Applying for Medicaid home care in NYC: a step-by-step checklist

The forms, the phone calls and the order they happen in, from the HRA application to your first aide visit.

Updated November 5, 2026 · Reviewed by Ettrick M. Campbell, Esq.

Getting Medicaid to pay for home care in New York City happens in three stages: get Medicaid, get assessed, then get a plan. Here's the order, and what you need for each.

Stage 1: Get Medicaid with home care coverage

  • No Medicaid yet? Apply with the Access NY application (DOH-4220) through HRA.
  • Already on Medicaid but without long-term care? File Supplement A (DOH-4495A) to add home care coverage.

Gather before you apply:

  • Photo ID and proof of age (passport, birth certificate)
  • Social Security card and Medicare card
  • Proof of NYC address (lease, utility bill)
  • Proof of all income: Social Security letter, pension statements, rental income
  • Recent bank statements for every account
  • Life insurance, burial fund and property papers
  • Immigration documents (green card, I-94, other status papers), if not a U.S. citizen
  • If over the income limit: pooled income trust enrollment papers

Stage 2: Get assessed by the New York Independent Assessor (NYIA)

Once Medicaid is approved, call NYIA at 855-222-8350. NYIA won't schedule while the Medicaid application is still pending.

  1. Community Health Assessment: a nurse reviews what help is needed.
  2. Clinical appointment: a clinician completes the Practitioner's Order.

Both appointments must be scheduled and completed within 14 days of your call. Either one can be in person or by video. Have the doctor's letter and recent medical records ready. Results are good for 12 months.

The bar is higher since September 1, 2025. New applicants for home care through an MLTC plan must need help for more than 120 days, and must meet one of these:

  • need hands-on help with more than two daily activities, such as bathing, dressing, toileting or moving around; or
  • have a diagnosis of dementia or Alzheimer's and need supervision with more than one daily activity.

Stage 3: Enroll in a plan and start care

  • If you have Medicare and Medicaid, you'll usually join a Managed Long Term Care (MLTC) plan. See our MLTC guide.
  • Enrollment paperwork received by the 18th of a month starts coverage the 1st of that month. After the 18th, coverage starts the 1st of the next month.
  • The plan sets your hours. You can choose an agency aide, or CDPAP to have a family member paid.

Need care urgently?

NYC has an immediate need process for people who need care right away and can't wait for the normal steps. The request goes to HRA's Home Care Services Program, not to NYIA. It needs these forms:

  • a medical request signed by the doctor;
  • an attestation of immediate need;
  • the Medicaid application.

If you're denied or get too few hours

You have 60 days to ask for a fair hearing. Ask for the hearing in writing and keep copies of everything.

General information, not legal advice. Process details from Legal Services NYC and NYS Department of Health guidance (2025). Confirm current forms with HRA before filing.

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