Assisted Living New York

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 sixth in the nation overall. While the state ranked first in the Transportation, Quality of Life, and Senior Living & Housing categories, it ranked near the bottom for affordability, and only middle of the road for Health Care. 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.

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.

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.

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 

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.

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.

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.

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

Outings & Social Activities

COVID-19 Safety Measures for Staff and Residents

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.

Frequently Asked Questions