New York Assisted Living Program: New York 2026 Guide

New York’s Assisted Living Program (ALP) is a Medicaid-funded program that pays for personal care, home health services and case management for people who live in certain licensed adult homes or enriched housing residences. It serves people who would otherwise need a nursing home but do not need round-the-clock skilled nursing.

This guide covers who qualifies for the Assisted Living Program, what Medicaid pays in assisted living, the application steps and the nursing home comparison. For the full statewide rules on income, assets, spouses and the look-back, see our New York Medicaid guide.

Figures change periodically. Double-check current amounts before relying on them.

What the Assisted Living Program is

ALP is not the same as any assisted living residence. Only residences that hold an ALP license and have ALP beds approved by the Department of Health take part. Medicaid pays the residence a daily rate for services. The resident pays for room and board from their own income, usually from Social Security or other income at a rate tied to the SSI level for congregate care, and keeps a personal needs allowance. ALP services are paid outside of Managed Long Term Care.

In federal terms, the Assisted Living Program is a home and community-based services (HCBS) waiver. That label means New York received approval to bend some usual Medicaid rules, most importantly the link between long-term care and a nursing home bed. Waivers are optional for states, so each sets its own services and, often, a limit on enrollment. That is the main difference from regular Medicaid benefits: meeting the rules does not by itself guarantee a slot.

Who qualifies in 2026

To get the Assisted Living Program, a person generally has to pass two separate tests, one about care need and one about money, and then receive an opening. In general, an applicant must:

• be medically eligible for nursing home placement, but not need continuous skilled nursing;
• be eligible for New York Medicaid;
• be appropriate for residential care, for example not a danger to self or others and able to evacuate with help in an emergency;
• live in, or be accepted by, a residence with an available ALP bed; and
• meet the residence’s admission requirements.

Financial rules. For the Assisted Living Program, New York State Medicaid (your local LDSS or HRA) applies the long-term care Medicaid rules for income and assets, generally the same ones used for nursing home care. Countable assets include bank accounts, investments and property other than the home, while the home, one car, personal belongings and certain burial funds are usually not counted. Gifts made in the five years before applying can trigger a penalty that delays waiver services, just as it would delay nursing home coverage.

ALP uses New York’s community Medicaid rules for income and assets: in 2026, about $1,836 a month of income for one person and $33,038 in assets. Because the resident pays room and board, income is handled differently than for care at home.

New York’s 2026 long-term care Medicaid numbers, from our state guide:

Married applicants. When one spouse applies and the other stays at home, spousal impoverishment protections generally apply, so the spouse at home can keep a share of the couple’s assets and may receive part of the applicant’s income. The spousal allowance pages explain how these amounts are figured.

Services the Assisted Living Program can cover

The care plan picks from a menu of services. For the Assisted Living Program, that menu includes:

• personal care
• home health aide services
• nursing visits and supervision
• physical, occupational and speech therapy
• medical supplies and equipment
• case management
• adult day health in some cases
• room, board, housekeeping and supervision (paid by the resident, not by Medicaid)

Room and board is separate. Medicaid cannot pay rent and food in assisted living, so the resident pays room and board from income and keeps a small allowance. Not every residence accepts Medicaid, and those that do may limit Medicaid residents. See Finding assisted living that accepts Medicaid.

How to apply for the Assisted Living Program

The usual sequence for the Assisted Living Program is below. Running the financial application and the care assessment in parallel can shorten the wait.

1. Find a residence with ALP beds. The Department of Health publishes a list, and the local Office for the Aging can help.
2. Ask the residence whether it has an ALP opening and for its admission paperwork.
3. Apply for Medicaid through the local Department of Social Services or HRA, if not already enrolled.
4. The residence completes an assessment and coordinates with a home care agency and the person’s doctor.
5. Move in once Medicaid and the ALP admission are approved.

Practical tips. Keep copies of everything you send and note the name of each person you speak with. During the assessment, describe a typical bad day rather than a good day, and have a family member present who knows how much help is really needed. Cognitive problems and fall risk count toward need. If services are denied, the notice lists the deadline to appeal.

Waiting lists and timing

ALP beds are limited, and in many parts of the state residences have waiting lists. Apply to several residences at once.

Getting on a list early, before a crisis, is usually wise. While waiting, other options can help: state plan personal care, adult day programs, PACE where offered, Older Americans Act services through the Area Agency on Aging, and family caregiver support. The waiver waiting lists page explains common rules.

How it relates to nursing home Medicaid

ALP is a direct alternative to a nursing home for people who meet nursing home level of care but can live safely in a residential setting. Nursing home Medicaid in New York uses a 60-month look-back and different income rules, while ALP follows community Medicaid rules.

the Assisted Living Program and nursing home Medicaid serve the same group of people; the difference is where care is given. One practical difference: nursing home Medicaid has no enrollment cap in New York, while a waiver can. If care at home becomes unsafe, a participant can move to a nursing home and keep Medicaid, though the share of income paid toward care changes. Moving the other way is often given priority, and Money Follows the Person can help.

Getting ready for the Assisted Living Program

The need for the Assisted Living Program often arrives suddenly, after a hospital stay or a fall. Some preparation goes a long way. Begin with a list of daily tasks, the people who handle them, and the gaps that appear when a caregiver is away. It also helps the assessor see real needs rather than a single snapshot.

On the financial side, gather recent bank statements, income letters such as Social Security and pension notices, health insurance cards, and proof of age and residence in New York. If long-term care Medicaid may be needed later, five years of records will matter, so it helps to keep them now. Legal documents matter too. A durable power of attorney and a health care directive let a trusted person act on applications without a guardianship.

Needs rarely stay the same, so revisit the arrangement regularly and request a reassessment when things change. Families who keep notes on changes, such as new diagnoses, falls or hospital visits, find later reviews and applications go more smoothly.

Tips for families

Find out early whether a residence takes the Assisted Living Program, has an opening, and will keep a resident who converts from private pay, in writing. Applications take time, so plan the conversion months ahead. Past gifts or family payments may need review because of the look-back.

Working with a Certified Medicaid Planner is often the fastest way through the Assisted Living Program. A planner who handles New York cases regularly can spot eligibility problems before New York State Medicaid (your local LDSS or HRA) does, organize the records and help plan around any wait. Fees vary: roughly $500 to $6,000 for application help, $2,500 to $15,000 or more for full planning, and $150 to $600 an hour for advice.

Related pages

• New York Medicaid guide
• New York Managed Long Term Care
• Will Medicaid pay for assisted living?
• Assisted living rules by state
• Finding assisted living that accepts Medicaid
• HCBS waivers explained
• Assisted living evictions

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.