Insurance Options in New York State for Home Care in 2026

The future of care for thousands of families in New York is uncertain: Will my insurance cover home care in 2026?

Increasingly, families are seeking safe, more personalized and less expensive options than traditional assisted living as they transition through the aging process. Navigating the insurance system – Medicare, Medicaid, long term care policy, and private insurance – has become an extremely confusing experience.

Below is a detailed explanation of the home care services insurance coverage in New York, the anticipated changes in 2026, and recommendations for families to create a well-planned strategy for securing high quality care for your loved ones.

Growing Need for Home Care in New York

By 2030, nearly 1 in 5 people in New York will be 65 years old or older, and a significant number of those individuals will require some sort of daily assistance. The past two years have increased the demand for in-home services due to fear of contracting COVID-19, personal choice, and cost savings.

More and more families are electing to have home care for their loved ones so they can stay comfortable, independent, and accompanied while reducing the emotional impact of relocating to nursing facilities.

Home Care NY in 2026

How Insurance Pays for Home Care in New York

Coverage varies greatly depending on the type of insurance. Some services are covered under Medicare or Medicaid; however, the majority of long term care requires private coverage or is paid out of pocket.

Below is an overview of the types of insurance available today — 2025 — with projections for 2026.

Type of Coverage What It Includes Limitations / Notes for 2026
Medicare (Original) Short-term skilled nursing, physical therapy (PT), occupational therapy (OT), and in-home short-term home health care. Only covers medical home care — does not include personal assistance, cooking, cleaning, and companionship.
Medicare Advantage (Part C) Includes optional limited in-home support and wellness programs depending on the plan. Most NYC plans expanding coverage for non-medical support under new federal guidelines.
Medicaid (New York) Covers personal care, home attendants, and 24-hour support through programs like CDPAP (Consumer Directed Personal Assistance Program). Eligible based on income and medical need. Expected to expand digital monitoring support by 2026.
Long Term Care Policy Customizable plans covering daily living assistance, personal care, and home modification. Premiums vary; policies must be purchased prior to medical need.
Veterans’ Benefits (Aid & Attendance) Benefits for veterans and spouses requiring assistance with daily living needs. Must be approved by VA; coordination with home care agencies recommended.

Anticipated Developments in 2026

New York’s healthcare legislation is moving to address the state’s rapid growth of its elderly population and the lack of caregivers for them. Three major trends are expected in home care coverage by 2026:

  • Increased Funding for Alternative Medicaid Programs:

The state is expected to fund more home-based care alternatives to nursing home care through Medicaid Managed Long Term Care (MLTC) and CDPAP.

  • Expanded Medicare Flexibility:

Recent federal changes now permit Medicare Advantage plans to pay for non-medical home services such as meal delivery, transportation, and home safety modifications — a huge shift towards prevention.

  • Hybrid Models Combining In-Person and Virtual Health Supervision:

Private and public programs are starting to implement hybrid models of in-person care and virtual health supervision. These hybrid models are expected to decrease costs and expand eligibility for home care for seniors who live independently.

When Insurance Is Insufficient

Although there are expected changes, insurance typically does not cover 100% of home care costs. Most families incur additional costs such as co-payments, service hour limitations, or tasks that are not covered by insurance such as housekeeping and companionship.

Common Out of Pocket Costs That New York Families Still Encounter:

  • Additional hours of a caregiver beyond insurance limits;
  • Nighttime or weekend support;
  • Specialized assistance with dementia or post surgical recovery;
  • Transportation and errands;
  • Emotional and social companionship.

That is why most families use insurance to cover skilled services (i.e. wound care, PT/OT) and then use private pay for personal care services to ensure continuity of care.

Why Home Care Remains the Most Cost Effective Solution for New York Families in 2026

Choosing home care will continue to provide the most cost effective and emotionally rewarding option for New York families in 2026. Consider the following:

  • The average monthly cost of a nursing facility in New York exceeds $15,000-$17,000,
  • Average monthly cost of home care is between $5,000-$7,000 — may qualify for partial reimbursement from insurance.
  • Home care also offers something that nursing facilities do not: familiarity, routine and peace of mind.

One of our Angel Care clients shared the following: “My mom stays in her apartment in Brooklyn, she drinks her morning coffee and chats with her caregiver — that is priceless.”

Final Thoughts: Plan Now for 2026

There will be continued change in the healthcare industry in the upcoming year with a growing focus on aging at home. Insurance systems will begin to adapt to these trends.

Proactive planning will remain the best course of action for families to take advantage of the changing landscape. Families should:

  • Review their current Medicare, Medicaid or private insurance coverage;
  • Discuss eligibility for programs like CDPAP;
  • Seek guidance from licensed home care agencies familiar with New York’s laws and regulations.

A Message From Angel Care Home Care Agency Inc.

At Angel Care Home Care Agency Inc., we believe that every senior deserves caring, affordable, and safe care — in the comfort of their own home. We assist clients in navigating insurance options, developing customized care plans and providing support so that no family member has to go through the challenges of aging or illness alone.

We are proud to offer trusted home care services to the citizens of all New York City Boroughs with honesty, compassion and expertise — making home the safest place to be.

Angel Care Home Care Agency Inc. — Helping Families Live Better, Longer and Together.