For Medicaid caregivers, HRA and a county DSS office use the same eligibility rules. HRA, the Human Resources Administration, covers New York City's five boroughs, while other New Yorkers use their county office.
A Medicaid district is the local office that decides financial eligibility. For caregivers, that decision does not grant home-care hours. A separate statewide assessment decides care need before a family member can be paid.
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 Nyc — Use this primary source to verify the official guidance.
- Check eligibility on Legalaidnyc’s official study page — Use this page to check the study’s participation requirements.
Table of Contents
- Where HRA and a county office fit in
- Which application door fits the care recipient?
- Why Medicaid approval does not set care hours
- What dementia caregivers should file first
Where HRA and a county office fit in
The NYC Human Resources Administration says HRA is the local Medicaid district for the five boroughs. That office says residents elsewhere apply through their county Local Department of Social Services HRA public health insurance page.
NYC applicants use ACCESS HRA, HRA Medicaid offices, or the helpline. County applicants use their own county office for the same financial role.
Which application door fits the care recipient?
HRA directs older adults over 65 and people needing Medicaid for disability or blindness to its aged or disabled path. It also routes Medicare beneficiaries without parent status, former foster youth under 26, and working people with disabilities the same way. Filings go through ACCESS HRA, HRA offices, or 888-692-6116.
HRA says low-income pregnant women, children, and adults under 65 cannot use that aged or disabled path. They must apply through NY State of Health at 855-355-5777. For dementia care, use the age or disability status of the person needing care to pick the door.
Why Medicaid approval does not set care hours
The Legal Aid Society explains that applicants first obtain Medicaid at the local DSS office, HRA in New York City. Financial eligibility is separate from approval for home-care hours. In person, mail, and ACCESS HRA online are the NYC filing routes. NYLAG and Empire Justice, writing for NY Health Access, say statewide assessment now decides care need.
The New York Independent Assessor Program reviews personal care, CDPAP, and Managed Long Term Care enrollment NY Health Access summary. NY Legal Assistance Group testimony warns of a tighter clinical bar starting Sept. 1, 2025. New adult applicants for personal care, CDPAP, or MLTC enrollment must need limited help with physical maneuvering for 3 or more daily activities. The other path is supervision for 2 or more daily activities tied to dementia or Alzheimer's.
What dementia caregivers should file first
HRA lists the NYC aged or disabled mailing address as Medical Assistance Program, Initial Eligibility Unit, PO Box 24390, Brooklyn, NY 11202. Fax is 917-639-0732, then pursue NYIAP assessment and managed-care enrollment before a family member can be paid.
The State Health Department CDPAP explainer says a self-directing consumer can recruit, hire, train, and supervise a chosen assistant, including most adult family members. The State Health Department says all CDPAP cases moved to one statewide fiscal intermediary, Public Partnerships LLC, on April 1, 2025 State Health Department press release. Keep the PPL enrollment notice with the Medicaid approval letter for payroll start.
- Send financial Medicaid papers to HRA or the county DSS for the care recipient.
- Complete the NYIAP clinical assessment for personal care or CDPAP.
- Join the assigned managed-care plan and finish hiring paperwork.
