The older adult population is booming in the Big Apple. Nearly one in six New Yorkers are aged 65 or older, which includes about 17% of its population of more than 20 million people. The state boasts numerous famous landmarks and nationally ranked hospitals, including several New York-Presbyterian Hospital and Mount Sinai locations.

In our 2022 Senior Living Report, New York ranked second in the nation overall. While the state ranked first in both transportation and quality of life, it ranked poorly for affordability and community involvement. However, the state doesn’t tax Social Security benefits, federal and state government pensions, military retirement pay and up to $20,000 in private retirement plans, which benefits retirees. Older New Yorkers who need low to moderate assistance and want to live in a home-like residential setting pay an average of $4,580 for assisted living, only slightly higher than the national average.

This introductory guide to assisted living in New York covers the cost of senior care in the state and financial assistance available for assisted living, including assisted living waivers. It also provides contact information for nonprofit and government agencies that provide free or low-cost resources to seniors.

The Cost of Assisted Living in New York

According to the 2021 Genworth Cost of Care Survey, the average cost of assisted living in New York is $4,580, which is only $80 higher per month compared to the average cost nationwide. However, assisted living is much cheaper in New York compared to all but one neighboring state. While Pennsylvania costs less per month at $4,100, New York’s average cost is several hundred to nearly $2,000 lower than Connecticut’s $5,129, Vermont’s $5,250, New Jersey’s $6,495 and Massachusetts’s $6,500.

$4580

New York

$4500

The United States

$4100

Pennsylvania

$5129

Connecticut

$5250

Vermont

$6495

New Jersey

$6500

Massachusetts

When comparing the cost of assisted living in various cities across the state, seniors will find a wide range. While cities like Watertown and Ithaca are some of the most expensive cities at $8,415 and $8,075, respectively, Rochester is one of the least expensive at $3,775. The state’s largest city, New York, lands about midway at $5,750 as does its capital, Albany, with an average cost of $5,269. The second-largest city, Buffalo, has an average monthly cost of $4,741 while Syracuse comes in right at the national average of $4,500.

$8415

Watertown

$8075

Ithaca

$5750

New York

$5269

Albany

$4741

Buffalo

$4500

Syracuse

$3775

Rochester

Seniors interested in comparing all their senior care options have a variety of choices in New York. Adult day health care is the least expensive option at an average of $1,907 per month. It also provides the least amount of care. Older New Yorkers wanting to age in place will pay an average of $5,339 for homemaker services or $5,529 for home health aides if they need more hands-on care. For those needing a high level of care, semiprivate rooms in nursing home facilities run about $12,775 while private rooms average $13,233.

$4580

Assisted Living

$1907

Adult Day Health Care

$5339

Homemaker Services

$5529

Home Health Aides

$12775

Nursing Home Care (semiprivate)

$13233

Nursing Home Care (private)

Does Medicaid Cover Assisted Living in New York?

New York’s Medicaid program directly helps with some assisted living costs based on income and assets. Senior New Yorkers also may be eligible for the state’s Medicaid Managed Long Term Care (MLTC) program, which delays nursing home admissions by providing home and community-based services (HCBS). Medicaid waivers/HCBS aren’t an entitlement program, so there are limited spots available. The New York Assisted Living Program (ALP) is another option for seniors who qualify.

What Assisted Living Services Are Covered by Medicaid in New York?

The New York MLTC Program Waiver and the New York Assisted Living Program are intended for seniors who require a nursing home level of care but want to live in assisted living facilities. Long-term care supports are provided to allow them to live in a less restrictive environment by providing the care they need to thrive and retain their independence. Covered services vary by program but may include:

  • Personal care assistance
  • Skilled nursing
  • Personal emergency response systems
  • Meal delivery
  • Housecleaning

Assisted Living Waiver Programs in New York

New York Managed Long-Term Care (MLTC) Program Waiver

The New York MLTC Program Waiver provides long-term supports for chronically ill or disabled residents in danger of nursing home placement. The primary goal is to prevent/delay admission to a nursing home through home and community-based services. Eligible individuals can live at home, with a relative or within assisted living but can’t be simultaneously enrolled in the New York MLTC and the ALP programs or reside in an adult foster care home. Each person’s plan of care determines which benefits they receive, so programs vary. Benefits that are helpful to those in assisted living might include:

  • Audiology services
  • Personal care assistance
  • Durable medical equipment
  • Care management
  • Personal emergency response systems
  • Dental services
  • Medical supplies
  • Optometry services
  • Podiatry
  • Private duty nursing
  • Occupational, physical and speech therapies

While many services provided through the MLTC program can be provided in an assisted living setting, the cost of room and board isn’t covered. To be eligible, applicants must meet specific functional and financial requirements, which include requiring long-term care for more than 120 days and hands-on assistance with three activities of daily living. The application process includes: 

  • Applying via the local Department of Social Services office
  • Calling NY Medicaid Choice’s Conflict-Free Evaluation & Enrollment Center at 855-222-8350 to request a functional needs assessment
  • Choosing an MLTC plan and completing a second assessment to create an individualized care plan

New York Assisted Living Program

New York’s ALP provides a supportive residential environment for seniors or disabled individuals who are at risk of being admitted to a nursing home. The goal is to prevent or delay nursing home care by providing personal and home health assistance in a long-term adult care facility licensed as an assisted living program. Based on financial means, a program participant may/may not pay for room and board out of their pocket. Other possible benefits include: 

  • Personal care assistance
  • Case management
  • Housekeeping
  • Medical supplies/equipment
  • Nursing services
  • Personal emergency response services
  • Occupational, physical and speech therapies

Medicaid pays for long-term care under this program but won’t cover room and board. However, Supplemental Security Income will supplement an individual’s income to cover room and board for those with limited income and assets. Those who don’t qualify for SSI can pay privately. The ALP has a limited number of available beds and a waitlist starts when all beds are full.

To be eligible, applicants must not be bedridden, require 24/7 nursing care or present a danger to other residents but are at risk of being placed into a nursing home. Applicants undergo a Uniform Assessment System eligibility assessment to determine whether they have a nursing home level of care. Income limits are higher for the ALP than other Medicaid programs and applying for ALP services requires getting approved in advance by the local Social Services District.

How To Know If You’re Eligible for Medicaid in New York

The New York Department of Social Services determines eligibility for Medicaid statewide. In general, applicants must: 

  • Be aged 65 or older
  • Be blind
  • Have a disability or have a family member in the household with a disability
  • Meet financial guidelines 

As of 2022, single applicants may have a monthly pre-tax income of no more than $934. New Yorkers aged 65 or older who don’t meet the eligibility requirements can become income eligible if they have high medical bills through the Medically Needy Pathway

2022 Medicaid Income Limits for Seniors in New York 

Annual Income Limits

Annual Asset Limits

Single Applicant

$934

$16,800

Two-Person Household

(Only One Applying)

$934 (applicant)

$16,800 for applicant and $137,400 for non-applicant

Two-Person Household

(Both Applying)

$1,367

$24,600

To be eligible for New York Medicaid, applicants must also be:

  • A resident of New York State
  • A U.S. national, citizen, permanent resident or legal alien
  • In need of health care/insurance assistance with low income

How To Apply for Medicaid in New York

Prior to applying, ensure eligibility by taking the American Council on Aging’s free Medicaid eligibility test. Seniors in New York must apply for Medicaid with their local Department of Social Services office either in person or over the phone or they can apply online. The application process can take up to three months or longer. Applicants call New York Medicaid Choice at (888) 401-6582 with questions about their enrollment and help choosing and enrolling in a plan. They can also get help with the process by calling the Medicaid Helpline at (800) 541-2831.

Information You Will Need

To apply for Medicaid in New York, applicants must gather appropriate documents to provide proof of:

  • Identity
  • Residency
  • Citizenship/Immigration status
  • Income
  • Resources
  • Other health insurance, including Medicare

How To Get Help Applying for Medicaid

New York seniors have several sources to get help with Medicaid, including free resources that help them apply for coverage. The following resources help aging adults get the Medicaid coverage they need, understand their benefits and dispute denied claims.

Resource

Contact

Description

(800) 701-0501

New York State's HIICAP is the state health insurance assistance program (SHIP) and provides free information, counseling and assistance on Medicare, Medicaid and private insurance plans.

(800) 342-9871

NY Connects provides free, unbiased information on long-term services and supports, including Medicaid, for people of all ages or with any disability.

(888) 692-6116

The New York City HRA helps residents in the most populous city nationwide who are aged 65 or older, disabled or blind apply for Medicaid.

Does Medicare Cover Assisted Living in New York?

The short answer is that no, Medicare does not cover the cost of assisted living in New York. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in New York.

Other Financial Assistance Options for Assisted Living in New York

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for assisted living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for assisted living. Reverse mortgages are loans that seniors can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for assisted living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of assisted living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in New York

Numerous nonprofit organizations and government entities throughout New York offer free and low-cost resources to seniors to improve their access to supportive services that allow them to stay active and retain their independence. Many programs support older New Yorkers and improve their ability to age in their community and avoid higher levels of institutionalized care.

Resource

Contact

Description

(844) 697-6321

The New York State Office for the Aging offers advocacy and various home and community-based programs to assist older New Yorkers with getting the services they need to retain their independence. It coordinates with local partners to provide nutrition counseling, health promotion, legal services, elder abuse prevention and volunteer opportunities, among others.

(888) 838-7697

New York has the fifth-largest veteran population in the nation and more than half are aged 65 or older. The New York State Division of Veterans' Services advocates for all veterans, current service members and their families. It connects them with all the medical, economic and social benefits they’ve earned through their military service.

(855) 582-6769

The Long Term Care Ombudsman Program advocates for residents of long-term care facilities, including assisted living. Ombudsmen help residents understand their rights to protect their quality of life and will act on their behalf to ensure these rights aren’t violated, which includes investigating and helping to resolve complaints.

(800) 772-1213

Seniors in New York can visit their local Social Security office to get assistance with their Social Security benefits, including SSI benefits that could help cover assisted living room and board costs.

(212) 962-7559

The NYFSC strives to help New York’s seniors lead healthier, more productive lives in their communities while helping them avoid premature institutionalization. The nonprofit serves all five of New York’s boroughs and provides a variety of support services and senior centers to help seniors stay active and engaged with their peers.

(212) 213-2788

NYFE supports initiatives serving seniors in New York City and provides funds to organizations that offer hands-on programs to older adults throughout the NYC region, including education, therapy, treatment and one-on-one engagement.

(518) 449-7080

The Association on Aging operates the New York State Area Agencies on Aging to respond to seniors aged 60 or older living in the state. The AAAs provide home and community-based services to help older adults remain in their homes and communities longer. Services include nutrition counseling, health insurance assistance, long-term care information, volunteer opportunities and legal services, among others.

COVID-19 Rules for Assisted Living in New York

The following information is based on research done on several government websites, including The Department of Health and Human Services and New York State Department of Health. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 3/8/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

RULES FOR NEW YORK COMMUNITIES

Can I visit my relative in person if he/she wants emotional support from me?

Yes (Conditions Apply)

Can I visit my relative in person for end-of-life compassion care?

Yes

Will my loved one be required to self-quarantine after I visit him or her?

No

Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?

Yes

Are Hairdressers and other non-medical contractors still allowed in senior living facilities?

Yes

Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?

Yes

Are visitors being screened for elevated temperatures?

Yes

Are visitors being asked questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

RULES FOR NEW YORK COMMUNITIES

Are residents allowed to leave the facility for non-medical reasons?

Yes

Are residents of senior living facilities who leave and return required to self-quarantine?

No (Conditions Apply)

Are senior living facilities required to cancel all group outings?

No

Are residents still eating together in the dining hall?

Yes (Conditions Apply)

Are facilities still allowed to host group activities within the community?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

RULES FOR NEW YORK COMMUNITIES

Are staff members and contractors being screened for elevated temperatures?

Yes

Are staff members and contractors being tested for Coronavirus?

Yes (Conditions Apply)

Are staff members and contractors being asked questions about health, travel, and potential virus contact?

Yes

Are staff members required to regularly screen residents for coronavirus symptoms?

Yes

Are residents relied on to screen themselves and self-report potential coronavirus symptoms?

No

Are staff members required to take residents’ temperatures?

Yes

Are residents being tested for coronavirus?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in New York

The New York State Department of Health licenses and supervises adult care facilities that provide long-term residential care to adults, including assisted living residences (ALRs). New York has extensive rules and regulations regarding ALRs that these facilities must follow to keep their licenses.

NEW YORK STATE LAWS AND REGULATIONS

Assisted Living Service Plan Requirements

A written individualized service plan must be developed for each resident upon admission. This plan must be developed with input from the resident, the resident’s representative and physician and a home care agency, if applicable. The plan must consider the resident’s medical, rehabilitation, cognitive, functional and nutritional needs and be reviewed and revised every six months or more frequently based on the changing needs of the resident.

Assisted Living Admission Requirements

Adults aged 55 or older who need limited supervision and help with personal care can live in an ALR. However, they can’t require continual nursing or medical care, suffer from a serious or persistent mental disability, be chronically bedfast or chairfast and require transfer assistance, regularly need assistance walking or going upstairs or downstairs, be chronically incontinent or pose a threat to themselves or others.

Assisted Living Scope of Care

ALRs must provide some assistance with personal care, such as bathing, dressing, grooming, eating and other activities of daily living. Residents also must be provided assistance with self-administration of medications, housekeeping tasks, case management and coordination of activities, such as social events. ALRs must provide three meals and an evening snack daily that adhere to the dietary allowances recommended by the National Academy of Science’s Food and Nutrition Board.

Assisted Living Medicaid Policy

ALRs that serve residents who receive Medicaid must provide additional nursing and therapeutic services based on the recipient’s initial assessment and routine reassessments. Although New York doesn’t provide public subsidization of services for low-income individuals living in ALRs, they can receive personal care services through Medicaid for individuals in community settings, such as ALRs.

Assisted Living Facility Requirements

Operators must be licensed as an ALR by the New York Department of Health. The Department inspects ALRs every 12 to 18 months. If the facility follows all ALR laws and regulations, the ALR license is renewed every two years.

Medication Management Regulations

ALR residents must take their medications themselves, but staff can give them reminders about taking their medications. Staff can also help residents identify, store, retrieve and open medications, and dispose of supplies related to these medications.

Staffing Requirements

ALRs have set staffing requirements that include employing an administrator to oversee daily operations, a case manager to evaluate residents’ needs, personal services staff who provide direct care to residents and an activities director to coordinate activities for residents. The facility must have at least one person on duty at all times who is qualified to provide first-aid.

Staff Training Requirements

All resident aides must receive 40 hours of initial training and 12 hours of in-service education every year on topics relevant to their job duties. Unlicensed administrators must complete 60 hours of continuing education every two years. All staff must go through facility orientation on policies, procedures, resident characteristics, disaster plans and emergency evacuation.

Background Checks for Assisted Living

ALRs must complete criminal history background checks on all prospective non-licensed, direct care employees through the Division of Criminal Justice Services that include fingerprinting. Applicants must also provide the facility administrator with a sworn statement regarding any prior findings of patient abuse.

Requirements for Reporting Abuse

Amendments to New York’s penal laws outline crimes against physically disabled and vulnerable elderly persons and require Protective Services for Adults to report suspected abuses against elderly persons to law enforcement.

Assisted Living Facilities in New York (139)