Free senior care guidance for Nassau and Suffolk County families. No cost to you, ever.
Call (934) 200-2603
Long Island Senior Advisor

Medicaid Waivers and Assisted Living

New York's Assisted Living Program (ALP) and Managed Long Term Care (MLTC) system, and what each actually pays for inside a licensed community.

Get matched freeCall (934) 200-2603
Home›Costs & Paying›Medicaid Waivers and Assisted Living
Short answer

New York runs several separate community-based Medicaid programs rather than one combined waiver: the Assisted Living Program (ALP) pays for care services inside specific licensed Adult Homes and Enriched Housing Programs, Managed Long Term Care (MLTC) coordinates home care and related services through managed care plans, and the Nursing Home Transition and Diversion (NHTD) waiver funds in-home services for those diverting from or transitioning out of a nursing facility.

What ALP actually pays for

ALP, regulated under 18 NYCRR Part 494, covers personal care, housekeeping, supervision, home health aides, nursing, therapy, medical supplies and RN case management delivered inside the ACF. It does not function as a cash voucher, and it does not fully cover room and board -- confirm the specific split with any community that participates.

Which program pays for in-home-only services

The NHTD waiver and MLTC both fund services delivered at home, not inside a licensed community. Neither covers rent or a mortgage payment.

How families pay for care. New York's Assisted Living Program, NHTD waiver and Managed Long Term Care each pay for different community-based settings. Read the full explanation →

Questions families ask

What is Suffolk County's Area Agency on Aging, and how do I reach them?

Suffolk County's Area Agency on Aging is its Office for the Aging, explicitly designated the Area Agency on Aging under the Older Americans Act, located at the H. Lee Dennison Building, 100 Veterans Memorial Highway, Hauppauge, NY 11788, phone 631-853-8200. The office has administered federal, state, and county aging programs for nearly 50 years.

Which has a bigger senior population - Nassau County or Suffolk County?

Suffolk County has slightly more seniors in raw numbers, about 291,400 residents age 65 and older versus Nassau's roughly 273,100, but Nassau has a slightly higher senior share of its total population, 19.6 percent versus roughly 19 percent in Suffolk. Both figures come from 2024 USAFacts/Census Bureau estimates, and both exceed the New York State average senior share of 18.9 percent.

What is NY Connects, and how does it relate to my county's Office for the Aging?

NY Connects is New York State's Aging and Disability Resource Center (ADRC) network, a free, no-obligation service that helps individuals and families learn about and access long-term care options. In both Nassau and Suffolk counties, the local NY Connects access point runs through the county Office for the Aging: Nassau's information is linked from its Office for the Aging page, and Suffolk's Office for the Aging directly operates its NY Connects, or Choices for Long Term Care, function through its main line, 631-853-8200.

Does Nassau County or Suffolk County have a bigger, more spread-out senior care market?

Suffolk County's senior care market is more geographically spread out, stretching from denser, transit-served western hamlets such as Huntington, Brentwood, Bay Shore, and Islip to more rural, exurban North and South Fork communities that have become popular retirement-relocation destinations. Nassau County's market is more geographically compact, concentrated along its village and LIRR corridor towns, including Garden City, Rockville Centre, Great Neck, Freeport, Long Beach, and Mineola.

What's the difference between standard assisted living and memory care in New York?

Standard assisted living in New York is licensed as an Assisted Living Residence (ALR) under 10 NYCRR Part 1001. Memory care is not a separate license; it's delivered through a Special Needs Assisted Living Residence (SNALR) certification, an additional certification an ALR can obtain to serve residents with dementia or cognitive impairments per an Individualized Service Plan, regulated under the same Part 1001 rules.

Not sure where to start?

Answer five questions and a local advisor will come back with senior care options in your area that actually fit your situation and budget. It is free, and there is no obligation.

Find care options
Find senior care — free