Memory Care in New York

Nearly 20 million people live in the state of New York, and 17.5% of this population are seniors. Current projections predict that the senior population will rise, increasing the need for dementia care in New York. Alzheimer’s deaths in New York increased by 24.55% between 2016 and 2020, reflecting a nationwide ranking of Alzheimer’s as the 7th leading cause of death in the country.

Memory care communities are a form of dementia care that takes place in a residential setting. At a memory care community, seniors with Alzheimer’s or dementia receive around-the-clock care and supervision from trained caregivers. Families exploring memory care options in New York can use this guide to compare average costs, learn about services and find local resources for care planning.

The Cost of Memory Care in New York

At $5,725 per month, the cost in New York is slightly higher than the national figure of $5,625. New York is also affordable when compared to most of its neighbors. New Jersey and Massachusetts have high memory care costs at $8,119 and $8,125, respectively. Vermont ($6,563) and Connecticut ($6,411) are also less affordable. Pennsylvania is the only neighboring state with lower costs lower than New York, with seniors there paying $5,125 per month. 

Memory care rates in New York vary widely depending on where you live. The most affordable care is found in Rochester, at $4,719 per month, and Glens Falls, where seniors pay $5,313. On the other end of the scale are Ithaca and Watertown, with costs of $10,094 and $10,519, respectively. The state’s biggest city, New York City, is at the higher end of the scale, with a cost of $7,188 per month, while Albany ($6,586) and Buffalo ($5,926) fall toward the middle of the range.

There are many long-term care options available to seniors in New York. Adult day health care is the most affordable at $1,907, while nursing home care costs are at the other end of the scale, at $12,775 for a semiprivate room and $13,233 for a private room. Assisted living in New York costs $4,580, while home care and home health care are $5,339 and $5,529, respectively. 

Does Medicaid Cover Memory Care in New York?

Seniors in New York who qualify for Medicaid may be able to get help paying for residential memory care services through two waiver programs. Both of these programs are designed to help people who require a nursing home level of care continue to live in the community. Both programs allow services to be provided in an assisted living environment.

What Memory Care Services Are Covered by Medicaid in New York? 

The waiver programs in New York generally pay for the services provided in a residential care setting. This can include personal care services, such as assistance with activities of daily living, case management and adult day health care. Medical aid offered includes intermittent skilled nursing and occupational therapy. 

Memory Care Waiver Programs in New York 

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. 

How to Know if You’re Eligible for Medicaid in New York

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 $934 per month if single or $1,367 if applying as a married couple
• Have assets of less than $16,800 if single or $24,600 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 $137,400 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. 

2022 Medicaid Income Limits for Seniors in New York

*Per year

People who don’t meet the financial eligibility requirements may be able to access Medicaid through alternative pathways. These allow seniors to spend extra assets or income on approved expenses, such as medical needs, until they reach the financial limit. Once this limit is reached, the individual is considered Medicaid-eligible until the end of the period. 

How to Apply for Medicaid in New York

Medicaid applications can be made through a local Department of Social Services office or online at the NY State of Health website. The department recommends that people aged 65 and over apply with the Department of Social Services, unless they are the parent or caretaker relative of a minor family member. 

Information You Will Need

When applying for Medicaid, people aged over 65 must provide proof of:

• Identity and date of birth
• U.S. citizenship or immigration status
• Current address
• Current income
• Health insurance, such as current policy, termination letter or Medicare card
• Medical bills for the last three months
• Resources, including bank account statements, and stock and bond certificates

How to Get Help Applying for Medicaid 

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. 

Does Medicare Cover Memory Care in New York?

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.

Other Financial Assistance Options for Memory Care 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 Memory Care affordable.

Free and Low-Cost Resources for Seniors in New York

New York has a variety of free and low-cost resources available to seniors that require memory care services. Services are offered by local and state governments and nonprofit organizations, and they can provide financial aid, advocacy and other support.

COVID-19 Rules for Memory Care in New York

The following information is based on research done on several government websites, including coronavirus.health.ny.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/13/2022, 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

Memory Care Laws and Regulations in New York

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.

Frequently Asked Questions