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Does Medicare Pay For CDPAP Or Home Care In New York?

Medicare covers a variety of services to help people stay healthy and safe in their own homes. This includes services like home health care and personal care, but excludes the CDPAP program unless the patient has Medicaid as well. It is possible for the patient to have Medicaid as well as Medicare at the same time. When it comes to planning your care, it is important to be aware of the fine print, as Medicare might not always cover these services completely. 

In this blog post, we’ll explore whether or not Medicare pays for CDPAP or home care in New York. We’ll also provide some tips on how to get the most out of your Medicare coverage. 

Keep reading for more information!

Key Takeaways

  • Although the entire process of applying for managed long-term care can be overwhelming, it is important for everyone to be aware of what kind of in-home care is covered under Medicare. 
  • In general, only a Medicaid plan will cover CDPAP care in New York State. There are other criteria that must be considered for eligible individuals for CDPAP services in New York as well, such as your income level.
  • To find out more about if you’ll qualify for in-home medical care under this program, contact your local department of social services.  

Does Medicare Pay for CDPAP in New York? 

Consumer Directed Personal Assistance Program (CDPAP) is a Medicaid program in New York State that allows Medicaid recipients to choose their own caregivers. 

The program gives members the freedom to select, train, and supervise their own caregivers. This includes family members, close friends, or even a neighbor. CDPAP is a Medicaid waiver program, which means that it is not covered by Medicare. 

Although both Medicare and Medicaid are government-sponsored health insurance programs, there are some key differences between the two. 

One significant difference is that Medicare does not cover the Cost of Direct Patient Alternative Program (CDPAP). CDPAP is a Medicaid program that pays for in-home health care services (or a personal assistant or personal care aide) for people with disabilities or chronic illnesses. This can be confusing for people who are used to Medicare covering a wide range of health care services. 

However, it is important to remember that each program has its own eligibility requirements and benefits. As a result, it is important to research each program carefully before applying.

If you are a Medicare recipient in New York State and you are interested in enrolling in CDPAP, you will need to pay for the program out of pocket. You can contact your local Medicaid office for more information on how to apply for CDPAP.

Consumers Who Have Both Medicare and Medicaid Can Qualify for CDPAP

If you have both Medicare and Medicaid, you may be eligible for the Consumer Directed Personal Assistance Program (CDPAP). This program allows consumers to choose their own caregivers and provides them with training and support. 

As a result, consumers are able to maintain their independence and receive the care they need in the comfort of their own homes. 

CDPAP is a great option for those who have difficulty accessing traditional home health services. If you are interested in learning more about this program, please contact your local Medicaid office.

Does Medicare Pay for Any Kind of Home Care?

Home health services are those medically necessary nursing, physical therapy, occupational therapy, speech-language pathology, and/or home health aide services that are ordered by a doctor for the treatment of an illness or injury. They’re provided to you when you’re confined at home and, as a result, your ability to function is limited. 

Medicare Part A (Hospital Insurance) and/or  Medicare Part B (Medical Insurance) cover eligible home health services like these:  

  • part-time or “intermittent” skilled nursing care
  • physical therapy
  • occupational therapy or speech-language pathology services
  • durable medical equipment or medical supplies for use at home
  • medical social services
  • part-time or intermittent home health aide care
  • injectable osteoporosis drugs for women

In order for home health services to be covered under Medicare, they must be considered medically necessary and ordered by a doctor. The care must also be provided by a Medicare-certified home health agency and furnished by Medicare-approved providers. 

Additionally, you must be confined to your home (i.e. your condition must limit your ability to leave home) in order to receive covered home health services. This means that if you can go out and shop, go to church, or visit the doctor on your own, you probably won’t qualify for covered home health services. 

While Medicare does cover a wide range of medical expenses, there are some services that it does not pay for. For example, Medicare does not cover 24-hour-a-day care at your home, meals delivered to your home, or homemaker services that aren’t related to your care plan. 

Additionally, Medicare will not pay for custodial or personal care that helps you with daily living activities when this is the only care you need. These services can be expensive, so it’s important to understand what Medicare will and will not cover before enrolling in the program.

Finally, if you need skilled care on a frequent basis (more than once a week or on more than an intermittent basis), you will not qualify for home health services covered under Medicare Part A or Part B. You would instead require care through a different program like hospice or a long-term care facility.

If a person only needs help with occasional tasks, such as grocery shopping or light housekeeping, Medicare will not cover these costs. However, if more intensive or long-term care is needed, obtaining Medicare will be required. 

In general, Medicare will help to cover the costs of skilled nursing care, physical therapy, and some types of home health aides. It is important to note that Medicare will only cover care that is deemed medically necessary, so it is important to consult with a doctor before making any decisions about home care.

How Can I Apply for Medicaid? 

Medicaid is a state and federal program that provides health insurance for low-income people. In order to qualify for Medicaid, you must meet certain income and asset requirements

In general, applicants must have an income that is below a certain threshold and assets that are below a certain limit. However, these requirements vary from state to state. In addition, some groups of people may be automatically eligible for Medicaid, such as pregnant women or children under the age of 19. To find out if you are eligible for Medicaid, you can contact your state’s Medicaid office or an eligibility specialist.

Medicaid covers a wide range of health care services, including doctor visits, hospital stays, prescription drugs, and long-term care. To apply for Medicaid, you can contact your state’s Medicaid office or go to the website of the Centers for Medicare & Medicaid Services. 

You will need to provide information about your income, assets, and family size. Once you have submitted your application, a caseworker will determine if you are eligible for Medicaid. 

If you are found to be eligible, you will be enrolled in the program and will be able to start using your benefits.


If you are in need of home care services for a loved one, it is important to do your research and understand all of the options that are available to you. 

The New York State Medicaid program is an option for those who meet certain income requirements, and there are also private home care agencies that can provide services at a cost. 

No matter what route you decide to take, make sure you get all of the information about Medicare coverage for Consumer Directed Personal Assistance Program(CDPAP) or home care services in New York so that you can make the best decision for your family.

Frequently Asked Questions

What is CDPAP’s hourly rate for home health care?

The hourly rate for home health care under New York’s Consumer Directed Personal Assistance Program (CDPAP) varies by County in New York State. A patient’s health plan may also impact the rate. Please reach out to Friends & Family Home Care Services for eligibility and rate specific questions. 

Does Medicare pay for home health care after a hospital stay?

Unfortunately, Medicare does not cover the costs of home health care after a hospital stay. Instead, patients are responsible for paying for their own care, which can be very expensive. In some cases, patients may be able to get help from Medicaid or private insurance. However, these programs often have strict eligibility requirements, so not everyone will qualify.

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