Does Insurance Cover Home Health Care in New York?

Home health care is more than just a convenience — for many New Yorkers, it’s a lifeline. Whether recovering from surgery, managing a chronic illness, or supporting aging in place, home care enables individuals to receive personalized medical or personal assistance in the comfort and familiarity of their own home.

But one major question always comes up:

Does insurance cover home health care in NY?

Let’s break it down — from what’s covered to what it might cost, and how to make sure you’re getting the most out of your benefits.

What Is Home Health Care?

Home health care includes a wide range of medical and non-medical services delivered in a patient’s home. These services are often prescribed by a doctor and can include:

• Skilled Nursing (wound care, injections, medication management)

• Physical, Occupational, and Speech Therapy

• Medical Social Services

• Home Health Aides (assistance with bathing, grooming, and other daily activities)

Providers like Special Touch Home Care, which is Joint Commission-accredited and serves NYC and beyond, offer both traditional home care and CDPAP services — allowing family members to get paid for caregiving under Medicaid.

So, Does Insurance Cover Home Health Care?

Yes — but it depends on your plan. Here’s how major insurance types typically handle coverage:

Medicare

Medicare covers home health care if:

• Care is medically necessary and ordered by a doctor

• You’re homebound

• You’re receiving services from a Medicare-certified agency like Special Touch

• Skilled services are needed (not just personal care)

Covered services include nursing, physical therapy, and speech-language pathology — but personal care (like bathing or housekeeping) is not typically covered unless it supports skilled care.

Medicaid (NY State)

New York offers one of the most comprehensive Medicaid home care programs in the country. Through initiatives like CDPAP (Consumer Directed Personal Assistance Program), patients can hire and train a family member or friend to be their paid caregiver.

Special Touch Home Care is a Lead FI (Fiscal Intermediary) in NY, supporting families with the CDPAP process from start to finish.

Other Medicaid programs cover home health aides, nursing, and therapy services for eligible low-income individuals.

Private Insurance

Coverage depends on the insurer and your specific plan. Some may fully or partially cover:

• Skilled nursing

• Therapy services

• Short-term personal care post-hospitalization

It’s essential to call your provider directly or have your care agency verify coverage.

Long-Term Care Insurance

These policies are designed to cover assistance with Activities of Daily Living (ADLs) and may help pay for home health aides and personal care — but premiums and requirements can vary.

How Much Does Home Health Care Cost in New York?

Without insurance, here’s what you can expect to pay on average:

A patient needing daily assistance and skilled nursing could easily face $5,000–$15,000+ per month — underscoring the importance of understanding your insurance coverage.

Tips to Maximize Your Insurance Benefits

Here’s how to get the most value from your home health care plan:

• Get a doctor’s order for care (Medicare/Medicaid requirement)

• Work with an accredited, licensed agency

• Choose a provider in-network with your insurer

• Ask about co-pays, visit limits, or authorizations

• Keep detailed records of all services received

• Consider adding long-term care insurance for future needs

Final Thoughts: Home Health Care Shouldn’t Be a Financial Burden

Whether you’re considering home health care for yourself or a loved one, insurance can dramatically reduce your out-of-pocket costs — but only if you understand what’s covered.

As one of New York’s most trusted home care agencies, Special Touch Home Care helps families navigate Medicare, Medicaid, CDPAP, and private insurance plans with compassion and clarity.

Need help figuring out your home care options?
Call Special Touch Home Care today at (718) 550-7813 or schedule a consultation.

Let’s make care at home not just possible — but affordable, accessible, and full of dignity.