Harbor Care

Loved one being cared for

Homecare in New York, Do I Qualify?

Navigating the world of home care services can be daunting, especially when it comes to understanding eligibility requirements. In New York, qualifying for home care services, whether traditional home health aide or the CDPAP program, involves several key steps and considerations. Here we will guide you through the steps needed to ensure you are eligible to receive the care you need.
Medicaid coverage: Most long-term care or non-skilled home care is funded by Medicaid insurance. To qualify for Medicaid, your income must be below a certain threshold. With that said, if your income is above the threshold, speak to a Medicaid enrollment expert, because there are options to structure your finances in order to qualify.
Assessment by New York Independent Assessor (NYIA): The first step in qualifying for home care services in NY is an assessment by the NYS assessment team, an independent team of healthcare professionals contracted by Medicaid. This assessment will evaluate your health condition and determine the level of care you require. It’s crucial to have a comprehensive evaluation to ensure you receive the appropriate care for your needs.

Often the assessment can be conducted remotely via Zoom.

What does the assessment entail?: Home care services are typically provided to individuals who have a medical need for skilled nursing care, therapy, or Activities of Daily Living (ADLs). ADLs include tasks such as bathing, dressing, eating, and moving around. If you require assistance with these tasks due to a physical or cognitive impairment, you may be eligible for home care services.
Insurance Coverage: Insurance coverage is another important factor in qualifying for home care services. Most home care and CDPAP patients are covered by a Managed Long Term Care plan (MLTC), however sometimes your HMO plan can cover health care as well. You will enroll in an MLTC plan, which will approve a certain amount of weekly hours
Development of a Care Plan: Once you’ve been assessed and deemed eligible for home care services, a care plan will be developed. This plan approves your weekly hours allotted, and outlines the services you’ll receive, how often you’ll receive them, and who will provide them. It’s important to be involved in the development of this plan to ensure it meets your needs.

CONGRATULATIONS! You’re ready to begin services!

Navigating the qualification process for home care services in New York can be complex, but understanding the criteria outlined above can help streamline the process. Here at Harbor Care, we stand ready to help ensure you meet the essential eligibility criteria for accessing home care services. Additionally, we offer comprehensive assistance and resources to ensure that you have all the information and support you need to make informed decisions about the care you will receive. From clarifying eligibility requirements to providing guidance on selecting the right caregiver, we’re here to empower you with the knowledge and tools necessary to navigate the home care journey successfully.
To get started call 718-500-3743