Does Medicaid pay for assisted living in New York?
Only through the Assisted Living Program. The state Health Department describes the ALP as a program that serves people who are medically eligible for nursing home placement in a less medically intensive, lower-cost setting. It is offered by an adult home or an enriched housing program that has been approved to run one.
That distinction is the source of most wasted phone calls. “Assisted living” in New York is a licensing category for private residences, many of which charge monthly fees with no Medicaid involvement. “Assisted Living Program” is a Medicaid-funded service package that only some of those buildings provide. A residence can be licensed as assisted living and have no ALP; a plain adult home with shared dining can have an ALP and accept Medicaid.
The question that sorts them in one call: “Is this building approved as an Assisted Living Program, and do you take residents whose care is paid by Medicaid?” If the answer is no, the residence may still be the right fit for someone paying privately, but Medicaid will not cover it.
Adult homes, assisted living residences and ALPs compared
The Health Department licenses several kinds of residences. They look similar from the street and differ in who pays.
| Type | What it provides | Medicaid role |
|---|---|---|
| Adult home | Room, board, housekeeping, personal care and supervision for five or more adults | None for the housing; may host an ALP |
| Enriched housing program | Similar services in apartment-style units, mainly for people 65 and older | None for the housing; may host an ALP |
| Residence for adults | Room, board, case management and supervision | None for the housing |
| Assisted living residence (ALR) | A licensed adult care facility offering assisted living | Generally private pay unless it also runs an ALP |
| Enhanced ALR | Lets residents age in place, for example those who need another person’s help to walk | Generally private pay |
| Special needs ALR | Services for people with dementia or cognitive impairment | Generally private pay; the state runs a separate voucher program for some residents with dementia |
| Assisted Living Program (ALP) | Adds nursing, aides, therapy and nurse case management inside an adult home or enriched housing | Medicaid pays the services for eligible residents |
None of these settings is licensed to give the continual medical or nursing care that a nursing home provides. When that need appears, the resident moves on. What a nursing home costs in New York City.
Who qualifies for the Assisted Living Program
The Health Department’s eligibility rule has two sides. On one side, a resident, whether on Medicaid or paying privately, must be medically eligible for and would otherwise need nursing home placement because they lack a home or a suitable home environment. On the other, the resident must not require continual nursing care, must not be chronically bedfast, and must not be so impaired that they endanger other residents.
In plain terms the ALP fits a narrow middle: someone who cannot safely live alone and needs daily hands-on help and some nursing oversight, but who can walk to a dining room or use a wheelchair, sleep through the night with supervision, and live among other residents.
The ALP assesses each resident at admission and periodically after that. On top of the medical test, a Medicaid resident needs Medicaid in a category that covers community-based long-term care, which for people 65 and older or with a disability is handled by HRA in New York City, and the local district’s advance approval of ALP services.
| Your situation | Likely route |
|---|---|
| Lives alone, unsafe at home, needs daily help, no continual nursing | ALP, if a bed is available |
| Has a safe home and family nearby | Home care through an MLTC plan or CDPAP |
| Needs nursing around the clock or is bedfast | Nursing home |
| Under 65 with a physical disability or a brain injury, wants to live in the community | NHTD or TBI waiver, subject to enrollment caps |
What Medicaid pays for inside an ALP
The Health Department lists what an ALP provides: personal care, room, board, housekeeping, supervision, home health aides, personal emergency response, nursing, physical, occupational and speech therapy, medical supplies and equipment, adult day health care, a range of home health services, and case management by a registered nurse.
For a Medicaid resident, the Medicaid payment covers the care services in that list. The room and board portion is paid from the resident’s own income. That is the split behind the existing advice on this site that Medicaid reaches assisted living “partially, and not for the housing itself.” Long-term care in New York.
Doctors, hospital care and prescriptions stay with the resident’s regular coverage, usually Medicare plus Medicaid for someone who is dual eligible.
How room and board is paid: the SSI rate
Most low-income adult home residents pay room and board with Supplemental Security Income at the Congregate Care Level 3 rate, the state’s SSI category for adult homes and enriched housing. LeadingAge New York, the trade association for these providers, summarized the state’s 2026 chart:
| 2026, Congregate Care Level 3 | Monthly amount |
|---|---|
| Federal SSI | $994 |
| New York State supplement | $694 |
| Total benefit | $1,688 |
| Personal needs allowance the resident keeps | $262 |
| Left for the facility | $1,426 |
Someone with income above the SSI level pays room and board from that income, at a rate the residence sets. Ask for the monthly room and board charge in writing, and what is left to you after it. For comparison, the state’s 2026 average private-pay nursing home figure for New York City is $15,282 a month, which is why a placement in an ALP, when it fits, matters so much to a family’s finances.
How to find and apply for an ALP in New York City
- Get Medicaid in place first, through HRA for people 65 and older or with a disability. If income is over the limit, ask about a pooled income trust.
- Find buildings with an ALP. The NYS Health Profiles site lists adult care facilities; call each one and ask the ALP question by name.
- Contact the ALP directly. The Health Department says private payers and Medicaid recipients may apply to the ALP themselves. The ALP does the initial assessment.
- Get the local district’s approval of ALP services for a Medicaid resident before the move, and ask the ALP who submits the request.
- Read the admission agreement, including the room and board rate and the personal needs allowance, before signing.
Transfers, the look-back and the ALP
The ALP counts as community-based long-term care, not nursing home care. It appears on the state’s list of services that a 30-month look-back would apply to once that rule starts. The 2020 law has not been put into operation: as of February 2026 it still needed federal approval and had no start date. For now, the 60-month nursing home look-back is the one that applies, and it matters if a later nursing home application follows. How the look-back works.
If something goes wrong
Complaints about an adult home, an assisted living residence or an ALP go to the Health Department’s Centralized Complaint Intake Program at 1-866-893-6772, weekdays 8:30 a.m. to 4:45 p.m., with voicemail after hours. The state’s Long Term Care Ombudsman Program advocates for residents. A denial of Medicaid coverage or of ALP services is appealable at a fair hearing.
Questions people ask
Does Medicaid cover assisted living in New York?
Only through the Assisted Living Program, which operates inside certain adult homes and enriched housing programs. Medicaid pays for the care services; the resident pays room and board, usually from SSI or other income.
What is the Assisted Living Program in NY?
A Medicaid-funded package of personal care, aides, nursing, therapy, supplies and nurse case management for people who are medically eligible for a nursing home but can live in a less intensive setting.
How do I find assisted living that accepts Medicaid in NYC?
Ask each adult home or residence whether it is approved as an Assisted Living Program and has an open bed for a Medicaid resident. The NYS Health Profiles site lists licensed adult care facilities.
How much does a Medicaid resident pay in an ALP?
Room and board from income. A resident on SSI at the 2026 Congregate Care Level 3 rate receives $1,688 a month, keeps $262 for personal needs, and the rest goes to the residence.
What is the difference between an adult home and assisted living?
Both are licensed adult care facilities. Assisted living residences carry an additional license, and enhanced and special needs versions serve residents with more needs. Medicaid reaches either only if the building runs an ALP.
Can I move from an ALP to a nursing home later?
Yes. An ALP cannot keep a resident who needs continual nursing care or is chronically bedfast. When that happens, the resident moves to a nursing home, and Medicaid’s institutional rules apply.
Sources
- NYS Department of Health, Assisted Living Program (ALP) (checked 2026-11-03)
- NYS Department of Health, Adult Care Facility services (adult homes, enriched housing, residences for adults, ALR, EALR, SNALR, ALP) (checked 2026-11-03)
- NYS Department of Health, Adult Care Facilities and Assisted Living (complaint intake, resources) (checked 2026-11-03)
- LeadingAge New York, State publishes SSI benefit chart for 2026, including rates for adult care facilities (checked 2026-11-03)
- NYS Department of Health, 30-month lookback for community based long term care services, 1115 waiver amendment request (checked 2026-11-03)
- NYS Department of Health, GIS 25 MA/14: Medicaid regional rates for 2026 (checked 2026-11-03)
More in Medicaid in New York: Who Qualifies, How to Apply, How to Keep It
- Pooled Income Trusts in New York: Keeping Medicaid Without Spending Down — A pooled income trust lets a New Yorker over the Medicaid income limit keep coverage, and the money still pays rent and food. How it works, and what it costs.
- Medicaid Home Care in New York: The Four Routes and Which One You Are In — Medicaid home care in New York covers four arrangements: personal care, CDPAP, home health and Managed Long Term Care. Your hours come from an assessment.
- NYC Medicaid Managed Care Plans Compared: All Seven Plans, State Quality Ratings and How to Choose — Seven Medicaid managed care plans serve all five NYC boroughs. Compare state star ratings, member counts and phone numbers, then choose by your own doctors.
This page explains how the system works. It is not medical advice. More.