NYC Senior Home Care Services: How to Apply for CDPAP, Home Attendant, and Caregiver Cost Assistance
As we age, needing a little extra help with daily life is entirely natural. But for many older adults and their families, moving into a nursing home isn’t the first choice — staying in a familiar home, with the right support, is. The good news is that New York State offers a range of home care programs that allow eligible seniors to receive professional assistance at home, often at little or no cost.
One program in particular has become especially popular among immigrant communities and families: CDPAP, which allows a family member to be hired and paid as the caregiver. In this guide, we’ll walk through the types of home care available in New York, how to apply, and what financial assistance programs exist to cover the cost.
📋 Table of Contents
What Is Home Care?
Home care services in New York State are designed to help older adults and people with disabilities live safely and independently in their own homes. Rather than transitioning to a nursing facility, eligible individuals can receive the assistance they need right where they live — a strong preference for most seniors and their families.
Home care typically covers help with daily activities such as personal hygiene, meal preparation, light housekeeping, medication reminders, and mobility assistance. Through Medicaid, New York State funds these services for eligible individuals at little or no out-of-pocket cost.
CDPAP — Consumer Directed Personal Assistance Program
How CDPAP Works
CDPAP (Consumer Directed Personal Assistance Program) is a unique New York State Medicaid program that gives you — the care recipient — direct control over who provides your care. Unlike traditional home care, where an agency assigns a caregiver to you, CDPAP lets you choose and direct your own personal assistant. Crucially, that person can be a family member or trusted friend — and they get paid by Medicaid for their work.
- Hire family: You can hire a family member (except your spouse) as your paid personal assistant
- You’re in charge: You set the schedule, direct the tasks, and manage your own care
- No certifications required: Your caregiver doesn’t need to be a licensed HHA or PCA — just 18 or older and legally authorized to work in the U.S.
- Paid through Medicaid: Caregivers are paid every two weeks via direct deposit or payment card. As of January 1, 2026, pay rates start at $18.65/hour in most counties, with higher rates in NYC metro counties
- Statewide fiscal intermediary: Since 2025, all CDPAP services in New York are administered through Public Partnership LLC (PPL) as the single statewide fiscal intermediary, handling payroll, taxes, and employment records for all personal assistants
CDPAP Eligibility Requirements
To qualify for CDPAP, you must meet all of the following:
- Be enrolled in or eligible for New York State Medicaid
- Have a physician’s order confirming that home care is medically necessary
- Be able to direct your own care, or have a designated representative who can do so on your behalf
- Not require nursing home-level care
Home Attendant Services
Home attendant services are delivered through a licensed home care agency. Unlike CDPAP, the agency selects and manages the caregiver on your behalf. This is a good option for those who prefer not to take on the administrative responsibilities that come with CDPAP.
Services Provided by a Home Attendant
| Service Type | What It Includes |
|---|---|
| Personal hygiene | Bathing, dressing, oral care, grooming, and toileting assistance |
| Meals | Meal preparation, feeding assistance, and nutrition support |
| Mobility | Moving around the home, escorting to appointments, wheelchair support |
| Light housekeeping | Cleaning, laundry, and grocery shopping |
| Health support | Medication reminders and accompanying to medical appointments |
CDPAP vs. Home Attendant — Key Differences
- Who chooses the caregiver: CDPAP — you do; Home Attendant — the agency does
- Who manages the caregiver: CDPAP — you do; Home Attendant — the agency does
- Can family be hired: CDPAP — yes (except spouse); Home Attendant — no
- Flexibility: CDPAP offers more flexibility but also more responsibility
Caregiver Cost Assistance Programs
New York State covers home care costs in full through Medicaid for those who qualify. If you don’t currently have Medicaid, other programs may still help.
Medicaid Home Care Coverage
Medicaid-enrolled individuals receive home care services at no cost. Once approved, a set number of hours per week is authorized based on your assessed needs — this can be adjusted over time as needs change.
Other Financial Assistance Options
- Veterans Benefits: Veterans may be eligible for caregiver support through the VA’s Aid and Attendance program
- Long-Term Care Insurance: If you have a private long-term care policy, it may cover home care costs
- Community Services for the Elderly: Local senior centers and nonprofits offer free or reduced-cost assistance programs
- Sliding Scale Programs: Some agencies adjust fees based on income for those who don’t qualify for Medicaid
How to Apply — Step by Step
Step 1: Apply for Medicaid
To receive home care at no cost, you’ll first need to establish Medicaid eligibility. New York State Medicaid is available to seniors who meet income and asset requirements. You can apply online through the ACCESS HRA portal, visit your local Medicaid office, or call to apply by phone.
Step 2: Get a Medical Assessment
Visit your primary care physician to obtain a doctor’s order confirming that home care is medically necessary. Your doctor will assess your health status and the level of support you require.
Step 3: Choose Your Program
Decide between CDPAP and traditional Home Attendant services. If you have a family member or trusted friend who can serve as your caregiver, CDPAP is generally the more flexible and personally empowering option.
Step 4: Contact an Agency or PPL
Reach out to a home care agency or, for CDPAP, contact PPL directly to begin enrollment.
📌 All CDPAP services in New York State are now managed exclusively through Public Partnership LLC (PPL) as the statewide fiscal intermediary. To register or get help, call PPL at 1-833-247-5346 or visit pplfirst.com. Multilingual support is available.
Step 5: In-Home Assessment & Approval
A nurse from your Managed Long-Term Care (MLTC) plan will visit your home to assess the level of care needed and determine how many hours per week will be authorized. Once Medicaid approves the plan, services can begin.
Eligibility Requirements
General Eligibility Criteria
| Requirement | Details |
|---|---|
| Residency | Must be a New York State resident |
| Insurance | Must be enrolled in or eligible to apply for Medicaid |
| Medical necessity | Doctor must confirm need for assistance with daily activities |
| Living situation | Must be able to safely receive care at home |
| Age | Generally 60 or older; those with disabilities may qualify at any age |
Medicaid Income & Asset Limits (2026)
Current New York State Medicaid eligibility thresholds for 2026:
- Individual monthly income limit: $1,732
- Individual asset limit: $31,175
- Married couples: Higher income and asset limits apply
📌 Important — 2026 Look-Back Period: As of January 1, 2026, New York State has implemented a 30-month look-back period for Community Medicaid (home care). This means that any assets transferred within the 30 months prior to your Medicaid application will be reviewed. If transfers are found, a penalty period may delay your eligibility. It is strongly recommended to consult with a Medicaid planning professional before applying if you have made any asset transfers.
Resources & Contact Information
Key Contacts
- NYC Department for the Aging (DFTA): (212) 244-6469
- Medicaid Helpline: (800) 541-2831
- PPL CDPAP Support Line: 1-833-247-5346 (multilingual support available)
Official Online Resources
- New York State Department of Health — Medicaid Long-Term Care Services
- NYC Department for the Aging (DFTA)
- PPL — NY CDPAP Program Information & Registration
Documents to Prepare When Applying
- Government-issued photo ID (driver’s license or state ID)
- Social Security card
- Proof of income (Social Security award letter, pension statements, etc.)
- Bank statements showing current assets
- Medical records and physician’s order for home care
- Medicaid card (if already enrolled)
📝 Key Takeaways
New York’s home care programs are among the most comprehensive in the country, offering real options for seniors who want to remain at home with proper support.
CDPAP is ideal for families who want to hire someone they already trust — including a son, daughter, or close friend — and have Medicaid pay them. Home Attendant services are a strong alternative for those who prefer a professionally managed arrangement through an agency.
If you have Medicaid, these services are available to you at no cost. The process follows five steps: apply for Medicaid → get a doctor’s order → choose your program → contact PPL or an agency → complete the in-home assessment.
For personalized help, contact the NYC Department for the Aging at (212) 244-6469 or PPL at 1-833-247-5346 — both offer multilingual support.
This article is for informational purposes only. Medicaid eligibility requirements, income limits, and program details are subject to change. Please consult a qualified Medicaid planning professional or contact the relevant agency directly for personalized guidance.