Medicaid home care in the Bronx: assessment, MLTC, and NYC Aging help

The Bronx has one of the highest rates of Medicaid enrollment of any county in the country, so a large share of the borough's older adults already have the first requirement for Medicaid home care in place. What they often do not have is a clear picture of the steps after that. The county name is easy here (Bronx is Bronx County). The assessment is the statewide New York Independent Assessor Program. Medicaid is HRA, citywide. Plan selection for Managed Long Term Care is New York Medicaid Choice. And for the smaller number of Bronx residents 60 and older who are not on Medicaid, NYC Aging funds in-home services on a sliding contribution.

Families in Fordham, Mott Haven, or Pelham Parkway whose parent or grandparent has Medicaid through a managed care plan and now needs an aide. People leaving a Bronx hospital or nursing home rehab stay who were told they need "an independent assessment" before home care can start. Residents of Co-op City or Riverdale who are over 60, not on Medicaid, and looking for a few hours of help with chores or personal care without spending down their savings first.

Medicaid is HRA. There is no Bronx County Department of Social Services. The Human Resources Administration administers Medicaid citywide; its Medicaid Helpline is 1-888-692-6116. For home care questions specifically, HRA's long-term care page names the DSS OneNumber at 718-557-1399 and the borough CASA offices, listed on nyc.gov/hra.

The assessment is NYIA. Once Medicaid is active, the New York Independent Assessor Program (1-855-222-8350) schedules a community health assessment by a nurse and a clinical appointment by a doctor, nurse practitioner, or physician assistant. The Department of Health's program page adds that for high-needs cases, where a proposed plan of care first exceeds an average of 12 hours a day, an independent review panel also looks at the plan. That review is not something a family requests; it happens inside the process.

New requests meet the Minimum Needs Requirements. For anyone first assessed on or after September 1, 2025, the Department of Health says personal care and consumer directed services are available for people assessed as "needing at least limited assistance with physical maneuvering with more than two ADLs," or with a dementia or Alzheimer's diagnosis, "at least supervision with more than one ADL." People already authorized before that date keep Legacy Status. Only the assessment applies this; do not try to score yourself.

Plan selection is New York Medicaid Choice. People 21 and older with both Medicare and Medicaid who need community-based long-term care for more than 120 days must join an MLTC plan to keep receiving it. The state's enrollment program handles that at 1-800-505-5678, long term care line 1-888-401-6582.

Non-Medicaid help is NYC Aging. Residents 60 and older who are not on Medicaid can ask NYC Aging for in-home services. A contracted case management agency does a phone intake and a home visit; NYC Aging says the fee or suggested contribution depends on income. Aging Connect is 212-244-6469.

The assessor's FAQ names three things: an identification card, a list of the medications you take, and records from recent hospital stays or doctor visits. Bronx families typically also gather:

• Medicaid number and whether the case is active or in renewal with HRA.
• The managed care plan name on the Medicaid card, because the FAQ says a mainstream plan member's plan reviews the assessment results and goes over next steps.
• Doctors' names and numbers, especially the primary doctor the clinician may call.
• A written medication list including inhalers, insulin, and over-the-counter items.
• ADL notes. Walking inside the apartment, stairs, bathing, dressing, toileting, eating, getting in and out of bed. Be specific about what needs a person's hands versus a reminder.
• Who helps today, and whether that help can continue.
• An authorized representative if needed: the designation form from New York Medicaid Choice, or a copy of a power of attorney or guardianship order.

Orientation only: Montefiore Moses in Norwood, NYC Health + Hospitals / Jacobi, Montefiore Einstein / Weiler in Morris Park, St. Barnabas / SBH Health in Belmont near Fordham, NYC Health + Hospitals / Lincoln in Mott Haven, and BronxCare on the Grand Concourse. A discharge from any of these often comes with a sheet that says "MLTC" and nothing more; the sections above fill in the rest.