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Medicaid Home Care is for eligible people who need assistance with the Activities of Daily Living (“ADLs”) but who otherwise can remain safely in their own homes. ADLs include dressing, bathing, eating, toileting, and “transferring” (moving from one place to another such as from your bed to a chair). Medicaid is also health insurance for eligible people if they don’t have Medicare.

If you are financially eligible and have been approved for Medicaid, there is a specific process that must be followed. First, to determine whether you need services, you must have a “Conflict-Free Evaluation,” conducted by a New York State Department of Health subcontractor called Maximus NYMC (New York Medicaid Choice). If Maximus determines that you need services that Medicaid covers, your next step is to choose a Managed Long Term Care (MLTC) agency. The agency will evaluate you and pre-qualify you for a certain number of hours of care, depending on what services you need. You can apply to more than one MLTC if you wish, since each MLTC might evaluate your needs differently. Once you have a determination from one or more MLTCs, you can choose to enroll with the one you prefer.

Financial eligibility for Medicaid is a complex topic, because it takes into account various factors such as your age, marital status, any assets you hold singly or with others, and sometimes your income. What is remarkable is that, for Community Medicaid in New York, it is usually possible to become eligible quickly. To find out if this is possible for you, click here to learn more about the rules that apply to your specific situation.

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