Home care in New York helps people stay safe at home when daily life gets harder. Sometimes that means an aide who helps a parent bathe and dress. Other times it means a nurse who visits after a hospital stay. The right kind of care depends on the person's needs, and the way to pay depends on their coverage.
This guide covers the full picture. It explains the types of home care, the agencies that provide it and the signs that a loved one may need help. You will also find Medicare, Medicaid and other ways to pay, what care costs, how to choose an agency and where to start in New York City. Use it as a reference before you make your first call.
01What Is Home Care?
Home care is support delivered in a person's home so they can live safely and comfortably. It ranges from help with daily tasks, like bathing, dressing, meals and getting around, to skilled services from nurses and therapists. Most home care in New York is provided through licensed agencies and paid for by Medicaid, Medicare, insurance or private funds.
New York's Department of Health describes home care as a health service provided at home to promote, maintain or restore health, or to lessen the effects of illness and disability.1 In plain terms, care comes to the person instead of the person going to a facility.
Who Uses Home Care?
People often picture home care as something only older adults use. In practice, it serves many groups:
- Older adults who need help with daily routines
- Adults living with a disability or chronic illness
- People recovering from surgery, a stroke or a hospital stay
- People living with dementia
- Children with developmental disabilities or complex medical needs
- People with a serious illness who want comfort care at home
For many families, home care also means one person no longer carries the whole load alone.
Who Provides Home Care?
Several kinds of workers provide home care. Aides help with personal care and daily routines. Nurses handle medical tasks, like wound care or medication management. Physical, occupational and speech therapists help people regain strength and skills. Social workers help families plan and find resources. In New York, any organization that provides or arranges home care must be licensed or certified by the state Department of Health.2
02Home Care vs. Home Health Care
Home care usually means non-medical help with daily living, such as bathing, dressing, meals and companionship. By contrast, home health care means skilled medical services, such as nursing and therapy, ordered by a doctor. Medicare may cover home health care for people who are homebound. Ongoing non-medical home care is usually paid through Medicaid, insurance or private funds.
The two terms get mixed up all the time, even by professionals. This difference matters because it decides who provides the care and who pays for it. Many people end up using both. A parent might get nursing visits after a fall, then keep an aide for daily tasks once the nursing ends.
A Quick Comparison
- Purpose: home care supports daily living; home health care treats an illness, injury or recovery.
- Who provides it: home care comes from aides; home health care comes from nurses and therapists, often with aides.
- Doctor's order: home care usually does not need one; home health care does.
- Length: home care can continue for years; home health care is often short-term.
- Payment: home care is often paid by Medicaid or private funds; home health care is often covered by Medicare.
03Types of Home Care
Home care is not one service. It is a range of services, from light help around the house to round-the-clock medical support. Here are the main types families come across.
Companion and Homemaker Services
Companions and homemakers help with the household side of life. That may include light cleaning, laundry, shopping, meal preparation and simple company. These services do not include hands-on personal care.
Personal Care Aides
Personal care aides help with bathing, dressing, toileting, grooming, eating and moving around the home. In New York, these aides work through licensed agencies, and registered nurses assign and supervise their work.3
Home Health Aides
Home health aides provide the same personal care. They can also help with some health-related tasks under a nurse's supervision. Families often choose this level of care for someone with a chronic condition or limited mobility.
Skilled Nursing at Home
Registered nurses and licensed practical nurses provide medical care at home. Common tasks include wound care, injections, medication management, catheter care and monitoring after a hospital stay. Skilled nursing usually needs a doctor's order.
Private Duty Nursing
Private duty nursing means longer nursing shifts at home, sometimes for many hours a day. It is often used for people with complex medical needs, like those who use a ventilator or feeding tube.
Physical, Occupational and Speech Therapy
Therapists help people rebuild strength, balance and everyday skills. Physical therapy focuses on movement. Occupational therapy focuses on daily tasks, like dressing and cooking. Speech therapy helps with communication and swallowing.
Dementia Care at Home
People living with Alzheimer's disease or another dementia often need supervision as much as hands-on help. Good dementia care keeps routines steady, reduces confusion and watches for safety risks, like wandering or leaving the stove on. Needs usually grow over time, so care plans should be reviewed often.
Respite Care
Respite care gives family caregivers a break. An aide or nurse steps in for a few hours, a day or longer. Even short breaks can help prevent caregiver burnout.
24-Hour and Live-In Care
Some people need someone present around the clock. Agencies usually handle this in one of two ways. One option is shifts, where two or three aides each cover part of the day. The other is a live-in aide who stays in the home and gets time to sleep. Which setup works best depends on how often the person needs help at night.
Care After a Hospital Stay
The weeks after a hospital discharge are a risky time. Short-term home health care can include nursing visits, therapy and aide support while a person recovers. The hospital's discharge planner usually arranges these services before the patient goes home.
Pediatric Home Care
Some children need care at home because of a developmental disability or medical condition. Pediatric home care adapts the same services to a child's routine and family life. Read more in our Pediatric Home Care guide.
Hospice and Palliative Care at Home
Palliative care focuses on comfort and quality of life during a serious illness. Hospice care is for people near the end of life. Both can be delivered at home by a team of nurses, aides, social workers and chaplains. Under Medicare, hospice teams visit on a schedule. Round-the-clock hospice care at home is provided only during short periods of crisis, such as uncontrolled pain.4
04Home Care Agencies and Workers in New York
Licensed Agencies vs. Certified Agencies
New York has two main types of home care agencies. A Licensed Home Care Services Agency (LHCSA) is licensed by the state and mostly provides personal care through aides.3 The other, a Certified Home Health Agency (CHHA), is also certified for Medicare. It provides or arranges skilled services, such as nursing, therapy, medical social work and home health aide care.5
Agencies, Registries and Private Hires
Families can get help in three main ways. An agency employs and supervises its aides, and in New York it must be licensed. A registry only connects families with workers, so the family may take on more of the employer's role. With a private hire, the family finds, pays and manages the worker directly. Each choice affects who handles training, backup coverage, taxes and liability.
Checking an Aide's Training
New York keeps a Home Care Registry. It lists home health aides and personal care aides who have completed a state-approved training program.1 Families can use it to confirm an aide's training before care starts.
05Signs a Loved One May Need Home Care
The need for help rarely shows up all at once. It builds slowly, which makes it easy to miss. Watch for changes like these:
- Trouble with bathing, dressing or using the bathroom
- Falls, near-falls or new bruises
- Weight loss, spoiled food or skipped meals
- Missed medications or doses taken twice
- Unpaid bills, piled-up mail or a messy home
- Memory slips that affect safety, like leaving the stove on
- Pulling away from friends, hobbies or routines
- A family caregiver who is exhausted or burning out
One sign is a reason to talk. Several signs together are a reason to plan. Start by speaking with the person's doctor, who can check for medical causes and suggest the right level of care.
If someone has fallen and cannot get up, has chest pain or shows signs of a stroke, call 911 right away. Home care is for ongoing support, not emergencies.
06Home Care vs. Other Care Options
Home care is one option among several. Comparing them helps families choose what fits.
Adult Day Care
Adult day programs offer supervision, meals and activities during the day, then the person returns home at night. They work well for people who are mostly safe at home but need company or supervision while family members work. In New York, the 2024 median annual cost for adult day care was $41,080.6
Assisted Living
Assisted living combines housing, meals and some personal care in a residential setting. It suits people who can no longer live alone but do not need nursing care around the clock.
Nursing Homes
Nursing homes provide 24-hour nursing care and supervision. They are usually considered when medical needs are too high to manage safely at home, even with help.
Why Many Families Start With Home Care
Most people prefer to stay in their own homes. Home care keeps them near their neighborhood, routines and family. It can also be scaled up or down as needs change, from a few hours a week to full-time help.
07How Home Care Is Paid For
Payment is often the biggest question families have. The answer depends on the type of care, the person's age and their coverage. Here are the main options for home care in New York.
Does Medicare Cover Home Care?
Medicare covers home health care, not ongoing personal care. A person must be homebound and need part-time or intermittent skilled services, such as nursing or therapy, under a doctor's plan. Medicare can then cover visits from a Medicare-certified agency, including some home health aide time. It does not cover long-term help with daily living alone.
Covered home health services are capped at up to 8 hours a day and 28 hours a week in combined skilled nursing and aide care.7 Medicare alone generally does not pay for ongoing custodial home care.8 That gap is why many New Yorkers turn to Medicaid for long-term help.
How Long Will Medicare Pay for Home Health Care?
Medicare does not set a fixed number of home health visits. Coverage can continue as long as the person stays eligible and their doctor keeps renewing the plan of care. Medicare should also cover home health care for chronic conditions, not just short-term recovery.9
How Do You Qualify for Medicaid Home Care in New York?
To get Medicaid home care in New York, a person must first qualify for Medicaid. New York City residents apply through the Human Resources Administration. Next, an independent assessor reviews their care needs. Since September 2025, most adults must need hands-on help with at least three daily activities, or supervision if they have dementia.
The state calls this rule the Minimum Needs Requirement. It applies to adults 21 and older seeking personal care services. The rule also covers anyone enrolling in a Managed Long Term Care plan.10 For people with a diagnosis of dementia or Alzheimer's, the threshold is needing at least supervision with more than one daily activity.11 The New York Independent Assessor Program (NYIAP) conducts these initial assessments for adults.12
After approval, the person receives a plan of care. It lists the type and amount of home care they are authorized to receive and when their needs will be reviewed again.8
New York City's Home Care Services Program
In New York City, the Human Resources Administration runs the Home Care Services Program. Its local offices are called CASA offices. They handle Medicaid home care for people who are not enrolled in, or eligible for, a Medicaid managed care plan. Every home care program through HRA requires Medicaid eligibility.13,14
What Is Managed Long Term Care (MLTC)?
Managed Long Term Care plans coordinate long-term services, such as home care and adult day care, for Medicaid members. To join, a person generally must be 21 or older and need community-based long-term care for more than 120 days.15 In New York City, people with both Medicare and Medicaid who meet these criteria must receive those services through an MLTC plan.15 Most MLTC members are 65 or older.15
Home Care for Older Adults Without Medicaid
New Yorkers 60 and older who need help but do not qualify for Medicaid home care may still find support. NYC Aging funds local case management agencies that assess needs and arrange services. Its home care program can cover personal care, like bathing and dressing, and housekeeping, like laundry and shopping. Medicaid recipients are not eligible for this program.16 Some services may have a sliding-scale fee based on income.17 Waitlists are common.18
Veterans Benefits
The VA's Homemaker and Home Health Aide program sends trained aides from VA-contracted agencies to help veterans at home. It can also provide respite for family caregivers. A VA clinical assessment decides eligibility, and a copay may apply depending on service-connected disability status.19 Veterans should start by talking with their VA care team or social worker.
Long-Term Care Insurance
Some long-term care policies cover home care after a waiting period. Check the policy for daily limits, lifetime maximums and which agencies qualify.
Private Health Insurance
Coverage for home care varies widely by plan. Many plans cover short-term skilled care after a hospital stay but not ongoing personal care.
Private Pay
Some families pay an agency directly. This is common for people who do not qualify for Medicaid, who need more hours than their coverage allows or who want more flexibility.
Related Study/Source: New York's Department of Health explains that Medicaid managed care plans and local social services departments contract with licensed agencies to provide Medicaid-funded personal care.10
08How Much Does Home Care Cost?
In New York, home health aide care cost a median of about $34 an hour in 2024, according to the Cost of Care Survey. At that rate, 24-hour care adds up to roughly $24,000 to $25,000 a month. Actual costs depend on location, agency, schedule and the level of care, and skilled nursing costs more.
The 2024 survey put New York's median annual cost for home health aide services at $77,792, based on 44 hours a week.6 Nationally, the median hourly rate for non-medical in-home care reached $35 in 2025. That same survey reported a national median of $90 an hour for skilled nursing at home.20
What Affects the Cost?
- Hours: a few hours a week costs far less than full-time or 24-hour care.
- Level of care: nursing costs more than aide care.
- Schedule: nights, weekends and holidays may cost more.
- Live-in vs. shifts: agencies price these arrangements differently.
- Location: rates vary across boroughs and counties.
- Minimum visits: some agencies require a minimum number of hours per visit.
For people with Medicaid, approved home care hours are covered by Medicaid rather than paid out of pocket.
09How to Choose a Home Care Agency
Choosing an agency is a big decision. The right one makes daily life easier. A poor fit adds stress. Some homework up front helps.
What to Check First
- The agency's license or certification with the New York State Department of Health. You can look it up on the state's Home Care Agency Profiles website.2
- Whether it accepts your coverage, such as your Medicaid or MLTC plan.
- Whether it serves your borough or county.
- Whether it offers the type of care you need, such as personal care, nursing or therapy.
Questions to Ask Any Home Care Agency
- How do you screen and train your aides?
- Who supervises the aides, and how often do supervisors visit?
- Will we have the same aide most of the time?
- What happens if an aide calls out sick?
- How do you handle complaints or a change of aide?
- Which languages do your aides speak?
- Do your aides have experience with conditions like dementia or limited mobility?
Red Flags to Watch For
- Pressure to sign up quickly
- Vague answers about licensing or supervision
- Promises that sound too good to be true, like guaranteed hours before an assessment
- Requests to pay in cash with no paperwork
- No clear way to reach a supervisor after hours
If Something Goes Wrong
Families can report concerns about a home care agency or hospice to the New York State Department of Health. The complaint line is 1-800-628-5972.1
10How to Get Started in New York City
The path depends on the type of care and how it will be paid for. For most families, the steps look like this.
- Talk with the person's doctor about their needs and whether skilled care is required.
- Check coverage. Medicare may cover home health care. Medicaid covers most long-term home care.
- If Medicaid is needed, apply through the Human Resources Administration in New York City or your county's Department of Social Services elsewhere.8
- Complete the needs assessment with the New York Independent Assessor Program.
- Choose a plan or agency, then review the plan of care with them.
- If the person is 60 or older and does not qualify for Medicaid, contact NYC Aging about case management and home care.
Keep notes from every call. Write down names, dates and what each person told you. It sounds small, but it helps a lot when questions come up later.
About City Choice Home Care Services
City Choice Home Care Services publishes this guide. It is a Licensed Home Care Services Agency (LHCSA) based in Brooklyn, New York. The New York State Department of Health first licensed the agency in October 2005.21
The agency provides long-term personal care at home through home health aides. Aides help with daily needs such as bathing, dressing, toileting, meals, mobility and supervision. City Choice Home Care Services also provides pediatric home care and is an OPWDD-approved provider.
Its licensed service area covers The Bronx, Brooklyn, Manhattan, Queens, Staten Island and Westchester County.21 The office is at 2719 Coney Island Avenue, 2nd Floor, Brooklyn, New York 11235. Like any agency in this guide, its license can be checked on the state's Home Care Agency Profiles website.2
To talk about home care for a loved one, call City Choice Home Care Services at 718.645.1116 or contact the team online.
11Frequently Asked Questions
Who qualifies for home health care under Medicare?
People with Medicare who are homebound, need part-time or intermittent skilled care and are under a doctor's plan of care may qualify. Care must come from a Medicare-certified agency.7
Does hospice cover 24-hour care at home?
Usually not. Hospice teams make scheduled visits. Medicare covers continuous care at home only during short crises, when a person needs at least 8 hours of mostly nursing care in a day.4
Can you get home care without Medicaid in New York City?
Yes. Options include Medicare home health care, long-term care insurance, VA benefits, private pay and, for people 60 and older, NYC Aging's home care program.16,19
Is home care only for seniors?
No. Home care serves adults with disabilities, people recovering from illness or surgery, children with complex needs and people at the end of life.
How quickly can home care start?
It depends on the route. Private pay care can often start quickly. Medicaid home care takes longer, because Medicaid eligibility and the needs assessment must be completed first.
References
1. New York State Department of Health. Home care: information for consumers. Accessed November 3, 2026. https://healthweb-back.health.ny.gov/facilities/home_care/consumer.htm
2. New York State Department of Health. Home care agency profiles. Accessed November 3, 2026. https://profiles.health.ny.gov/home_care/
3. Dutchess County Office for the Aging. Help at home. Accessed November 3, 2026. https://www.dutchessny.gov/Departments/Aging/Office-for-the-Aging-Help-at-Home.htm
4. Centers for Medicare & Medicaid Services. Coverage of continuous home care under the Medicare hospice benefit (Transmittal A-03-016). Accessed November 3, 2026. https://cms.hhs.gov/regulations-and-guidance/guidance/transmittals/downloads/a03016.pdf
5. Ontario County, New York. Certified and licensed home care agencies. Accessed November 3, 2026. https://www.ontariocountyny.gov/1229/Certified-and-Licensed-Home-Care-Agencie
6. Genworth and CareScout. Cost of long-term care in New York: 2024 Cost of Care Survey. Business Wire. March 2025. Accessed November 3, 2026. https://www.businesswire.com/news/home/20250301314393/en/
7. Centers for Medicare & Medicaid Services. Home health services. Medicare.gov. Accessed November 3, 2026. https://www.medicare.gov/coverage/home-health-services
8. The Legal Aid Society. Medicaid home care. Accessed November 3, 2026. https://legalaidnyc.org/?p=59629
9. SHIP National Technical Assistance Center. Medicare and home health care. Accessed November 3, 2026. https://www.shiphelp.org/medicare-and-home-health-care/
10. New York State Department of Health. Personal Care Services Program (PCS). Accessed November 3, 2026. https://healthweb-back.health.ny.gov/health_care/medicaid/program/longterm/pcs.htm
11. LeadingAge New York. State initiates implementation of revised minimum needs requirement for personal care services and MLTC eligibility and enrollment. July 1, 2025. Accessed November 3, 2026. https://www.leadingageny.org/providers/managed-long-term-care/managed-long-term-care/state-initiates-implementation-of-revised-minimum-needs-requirement-for-personal-care-services-and-mltc-eligibility-and-enrollment/
12. New York State Department of Health. New York Independent Assessor Program: Medicaid managed care plan training. December 2025. Accessed November 3, 2026. https://healthweb-back.health.ny.gov/health_care/medicaid/redesign/mrt90/2025/docs/nyiap_mmcp.pdf
13. NYC311. In-home health care services. Accessed November 3, 2026. https://portal.311.nyc.gov/article/?kanumber=KA-02782
14. ACCESS NYC. Home Care Services Program (HCSP). Accessed November 3, 2026. https://access.nyc.gov/programs/home-care-services-program
15. New York State Department of Health. Managed Long Term Care frequently asked questions. Accessed November 3, 2026. https://healthweb-back.health.ny.gov/health_care/medicaid/redesign/mltc_faq2_final.htm
16. NYC Aging. In-home services. Accessed November 3, 2026. https://www.nyc.gov/site/dfta/services/in-home-services.page
17. New York Foundation for Senior Citizens. Case management program. Accessed November 3, 2026. https://www.nyfsc.org/?p=6
18. New York City Council. NYC Aging case management services report, July 1 to December 31, 2025. Accessed November 3, 2026. https://council.nyc.gov/budget/wp-content/uploads/sites/54/2026/06/Department-for-the-Aging-Case-Management-Services-Report-1-of-2-PDF-3.pdf
19. U.S. Department of Veterans Affairs. Homemaker and home health aide care. Accessed November 3, 2026. https://www.va.gov/GERIATRICS/pages/Homemaker_and_Home_Health_Aide_Care.asp
20. CareScout. Cost of Care Survey 2025. Accessed November 3, 2026. https://www.carescout.com/cost-of-care
21. New York State Department of Health. Health Facility Information System: City Choice Home Care Services (facility ID 12825), via OpenGovNY. Accessed November 3, 2026. https://opengovny.com/health-facility/12825