The Empire State is one of the largest U.S. states by population. New York serves as home to over 19 million individuals, around half of whom live in the greater New York City area. Outside of the concrete jungle, the landscape is dotted with forests, rural communities and smaller cities, creating a unique dichotomy of lifestyles.

Just over 16% of the New York state population is over age 65, equating to 3.1 million residents. As the baby boomer generation continues to age, the number of seniors is growing as well; over the last decade, the population of seniors has risen 26%. Unfortunately, as a state with one of the highest costs of living anywhere in the nation, New York seniors can expect to pay more than the national average for senior living care. With Senior  living facilities averaging $4,630 per month, and some areas going far beyond this, calling New York home in retirement isn’t always affordable.

For seniors who need support, however, numerous programs provide a way to save money on senior living. This guide offers an overview of senior living in New York state, including costs of care, financial resources and local programs that can help seniors.

The Cost of Senior Living in New York

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Genworth’s 2021 Cost of Care Survey shows that institutional care in New York is exceedingly costly compared to the national average and the Empire State’s three other long-term care options. Nursing home care is the most expensive option, as it provides 24-hour skilled care and other necessary health care services.

The nursing home care average cost of $12,775 per month is nearly triple the cost of assisted living, at $4,580, and more than quadruple of the independent living average, which is the most affordable at $2,977. Some skilled nursing facilities also have specialized dementia care units, but memory-impaired seniors who do not require around-the-clock medical attention may benefit from community-based memory care, which costs $5,725 per month.

The Cost of Assisted Living in New York

New York’s average assisted living cost of $4,580 per month is comparable to the national average of $4,580. The most affordable neighboring state is Pennsylvania, at $4,100, which is nearly $500 cheaper than New York. All other bordering states are more expensive than New York, with Connecticut and Vermont costing over $5,000. Assisted living costs in New Jersey and Connecticut are in the $6,500 range, saving older New Yorkers almost $2,000 monthly.

The Cost of Nursing Home Care in New York

The monthly cost of nursing home care in New York is $12,775 for semiprivate accommodations, which is nearly $4,900 more than the national average of $7,908 and comparable to Massachusetts at $12,623. New York is about $1,000 more affordable than Connecticut, which is the most expensive neighboring state for nursing home care at $13,764 per month. Vermont and Pennsylvania have nursing home care costs close to $10,500, saving older New Yorkers over $2,000 monthly. New Jersey is also considered less expensive at $11,254.

Can You Use Medicaid to Pay for Senior Living in New York?

New York has several Medicaid programs that pay for long-term care services at home, in nursing facilities and nonmedical residential care settings. These programs include the state plan, specific Medicaid waivers for home and community-based care and managed long-term care plans, which provide expanded health care coverage. They do not cover independent living arrangements, but independent seniors with regular Medicaid may still receive their usual health care services.

Because most of New York’s Medicaid programs allocate greater funding for in-home supports and nursing home care, they currently provide limited coverage for long-term care in residential care settings. These community-based establishments are called adult care facilities (ACFs), and they include those that provide assisted living and memory care.

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Partial to Full	Medicaid and Medicaid Extended Coverage	No for MedicaidYes for MEC
Independent Living	None	N/A	N/A
Memory Care	Partial to Full	Medicaid and Medicaid Extended Coverage	No for MedicaidYes for MEC
Nursing Home Care	Full	Medicaid and Medicaid Extended Coverage	Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” participant caps could be in place and there may be a waiting list.

Medicaid’s Coverage of Assisted Living & Memory Care in New York

The Empire State currently has one Medicaid program for assisted living and memory care in select adult care facilities, particularly adult homes and enriched housing programs. In addition to Medicaid, the NYS Department of Health also has a Medicaid Extended Coverage program that’s combined with private long-term care insurance.

Assisted Living Program

ALP pays for assisted living services provided in contracted adult homes and enriched housing programs. It covers the costs of room and board, personal care and supervision, home health care and case management services. Its scope of service also includes limited nursing services, physical, occupational and speech therapies, as well as medical supplies and equipment. Because it’s not an entitlement program, ALP accommodates a limited number of participants (mostly Medicaid recipients and some private-pay enrollees).

For an initial request for ALP admission, an applicant shall directly approach a participating ALP provider of choice. An eligible ALP participant must be at risk of nursing home placement as determined through the provider’s nursing assessment using the Patient Review Instrument (PRI), a screening tool by the NYS Department of Health. The local Department of Social Services (DSS) office determines the applicant’s financial eligibility. To find an ALP provider, filter this list of ACFs to include only those with ALP beds in the “Assisted Living Program beds” column.

NYS Partnership for Long-Term Care

For New Yorkers who wish to prepare financially for long-term care while protecting their assets, NYSPLTC may be a sound option. This DOH program combines both private long-term care insurance and Medicaid Extended Coverage to pay for services provided at home and in participating residential care and nursing facilities. When a policyholder’s care needs are extended beyond the policy’s coverage period, they may apply for MEC for continued coverage without having to spend down.

There are several Partnership plans to choose from, each differing in their minimum coverage periods for different care types and their daily benefit amounts. Unlike with the program’s Total Asset Protection Plans, the Dollar-for-Dollar Asset Protection Plans are subject to Medicaid resource and income allowances. Interested individuals may contact the NYSPLTC unit at (518) 474-0662 or (866) 950-7526 or via [email protected] for more information about the program and to apply for available policies.

Medicaid’s Coverage of Nursing Home Care in New York

To receive long-term care in the home, an adult day health care center or a nursing facility, a dual-eligible senior must enroll in an MLTC plan. Dual-eligible seniors are those who are qualified for both Medicaid and Medicare. MLTCs are mandatory for those requiring long-term care services for over 120 days, including those determined eligible for permanent nursing home placement. The three available MLTC plan options all include nursing home care coverage:

• MLTC Medicaid plan (separate from Medicare to retain existing doctors/services)
• Medicaid Advantage Plus plan (manages both Medicaid and Medicare services)
• Program of All-Inclusive Care for the Elderly (PACE)

If an individual enrolling in MLTC does not select a plan, the county’s local Medicaid program may select for that client. Applicants shall undergo PRI assessments to determine their functional and medical eligibility. Interested low-income seniors who are not dual-eligible but require long-term care may also voluntarily apply for MLTC. For those who do not meet the financial and/or care duration criteria, New York’s Medicaid state plan and Partnership for Long-Term Care are available programs that also cover nursing home care.

Eligibility for Medicaid in New York

Low-income older New Yorkers who meet the maximum income and resource requirements below (as of 2022) are qualified under NYS Medicaid’s non-MAGI (Modified Adjustment Group Income) eligibility group. Those who might not meet the resource limits may opt to spend down through the Excess Income Program.

	Income Limits*	Asset Limits
Single Person	$934	$16,800
Two-Person Household(Only one applicant)	$934	$16,800
Two-Person Household(Two applicants)	$1,367	$24,600

*per year

New York seniors must also satisfy the following criteria:

• Be aged 65 or older or certified blind or disabled
• Be U.S. citizens or permanent residents in New York
• Be Medicare-enrolled or also applying for Medicare if earning up to 120% of the federal poverty level

Applying for Medicaid in New York

Seniors applying for Medicaid long-term care programs in New York may use one of the following options:

• Call, visit or email a Local Department of Social Services (LDSS) county office.
• Complete the printable Medicaid application form for older adults and Supplement A (for those chronically ill or in need of nursing home care), if applicable, and mail it to a county LDSS.
• Contact a Managed Care Organization or New York Medicaid Choice if applying for a Medicaid health plan.
• Call Medicaid Helpline at (800) 541-2831 or TTY (877) 898-5849 for free information and assistance.

Before You Apply

The following details and documents shall be provided by seniors 65+ who are applying for New York State’s Medicaid:

• Valid Social Security numbers
• Medicare card or proof of application for Medicare
• Proof of age (e.g. birth certificate) if not verifiable by SSA
• Proof of current address (e.g. recent rent receipts, mailed statements, etc.)
• Proof of citizenship or immigration status
• Proof of income from sources such as retirement benefits, SSI, VA benefits, etc.
• Asset/resource documents (e.g. bank accounts, insurance policies, investments, etc.)

How to Get Help

Alternative format forms are available to those who need large-print, screen-reader-accessible and audio transcription versions of the Medicaid application form. Braille materials are also available in LDSS offices. For other forms of assistance with NYS Medicaid, seniors may refer to the below resources.

	Contact	What You Should Know
NY State Department of Social Services	Local DSS offices	Operating under the NYS Department of Health, LDSS offices serve low-income residents in their respective counties. They provide information and assistance with applications for available public benefits, including Medicaid.
New York Medicaid Choice	(800) 505-5678, TTY (888) 401-6582	NY Medicaid Choice is a state program that informs and assists clients with managed care plan options. Its counselors help seniors choose and enroll in Medicaid Long-Term Care plans, which are mandatory for dual-eligible (Medicaid and Medicare) adults.
Medical Answering Services – Medicaid Transportation	(800) 505-5678, TTY (888) 401-6582	MAS is contracted by NYSDOH to coordinate non-emergency medical transportation for Medicaid recipients at no cost. It provides passes for public transit or assigns a private vehicle, ambulatory taxi or ambulette when transporting a MAS enrollee to authorized health care services.

Can You Use Medicare to Pay for Senior Living in New York?

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing services
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Nursing Home Care Services Aren’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

Medicare Support & Resources in New York

Medicare enrollment is mandatory for low-income New York seniors aged 65+ so that they can also be eligible for Medicaid and/or receive long-term care services under the Medicaid Managed Long-Term Care program. They may also refer to the below resources to help them understand and take advantage of Medicare benefits that are available to them.

	Contact	What You Should Know
Health Insurance Information and Counseling Assistance Program	(800) 701-0501	HIICAP is New York’s state health insurance assistance program (SHIP), which provides free counseling on Medicare benefits, Medicare Advantage managed care services, Medigap, Medicare Part D prescription drug coverage and other matters on long-term care insurance. Medicare beneficiaries may get in touch with trained HIICAP counselors by phone or in person through their local Area Agency on Aging offices.
Medicare Savings Program	Medicaid Helpline (800) 541-2831	Administered through Medicaid, MSP helps recipients pay for Medicare premiums. MSP participants are automatically qualified for Extra Help, which covers Part D (prescription drug) plan costs. Low-income seniors who are not Medicaid-eligible may still qualify for MSP because there are no resource limit requirements. To apply for MSP, a printable application form is available for download and submission to an LDSS office.
Elderly Pharmaceutical Insurance Coverage Program	(800) 332-3742 / TTY (800) 290-9138[email protected]	EPIC is an NYSDOH program that helps eligible seniors pay for Medicare Part D drug plan costs and/or premiums as well as approved non-Part D drugs and prescription vitamins. Recipients must be aged 65+, meet the income and not be receiving full Medicaid benefits. EPIC members pay minimal, income-based Fee Plan or Deductible Plan annual fees to help them save costs for copayments.
New York StateWide Senior Action Council, Inc.	(800) 333-4374[email protected]	StateWide facilitates New York’s Senior Medicare Patrol program which educates seniors on protection, detection and reporting of Medicare-related identity theft, financial scams and other fraudulent activities. This senior advocacy organization also has certified HIICAP counselors who can provide free information on available Medicare benefits and plan options.

Are There Other Financial Assistance Options for Senior Living in New York?

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in New York. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov.	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free Senior Living Resources for Seniors in New York

The wide range of senior resources in New York offers easy access to long-term services for the elderly who are qualified for community-based and institutional care. There are also many lifestyle options and opportunities for active adults aged 55+. 

	Contact	What You Should Know
NY Connects	(800) 342-9871NY Connects county offices	NY Connects is a free, comprehensive resource directory of long-term services and supports for seniors, disabled adults and their caregivers. Visitors can easily find locally available programs and service providers through the website’s self-guided search feature, as well as its keyword and category search options. Some of its diverse service subcategories include long-term care facilities, health insurance, support groups, recreation and leisure, financial assistance and legal aid.
New York State Office of the Aging	(844) 697-6321[email protected]	NYSOFA plans and coordinates home and community-based services so that seniors can access cost-effective nonmedical supports, which help prevent the need for higher levels of care. It administers the Long Term Care Ombudsman Program, which advocates for the welfare of seniors in nursing homes and residential care facilities. Employment programs and volunteer opportunities are available to older adults aged 55+. NYSOFA also publishes the Older New Yorker’s Guide to Resources annually and has helpful video tutorials on how to apply for public benefits.
Area Agencies on Aging	Local AAA offices	In partnership with NYSOFA, New York’s network of 59 AAAs connects seniors to local programs and services that are tailored to support their independence and long-term care needs. Their trained specialists may provide information on Medicaid and Medicare programs, referrals to public and private service providers, senior center activities and eligibility/application requirements for local public benefits.
Special Needs Assisted Living Voucher Demonstration Program for Persons with Dementia	[email protected]	The SNALR voucher program helps current memory care residents pay for their care when they’re no longer able to afford private pay. This non-entitlement assistance allows recipients to remain in community-based settings and reduce the need for Medicaid-funded nursing home care. Qualified recipients must be residing in their facilities for at least 12 months, meet the program’s location-based income requirements and not become eligible for Medicaid.
Centers of Excellence for Alzheimer’s Disease	Local centers/program offices CEADs	New York’s NYSDOH-funded initiatives include Alzheimer’s Association local chapters, regional dementia organizations and medical/academic institutions designated as Centers of Excellence for Alzheimer’s Disease. Seniors and their loved ones may contact their nearest CEADs for diagnosis, treatment and management, clinical trials and coordinated medical services. The ALZ chapters and other dementia support organizations may provide support groups, care consultations and long-term care referrals.
New York State Division of Veterans’ Services	(888) 838-76971-888-VETS-NYS	DVS has dedicated Veterans Benefits Advisors to provide free counseling and assistance with filing claims for federal, state, local and private benefits. They help New York vets and their dependents with applications, obtaining documents, follow-ups and decision appeals. Aside from financial benefits which can help vets pay for long-term care, there are NYSDOH-operated Veterans’ Nursing Homes where the DVS pays 100% of the costs of care for eligible residents with at least a 70% disability rating.
LeadingAge New York	(518) 867-8383[email protected]	LeadingAge is a statewide membership association of not-for-profit continuing care providers, and its dedicated consumer hub publishes the Consumer Guide to Continuing Care annually. This guide includes a resource directory of public and private nonprofit long-term care services and housing options such as adult care facilities, nursing homes, 55+ senior apartments and continuing care retirement communities.

COVID-19 Rules and Restrictions for New York Senior Living Facilities

The following information is based on research done on several government websites, including coronavirus.health.ny.gov and cms.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/13/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Yes
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Senior Living Laws and Regulations in New York

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations. 

In New York state, the health and wellness of seniors in senior living is a top priority. The rules and regulations facilitate this, supporting the maintenance of clean, safe and sanitary centers for seniors.

Admissions Requirements

Assisted Living Residences are available for those over the age of 55 who need assistance with activities of daily living but don’t require specialized medical care, continual nursing or are bedfast. An Enhanced Assisted Living Residence, a Special Needs Assisted Living Residence or, potentially, a traditional nursing home might better serve those who fall under these circumstances.

Scope of Care

As a resident of an ALR, a senior should expect to receive help with daily tasks such as using the bathroom, bathing, grooming, eating, dressing and housekeeping duties like cleaning and laundry. Residents can also receive help with medication management and basic medical needs. ALRs must provide three meals a day to residents.

All residents in ALRs must have an individualized service plan that includes feedback from the resident or their caregiver, a home health agency if necessary and the resident’s physician. This plan must be reviewed and renewed every six months and is required to address medical, physical, mental and nutritional needs.

Memory Care

Any ALR that offers memory care for dementia patients must have licensed practical nurses, registered nurses and home health aides on staff. Facilities must fully train staff on topics that cover the needs of dementia patients, including behavioral and mental symptoms, emotional changes and methods for meeting patient needs. Dementia units must be fully self-contained with a delayed-egress system on all doors to the unit, windows and access points to enclosed courtyards.

Medication Management Rules

Whenever possible, ALR residents should take their medication without assistance. However, staff may assist residents by providing reminders, identifying medication, storing medication, providing supplies required to take medication and helping residents get in the proper position for medication administration.

Staffing Requirements and Regulations

All senior living residences need to have an administrator, resident aides and a case manager on staff. Case managers must be available between 20 and 40 hours a week to work with residents on any issues related to housing, local services, access to activities and emergency care. A resident aide must be available in the facility 24 hours a day.

Staff working in an ALR must take extensive training classes prior to hiring and during the course of employment. Administrators who aren’t licensed nurses are required to take 60 hours of continuing education every two years. Resident aides are required to have 40 hours of initial training and 12 hours a year in continuing education.

Background checks conducted by the Division of Criminal Justice Services, including a comprehensive criminal history and fingerprinting, are required for hiring.

Frequently Asked Questions

How much does assisted living cost in New York?

In New York, the average per month cost for assisted living is $4,630. This amount is higher than the national average of $4,051. However, some areas in the state are far more expensive than the state average. For example, New York City and the surrounding areas cost around $6,950 monthly.

Are there financial assistance programs for assisted living in New York?

Yes, there are financial assistance programs for assisted living available in New York. These programs include the Assisted Living Program (ALP), a waiver program that provides care coverage for those who require long-term care but choose not to live in a nursing home. Residents can also consider some of the benefits available through the New York Medicaid program, including the cost-saving measures through the Managed Excess Income Program.

What types of care are provided by Assisted Living Facilities?

Care provided by assisted living facilities is intended to be supportive but not a substitute for around-the-clock nursing care. Activities of daily living, or ADLs, are a primary focus in these communities, including tasks like feeding, bathing, dressing, eating and cleaning.

What is the difference between assisted living and nursing homes?

The primary difference between nursing homes and assisted living facilities relates to the level of medical care provided. In an assisted living facility, caretakers are usually limited to medication management and basic first aid. When patients need more comprehensive care, such as ventilator support or wound care, a nursing home is far more appropriate.

Who should consider assisted living?

Assisted living is best for seniors who require regular assistance with activities of daily living but don’t need the additional support of a full nursing home facility. Assisted living facilities can be a good alternative to home health care aides for those who don’t want to stay in their own home.

Learn More About Senior Living in New York

For more information about specific types of senior living in New York read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in New York

Learn more about the cost of senior living in the top New York cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.