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How Medicaid pays for long-term care around Rochester

Nursing homes, home care through managed plans, PACE, and what Medicaid will not cover.

Quick answer

New York Medicaid pays for nursing home care, home care and personal care at home (usually through a Managed Long Term Care plan), adult day health care, the Assisted Living Program's services, and PACE, but it does not pay room and board in ordinary assisted living.

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Last verified: October 2026

What long-term care does New York Medicaid pay for?

New York Medicaid pays for nursing home care, home care and personal care at home (usually through a Managed Long Term Care plan), adult day health care, the Assisted Living Program's services, and PACE, but it does not pay room and board in ordinary assisted living.

That last point surprises families most. An assisted living residence that is not an Assisted Living Program provider is private pay, even for a resident who qualifies for Medicaid. See the Assisted Living Program for the exception.

Who must enroll in a Managed Long Term Care plan?

Adults who have both Medicare and Medicaid and need community-based long-term care, such as home care, for more than 120 days generally must enroll in a Managed Long Term Care (MLTC) plan, which then authorizes and pays for those services.

Before enrolling, a person needs an assessment from the New York Independent Assessor Program, which schedules initial assessments through its helpline at 855-222-8350. The plan then sets hours of care through its own care planning. NY Connects in Monroe County, (585) 325-2800, explains the steps.

Is there a PACE program in the Rochester area?

Yes; ElderONE, an affiliate of Rochester Regional Health, is the only PACE program in the greater Rochester area and serves Monroe, Ontario and Wayne counties.

PACE covers all medical and long-term care through a day center, clinic and home care team, for people 55 and older who live in the service area, need community-based long-term care for more than 120 days and can live safely at home with PACE support. Livingston and Orleans residents are outside ElderONE's service area.

What are New York's 2026 Medicaid income and asset limits for seniors?

For a single person 65 or older in 2026, New York's Medicaid income level is $1,836 a month and the resource limit is $33,038; for a couple the figures are $2,489 and $44,796.

2026 New York Medicaid (non-MAGI)SingleCouple
Monthly income level$1,836$2,489
Resource limit$33,038$44,796

Source: NYSDOH GIS 26 MA/05, Income and Resource Standards for Non-MAGI Population, effective January 1, 2026 (rev. 2/5/2026).

Income above the limit does not end eligibility: New York lets people spend down the excess on medical bills, or for community care place it in a pooled supplemental needs trust. Those strategies need advice from an elder law attorney or the county Department of Social Services.

Where do Rochester families apply for long-term care Medicaid?

Apply through the county Department of Social Services where the person lives, which for Monroe County is the Department of Human Services; NY Connects at (585) 325-2800 and the Monroe County Office for the Aging at (585) 753-6280 help with applications.

Ontario, Wayne, Livingston and Orleans residents apply through their own county DSS. Nursing home Medicaid applications require five years of financial records, so start gathering bank statements early.

At a glance

New York Medicaid doesNew York Medicaid does not
Nursing homesPay for eligible long-stay residentsPay without a financial review
Home carePay through MLTC plans after an assessmentPay hourly care without a plan
Assisted livingPay services in ALP bedsPay room and board in ordinary assisted living
PACEFund ElderONE in Monroe, Ontario and WayneOffer PACE in Livingston or Orleans

Sources include the N.Y. Social Services Law and Public Health Law, 18 NYCRR Parts 487-494, 10 NYCRR Parts 415 and 1001, Department of Health GIS messages, CMS, the VA and CareScout, as cited above; see our editorial standards.

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