In-Home Care for Seniors in Brooklyn, Queens, the Bronx, Manhattan, and Staten Island: A Medicaid Guide

# In-Home Care for Seniors in Brooklyn, Queens, the Bronx, Manhattan, and Staten Island: A Medicaid Guide

New York City has one of the largest home care systems in the country — and one of the most complex. For seniors and adults with disabilities in Brooklyn, Queens, the Bronx, Manhattan, and Staten Island, understanding what Medicaid actually covers and how to access it is the difference between staying home and entering a nursing facility.

This guide is for NYC families navigating Medicaid home care: what it pays for, which program applies to your situation, and how to get started.

What Medicaid Home Care Covers in New York City

New York’s Medicaid program covers home-based care for eligible seniors and adults with disabilities. The main services:

Home Health Aide (HHA): Certified aides assist with bathing, dressing, grooming, meal preparation, medication reminders, and mobility. Authorized through your Medicaid managed care plan based on physician documentation.
Personal Care Aide (PCA): Similar to HHA but without skilled nursing oversight. Helps with activities of daily living. Available through managed care plans or, for some seniors, through Managed Long-Term Care (MLTC).
Managed Long-Term Care (MLTC): For NYC seniors needing 120+ days of ongoing home care. Bundles all long-term services — HHA, transportation, adult day care, personal care — under a single care management plan. Most NYC seniors with ongoing home care needs are enrolled in MLTC.
NHTD Waiver: For seniors and adults with physical disabilities who need nursing-facility level care but want to remain at home. Covers a broader range of services than standard HHA, including community integration counseling, environmental modifications, and assistive technology.
TBI Waiver: For adults ages 18–64 with traumatic brain injuries. Similar structure to NHTD but with services tailored to cognitive rehabilitation and community integration.

Which NYC Seniors Qualify?

Medicaid home care in NYC requires:

• Active New York State Medicaid — enrollment through HRA (Human Resources Administration) for NYC residents, or through NY State of Health
• A documented need for assistance with activities of daily living (bathing, dressing, meals, mobility)
• A physician order specifying the type and frequency of care needed
• For MLTC and NHTD: a higher level of assessed care need (nursing-facility level of care criteria)

Most low-income seniors in NYC qualify for Medicaid. Eligibility rules for seniors applying for long-term care Medicaid (including home care) differ from standard Medicaid — income and asset thresholds vary.

Brooklyn Home Care

Brooklyn’s large senior population — particularly in neighborhoods like Bay Ridge, Flatbush, Crown Heights, Borough Park, and Sunset Park — has extensive demand for Medicaid home care. Many families in Brooklyn have adult members who speak languages other than English as a primary language, making language-matched care a priority.

Priority Groups serves Brooklyn seniors across all Medicaid managed care plans. Our care coordinators speak Spanish, Haitian Creole, Arabic, and Hindi.

Queens Home Care

Queens is one of the most ethnically diverse counties in the United States. In neighborhoods like Jamaica, Flushing, Elmhurst, Jackson Heights, and Astoria, Medicaid home care is a critical community resource for seniors who want to age in place. Queens seniors have access to a range of MLTC plans and NHTD Waiver providers.

Priority Groups serves Queens seniors and handles Medicaid home care authorization, agency selection, and NHTD/TBI Waiver enrollment.

The Bronx Home Care

The Bronx has a high proportion of Medicaid-eligible seniors and one of the highest demand densities for home health aide services in New York. Neighborhoods including Fordham, Mott Haven, Pelham Parkway, and Co-op City have large senior populations who rely on Medicaid home care to remain independent at home.

Manhattan Home Care

Manhattan seniors — particularly in Washington Heights, East Harlem, Harlem, and the Upper West Side — frequently access Medicaid home care through MLTC plans. For higher-acuity Manhattan seniors, NHTD Waiver services are available through licensed providers.

Staten Island Home Care

Staten Island’s senior population has grown significantly in recent years. Medicaid home care through managed care plans and MLTC is the primary pathway for Staten Island seniors who need ongoing in-home support.

How to Start the Process in NYC

If your family member has Medicaid and needs home care:

1. Talk to their primary care physician about home care needs. Ask for a written order specifying daily care needs in detail (which tasks require help, how often).

2. Identify your Medicaid plan — look at the Medicaid card for the plan name. Contact the plan directly to initiate a home care needs assessment.

3. Choose a licensed LHCSA — a Licensed Home Care Services Agency contracted with your plan. Ask the plan for their provider list or call Priority Groups directly.

If your family member may qualify for NHTD or MLTC:

Call Priority Groups at (718) 841-8000 for a free eligibility review. We serve all five NYC boroughs and can determine quickly whether NHTD Waiver, TBI Waiver, or MLTC is the appropriate pathway.

If your family member is in a nursing facility and wants to come home:

The NHTD Waiver Transition track is specifically designed for this. Contact Priority Groups before discharge — the enrollment process takes 45–90 days. Starting early gives the best chance of a safe, supported transition home.

Priority Groups — NYC Boroughs and Beyond

Priority Groups is a NYS-licensed LHCSA serving Brooklyn, Queens, the Bronx, Manhattan, Staten Island, and Rochester/Monroe County. We are licensed for NHTD Waiver services, accept all major NYC Medicaid managed care plans, and have multilingual care coordinators to serve the diverse communities across New York City.

Call (718) 841-8000 for a free Medicaid eligibility review. There is no cost and no obligation.