should be screened early.

How the Home Care Process Usually Starts

For Medicaid-funded Home Care, the process generally starts by confirming Medicaid coverage and determining whether the patient meets the applicable functional requirements.

Required assessments are then completed, and the Medicaid plan or local district uses the applicable assessment and care-planning process to determine what services can be authorized.

You can review our Home Care application process for a broader explanation of what happens from screening through the Start of Care.

Frequently Asked Questions About In-Home Help in New York

Can a senior get free Home Care in New York?

An eligible senior may receive Medicaid-funded Home Care without paying the private hourly cost of an aide. Eligibility, coverage, and any financial responsibility depend on the person’s Medicaid status, program, and plan.

Does Medicare pay for permanent Home Care for seniors?

Medicare can cover certain home health services when its requirements are met, but Medicare alone is generally not the funding source for ongoing custodial Personal Care Services. Medicaid is much more important for long-term PCA Home Care in New York.

What is the difference between MLTC and PCA Home Care?

PCA Home Care provides personal assistance in the home. MLTC is a managed-care structure that coordinates long-term services and supports for eligible members. PCA services may be included in an MLTC member’s authorized care plan.

What if an elderly person has Medicare and Medicaid?

A person with both programs is considered dual-eligible. Depending on age, care needs, and other requirements, options may include Managed Long-Term Care, Medicaid Advantage Plus, or PACE.

Is EISEP free?

Not always. EISEP serves eligible New Yorkers aged 60 and older who are not Medicaid recipients. Depending on income and applicable program rules, cost sharing may apply.

How many Home Care hours can a senior receive?

There is no standard number of hours for every senior. Authorized services depend on the applicable assessments, functional needs, plan of care, and Medicaid authorization process.