Memory Care in New York

Inflation is having an impact on memory care costs in New York. From 2022 to 2023, prices rose 23% from $5,244 to $6,449. The U.S. average had a more modest increase of 10% to $5,369. The picture in neighboring states is different. In Pennsylvania, costs rose by 12%, while in New Jersey they fell by 11%. Memory care prices in Connecticut and Massachusetts didn’t change much at all, with a decrease of 1% and increase of 2% respectively.

Managed Long Term Care Program Waiver

The MLTC program is intended to help people with chronic illnesses or disabilities, including memory loss, get the care they need without entering a nursing home. People in the program enroll in a managed care plan, which has a network of health care providers, and after enrolling, you must get services from your plan’s providers. 

There are three types of plans available for people in the program: MLTC Medicaid Program, Medicaid Advantage Plus (MAP) and Program for All-Inclusive Care for the Elderly (PACE). The MLTC Medicaid program keeps Medicaid and Medicare separate, while MAP and PACE combine Medicaid and Medicare services into one plan. 

Enrollment in the program is mandatory for anyone who is over 21, dual-eligible for both Medicaid and Medicare and in need of long-term care for at least four months. Enrollment is voluntary for adults who aren’t dual-eligible. In addition to these criteria, applicants must meet Medicaid’s income and asset limits and must require a nursing home level of care. Participants can’t be enrolled in MLTC and another waiver program, such as ALP, at the same time. 

The exact benefits differ slightly depending on the type of plan you choose, mainly because some plans combine Medicare and Medicaid services. All plans provide care management, home care and other community long-term care services. These can be provided in an assisted living setting. Other services include occupational therapy, vision and hearing aids and medical social services. 

Applications for the program are made through local Department of Social Services offices. 

Assisted Living Program

The Assisted Living Program uses a mix of Medicaid and non-Medicaid funding to pay for the cost of assisted living services in licensed assisted living residences. This hybrid funding model means it can pay for both care services and room and board for qualified participants. 

The program is available to both Medicaid recipients and private payers. Applicants must still meet the financial and residency criteria to be eligible for Medicaid and must require a nursing home level of care. The program isn’t available to people who are bedridden, need constant nursing care or who are impaired in a way that endangers other residents.

The ALP pays for the basic cost of assisted living. Services provided include case management, personal care, room and board, recreational activities and supervision. On the medical side, skilled nursing, some therapies and medical supplies and equipment can be included. It’s important to note that basic costs may not cover every service that’s offered in a facility. Some memory care services may be offered in addition to the basic services and would need to be paid for by other means. 

As of February 2022, the ALP is only funded for 4,200 participants and new applicants are put on a waiting list. If eligible for other programs, such as MLTC, you may still be able to get assistance paying for care in assisted living, although room and board costs won’t be covered. 

The Department of Health recommends that interested seniors contact participating assisted living providers in their area to see if there’s a position available. New York’s Adult Care Facility Directory does state whether the facility has beds in the ALP and is a good place to start if you’re looking for a facility. Local Department of Social Services offices can also offer assistance. 

Medicaid in New York can help low-income residents from all walks of life access health care. Eligibility is based on a number of criteria, including finances, residency and health status. The criteria can differ depending on your circumstances. 

To be eligible for the waiver programs included in this guide, you must:

• Be a New York resident
• Be a U.S. citizen, national, permanent resident or legal alien
• Be aged 65 or older, be legally blind or have a qualifying disability
• Have an income of less than $1,677 per month if single or $2,268 if applying as a married couple
• Have assets of less than $30,182 if single or $40,821 if applying as a married couple

If only one spouse is applying, the single limits apply. However, the non-applicant spouse can have up to $148,620 of assets and is entitled to a Community Spouse Monthly Income Allowance (CSMIA). Not all assets are included when making Medicaid assessments. Exempted assets include your primary home along with personal belongings, household items and a vehicle.

2024 Medicaid Income Limits for Seniors in New York

New York has a number of programs available to help seniors apply for Medicaid, including the statewide Navigator program and the Health Insurance Information, Counseling, and Assistance Program. Local Department of Social Services offices can also provide assistance. 

The short answer is that no, Medicare does not cover the cost of memory care in New York. As was mentioned above, this doesn’t apply to Memory Care received in a Nursing Home. Since it is the most common to receive memory care in a “social setting” (such as an assisted living facility), Medicare won’t be a viable financial assistance option for most seniors who need Memory Care. However, Medicare will 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 Memory Care in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in New York.

There are many resources in New York that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.

Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.

Cash assistance programs in New York provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.

Whether living in their own home or in a senior living community, New York seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.

Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help New York seniors afford the nutritious food they need.

Low-income elderly individuals in senior living communities can access financial assistance through local-run programs. These New York resources offer advice, guidance and support to help older adults pay for the services offered by long-term care providers.

Due to the high cost of purchasing new medical equipment, several organizations in New York collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.

New York seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.

Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in New York have different eligibility criteria and often assist retirees by providing grants or loans.

Many organizations offer free or low-cost legal services to New York seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.

Senior centers in New York bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.

Navigating the Medicaid system is often difficult and confusing. Several New York resources help older adults by providing advice on Medicaid options, waiver programs and eligibility criteria to help seniors receive the right health care benefits.

Social Security offices in New York help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.

Seniors can apply for tax assistance from several New York resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.

Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. New York retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.

New York retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.

The New York State Department of Health licenses and regulates all types of residential adult care facilities, including special needs assisted living residences that provide memory care to individuals with Alzheimer’s, dementia or other cognitive impairments. Adult care facility operators must adhere to all New York laws and regulations pertaining to the rules and responsibilities of these facilities, as highlighted below.