In New York City, the Human Resources Administration (HRA) decides financial eligibility for dementia patients seeking Medicaid as aged, blind, or disabled applicants. It applies income and resource tests, not a medical judgment about dementia care needs. HRA approval is only the first part for long-term home care. A separate state program decides whether the person functionally needs managed long-term care.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Official resources:
- Read the official guidance from Ny — Use this primary source to verify the official guidance.
- Check eligibility on Legalservicesnyc’s official study page — Use this page to check the study’s participation requirements.
Table of Contents
- What financial test does HRA apply?
- Why doesn't HRA approval mean home care?
- How does dementia change the daily-activity test?
- What steps should NYC families take?
What financial test does HRA apply?
HRA handles Aged, Blind and Disabled Medicaid for residents 65 or older, certified blind, or disabled. Most applicants under 65 who seek income-based Medicaid apply through NY State of Health instead. For dementia patients seeking ABD or community long-term-care Medicaid, HRA checks both monthly income and countable assets.
According to Legal Services NYC, the 2025 limits were $1,800 per month for a single person and $32,396 in countable assets in its financial eligibility guide. That test is about money alone. A dementia diagnosis does not change the income calculation, and high care costs do not raise the limit.
Why doesn't HRA approval mean home care?
HRA decides only whether the person can have Medicaid financially. It does not decide whether the person needs home care, personal care, or enrollment in a Managed Long-Term Care plan. That functional decision is made separately through the New York Independent Assessor Program, run for the state health department.
According to NY Health Access, families must complete HRA financial eligibility and the NYIA functional assessment as two different reviews in its NYIA assessment explainer. This split matters for planning. A family can win Medicaid financially and still need a separate functional finding before services start.
How does dementia change the daily-activity test?
Since Sept. 1, 2025, new Managed Long-Term Care and personal-care applicants generally must need community-based long-term services for more than 120 days. They also must need limited physical help with more than two activities of daily living. According to the state health department, those are bathing, dressing, toileting, transferring, walking, and eating on its MLTC partial-capitation policy page.
Patients with documented dementia or Alzheimer's face a lower functional bar. They may qualify with supervision or cueing with more than one daily activity, rather than hands-on help with more than two. Dementia status must be certified by a physician or doctor of osteopathy on Alzheimer's Disease or Dementia Form DOH-5821. The form is faxed to 917-228-8601 before or during the NYIA assessment.
What steps should NYC families take?
Start with HRA even when income looks too high. Dementia alone does not qualify anyone, but over-income patients may use Medicaid spend-down by incurring medical bills. Use this order:.
- Apply to HRA for active Medicaid for the aged, blind, or disabled category.
- Ask the doctor about Form DOH-5821 if dementia or Alzheimer's is documented.
- Call the NYIA at 1-855-222-8350 for a Uniform Assessment System evaluation and plan-enrollment decision.
- Fax Form DOH-5821 to 917-228-8601 before or during the NYIA assessment, then call 1-855-222-8350 to start the NYIA review.
