In-Home Dementia Care in New York State

Paying for care in New York: Managed Long Term Care

Medicare does not pay for the long-term help dementia requires. In New York the programme that can is MLTC, administered by state-approved managed care plans (three tracks: MLTCP, MAP, and PACE).

Who qualifies

Managed Long Term Care eligibility rests on an assessment of the help a person needs with daily activities; the specific functional criteria are not stated on that overview, so confirm them with the plan or the local district. The cited page does not describe any dementia-specific eligibility route, so ask the office that administers the programme how a dementia diagnosis is weighed in that assessment.

The financial limits

Single applicant

Not published on the cited NY Department of Health page; set by New York Medicaid financial eligibility rules

Married couple

Not published on the cited page; spousal impoverishment rules apply

Look-back period

Not published on the cited page; New York applies a look-back to community Medicaid asset transfers, and the current period should be confirmed with the local district

How to apply

Eligibility is determined through the New York Independent Assessor (NYIA), a separate step from enrolling in an MLTC plan, which then determines the actual weekly hours of care authorized.

What is unusual about New York

New York's Consumer Directed Personal Assistance Program (CDPAP) lets families self-direct care and hire their own caregiver, including certain relatives, rather than being assigned one by an agency.

Rules and figures change. Confirm the current position with the programme itself before making a financial decision.