Types of Home Care Services in New York City
Something happened. She fell, or the hospital gave you a discharge date, or a doctor finally said she can’t live alone.
Now you’re handed a set of words nobody explained: HHA, PCA, MLTC, CDPAP. Below is what each one means and what it costs. For most New York families it costs nothing. Medicaid covers home care, and it can start in days.
Which one sounds like yours?
Medicaid covers most of this list, and most New York families pay nothing. The private rate is there for everyone else.
- A few hours a day Home health aide She manages most things, but not washing, and not the stairs. You cannot be there every morning. Covered by Medicaidself-pay from $32/hr
- Washing, dressing, meals Personal care aide Nothing clinical is wrong. She simply cannot do alone what she has always done alone. Covered by Medicaidself-pay from $32/hr
- Not safe alone at night Live-in care Falls happen at night. Right now there is nobody in the apartment to hear one. Covered by Medicaidself-pay from $442/day
- Memory loss, wandering Dementia care The same question four times, then the front door. You have stopped leaving her alone. Covered by Medicaidself-pay from $32/hr
- Just home from hospital Post-surgery care Discharged on a Friday with a page of instructions and nobody at home to follow them. Covered by Medicaidself-pay from $32/hr
- After a stroke or a fall Therapy at home Three clinic visits a week is not realistic, so the recovery quietly stops. Medicaid or Medicareself-pay from $70/visit
- Wounds, injections, IV Nursing at home The dressing has to be changed every day, and the hospital expects you to do it. Medicaid or insuranceself-pay from $45/hr
- Medicaid is not an option Private home care You do not qualify for Medicaid, or you cannot wait for the assessment. No Medicaid neededself-pay from $32/hr
- A ride to the doctor Medical escort She will not remember what the doctor said, and you cannot take another day off. Not covered by Medicaidself-pay from $32/hr
Who pays for home care in New York?
Most families in New York pay $0 because Medicaid and MLTC plans cover home care for eligible residents. Others use private pay, long-term care insurance, or CDPAP, which lets a family member be paid to provide the care. Medicaid approval usually takes 3 to 6 weeks; private pay can start the same week.
Private pay is not a waiting room. Families choose it because Medicaid does not fit. Income or assets are over the limit. Care is funded from savings or a trust. Or the family wants to pick the caregiver rather than accept the hours and the person a plan assigns. Long-term care insurance is paid the same way.
The two are also not mutually exclusive. Some families start private because care is needed this week, file the Medicaid application in parallel, and move the same caregiver onto Medicaid hours once approval comes through. Nobody has to change caregivers.
CDPAP deserves its own mention. Through it, a Medicaid-eligible person can hire their own daughter, son, neighbor or friend as the paid caregiver and direct the care themselves. A spouse or legal guardian cannot be hired. Since New York moved the program to a single statewide fiscal intermediary, PPL, enrolment runs through them rather than through an agency. ProLife Home Care does not deliver care under CDPAP. Call us anyway if you are weighing it up: we will explain how it compares with an agency aide and say plainly which one fits your situation.
Private pay home care →What home care services are there?
Home care in New York covers seven licensed services: home health aide, personal care, nursing, medical social services, and physical, occupational and speech therapy. The first two help with daily living. The rest are clinical and need a physician order. Most families start with an aide.
Verify this yourself. ProLife Home Care is a Licensed Home Care Services Agency, operating certificate 2572L001. All seven services below are listed on our public record with the New York State Department of Health, along with the six counties we are approved to serve: Bronx, Kings, Nassau, New York, Queens and Richmond. Open our NYS Health Profile →
Home Health Aide (HHA)
Private pay from $32 a hour
A Home Health Aide helps with everything that keeps someone safe and comfortable at home: bathing, dressing, moving around, meals, medication reminders. In New York an HHA completes 75 hours of training and may take on health-related tasks under nurse supervision, such as checking vital signs.
Home Health Aide (HHA) in New York City →
Personal Care Services
Private pay from $32 a hour
A Personal Care Aide helps with daily living but not with health-related tasks: bathing, dressing, toileting, meals, light housekeeping. Training is 40 hours rather than 75. In New York City this role is often called a home attendant, and under Medicaid it is funded as Personal Care Services.
Personal Care Services in New York City →
Nursing
Private pay from $45 a hour
A registered nurse or licensed practical nurse delivers clinical care at home: wound care, injections, IV therapy, catheter and ostomy care, medication management. Treatment such as wound care or an IV needs a physician order. Supervision, medication management and assessment do not. Families who want a nurse on their own schedule can also buy it privately, which is usually called private duty nursing. Our nurses write and review every plan of care before an aide is assigned.
Medical Social Services
A medical social worker helps the family handle everything around the care itself: applying for benefits, coordinating with hospitals and physicians, arranging equipment, planning for what happens next. Families reach for this most often after a hospital discharge, when several systems need to be dealt with at once.
Physical Therapy
Private pay from $70 a visit
Physical therapy at home restores strength, balance and mobility after surgery, a fall, a stroke or a long hospital stay. The therapist comes to the apartment, works with the real stairs and the real bathroom, and teaches the family how to help safely between visits.
Physical Therapy in New York City →
Occupational Therapy
Private pay from $120 a visit
Occupational therapy focuses on daily tasks rather than muscles: dressing, cooking, bathing, getting in and out of bed. The therapist adds grab bars, changes seat height, rearranges the kitchen, so someone can keep doing things instead of waiting for help.
Occupational Therapy in New York City →
Speech Language Pathology
Private pay from $120 a visit
Speech therapy at home treats difficulty speaking and difficulty swallowing, most often after a stroke, a brain injury, or with progressive conditions. Swallowing problems are the part families underestimate: untreated, they lead to choking and aspiration pneumonia.
HHA vs PCA: what is the difference?
Both help with daily living, but a Home Health Aide completes 75 hours of training in New York and may perform health-related tasks under nurse supervision, such as checking vital signs. A Personal Care Aide completes 40 hours and focuses on bathing, dressing, meals and housekeeping. Medicaid assigns the level after an assessment.
In practice the choice is usually made for you. Medicaid and MLTC plans set the level from the assessment, not from preference. If the plan of care includes anything health-related, it will be an HHA. If it is help around the house and with the body, a PCA is enough and is often easier to staff quickly.
New Yorkers also hear a third word for the same work: home attendant. It is the local name for a personal care aide working under Medicaid, not a separate job.
What does not change between them: both work under a nurse-approved plan of care, both are supervised, and both are matched to the family by language and personality before anyone starts.
Is home care the same as home health care?
No. Home care means non-medical help with daily living from an aide. Home health care means clinical treatment ordered by a physician and delivered by a nurse or therapist. Medicaid and insurance treat them as separate benefits with separate approval routes, so asking for the wrong one costs you time.
Home health care usually runs short. A few weeks after surgery or a hospital stay, until the wound closes or the walking comes back. Home care is open-ended and is what most older adults live with, sometimes for years.
Many families end up with both at once: a nurse twice a week for wound care, a therapist twice a week for walking, and an aide daily for everything else. One agency can hold all three. That is the practical reason licensing matters: an agency without therapy on its license has to hand you off.
Hourly care or live-in care?
Choose hourly care when help is needed at predictable times, such as mornings and evenings. Choose live-in care when someone cannot be safely left alone: night wandering, fall risk, advanced dementia, or recovery after a hospital stay. Live-in means one caregiver lives in the home and sleeps there.
The honest test is the night. If the risk is spread across the day and nobody worries between visits, hourly works and costs less. If the family is checking a phone at 2am, hourly care is a false economy. The gap between visits is exactly where the fall happens.
Live-in is not the same as 24-hour care. A live-in caregiver sleeps in the home and needs uninterrupted rest. Someone who needs attention through the night requires two caregivers on rotating shifts, and that is a different arrangement with a different cost.
Live-in care in New York City →All seven services compared
| Service | What it covers | Physician order | Usually paid by | Private pay from |
|---|---|---|---|---|
| Home Health Aide | Daily living plus health-related tasks under nurse supervision | No | Medicaid, MLTC, private pay | $32 an hour |
| Personal Care (PCA) | Bathing, dressing, meals, light housekeeping | No | Medicaid Personal Care Services, private pay | $32 an hour |
| Nursing | Wound care, injections, IV, catheter, medication management | For clinical treatment | Medicaid, insurance, private pay | $45 an hour |
| Medical Social Services | Benefits, discharge planning, coordination with hospitals | Usually | Medicaid, insurance | Not sold separately |
| Physical Therapy | Strength, balance, walking after surgery, fall or stroke | Yes | Medicaid, Medicare, insurance, private pay | $70 a visit |
| Occupational Therapy | Dressing, cooking, bathing; adapting the home | Yes | Medicaid, Medicare, insurance, private pay | $120 a visit |
| Speech Language Pathology | Speaking and swallowing after stroke or brain injury | Yes | Medicaid, Medicare, insurance, private pay | $120 a visit |
Dementia care and live-in care are not separate licensed services. They are the same aide services arranged differently, with caregivers trained for memory loss or scheduled to live in the home. Medical escort is the exception on this site: it is almost always private pay, because Medicaid covers care inside the home rather than accompaniment outside it.
How do I know which service I need?
Start with three questions: how many hours a day is help needed, is there a physician order involved, and who is paying. A few hours with no medical task means an aide. Constant supervision means live-in care. A physician order means nursing or therapy. A free nurse assessment settles it in one call.
A registered nurse reviews every plan of care at ProLife before anyone is assigned. That review is where the answer gets made. Families call asking for live-in care and leave with six hours a day. Others ask for “someone a couple of times a week” and learn they qualify for far more.
We are a New York State licensed agency (NY DOH License #2572L001), operating since 2017, with 500+ caregivers speaking 13 languages across Brooklyn, Queens, Manhattan, The Bronx, Staten Island, and Nassau County.
Questions families ask before they call
What types of home care services are there?
Home care in New York covers seven licensed services: home health aide, personal care, nursing, medical social services, and physical, occupational and speech therapy. The first two help with daily living. The rest are clinical and need a physician order. Most families start with an aide.
What is the difference between an HHA and a PCA?
Both help with daily living, but a Home Health Aide completes 75 hours of training in New York and may perform health-related tasks under nurse supervision, such as checking vital signs. A Personal Care Aide completes 40 hours and focuses on bathing, dressing, meals and housekeeping. Medicaid assigns the level after an assessment.
What does a personal care aide do?
A personal care aide helps with bathing, dressing, toileting, grooming, meal preparation, light housekeeping and getting around the home safely. They do not give injections, change wound dressings or manage medical equipment. In New York City the same role is commonly called a home attendant.
Is home care the same as home health care?
No. Home care means non-medical help with daily living from an aide. Home health care means clinical treatment ordered by a physician and delivered by a nurse or therapist. Medicaid and insurance treat them as separate benefits with separate approval routes, so asking for the wrong one costs you time.
Should I choose hourly care or live-in care?
Choose hourly care when help is needed at predictable times, such as mornings and evenings. Choose live-in care when someone cannot be safely left alone: night wandering, fall risk, advanced dementia, or recovery after a hospital stay. Live-in means one caregiver lives in the home and sleeps there.
Who pays for home care in New York City?
Most families in New York pay $0 because Medicaid and MLTC plans cover home care for eligible residents. Others use private pay, long-term care insurance, or CDPAP, which lets a family member be paid to provide the care. Medicaid approval usually takes 3 to 6 weeks; private pay can start the same week.
Can I get physical or speech therapy at home in New York?
Yes. Physical, occupational and speech therapy can all be delivered at home with a physician order. ProLife Home Care is licensed by the New York State Department of Health for all three (operating certificate 2572L001). Home-based therapy works in the rooms the person lives in, which is why it transfers better than clinic sessions.
Can I pay for a nurse at home privately?
Yes. Private duty nursing means you hire a registered or licensed practical nurse directly and pay by the hour, without going through Medicaid or an insurance plan. Treatment such as wound care or IV therapy still needs a physician order; supervision and medication management do not. Families use it when they want a nurse on their own schedule, when a plan will not authorize the hours they want, or while a Medicaid application is still pending.
How do I know which home care service I need?
Start with three questions: how many hours a day is help needed, is there a physician order involved, and who is paying. A few hours with no medical task means an aide. Constant supervision means live-in care. A physician order means nursing or therapy. A free nurse assessment settles it in one call: (718) 232-2777.
Can a family member be paid to provide home care in New York?
Yes. New York's CDPAP lets a Medicaid-eligible person hire a relative or friend as their paid caregiver and direct the care themselves. A spouse or legal guardian cannot be hired. The program is administered statewide by a single fiscal intermediary, PPL. ProLife Home Care does not deliver care under CDPAP, but we will explain how it works and tell you when it fits your situation better than what we offer.
What families said
First, I have to say the ambiance is beautiful. Second, I was given a warm welcome by staff. They were very polite, professional, and answered all my questions thoroughly.
ProLife Home Care has friendly and nice staff who provide professional services. The communication is easy, which is a plus for families navigating home care.
Extremely helpful and knowledgeable staff. 100% recommend to everyone looking for a home care agency.
Written and reviewed by Anna Klyauzova, RN, co-founder and Director of Patient Services at ProLife Home Care, a New York State licensed Registered Nurse with 14 years in clinical practice and 9 years in home care. Last reviewed .
Not sure which one you need?
Tell us the situation in a few sentences. A nurse will tell you which service fits, whether Medicaid is likely to cover it, and how quickly care can start. No cost, no obligation.