Yes. For New Yorkers who qualify, the NHTD waiver is free. There are no premiums, no co-pays, and no out-of-pocket cost for the waiver services themselves, because they are funded through Medicaid.
The catch is in the word “qualify”: the NHTD waiver is only for people who already have Medicaid, who are assessed as needing a nursing-home level of care, and who can live safely in the community with the right support.
The waiver also does not pay for everything, most notably room and board. This guide explains exactly what the NHTD waiver covers, what it does not, who is eligible, and how long approval takes.
Key Takeaways
- The NHTD waiver is free for New Yorkers who qualify; there are no premiums or co-pays for covered services.
- It is a Medicaid waiver, so you must have Medicaid to take part.
- You must be assessed as needing a nursing-home level of care and be able to live safely at home with supports.
- It covers services like service coordination, home modifications, assistive technology, and community supports.
- It does not pay for room and board, such as rent, food, or a mortgage.
- Approval is not instant; it commonly takes a few months from application to the start of services
What Is the NHTD Waiver Program in New York State?
NHTD stands for Nursing Home Transition and Diversion. It is a New York State Medicaid waiver designed to help seniors and adults with disabilities either move out of a nursing home (transition) or avoid entering one in the first place (diversion), so they can live independently in their own homes and communities. Instead of institutional care, the program builds a person-centered service plan around the individual.
All Heart Homecare is an approved NHTD provider; you can learn more on our NHTD waiver guide page.
Is the NHTD Waiver Free?
Yes, for those who qualify. Because NHTD is funded by Medicaid, there is no cost to the participant for approved waiver services. You will not pay premiums, co-pays, or coinsurance for the supports in your service plan.
What makes it “free” is also what limits it: you must meet and keep Medicaid eligibility, be assessed at a nursing-home level of care, and stay within the services your plan authorizes. If you lose Medicaid eligibility, the waiver services end.
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What Does the NHTD Waiver Pay For?
The waiver funds a range of community-based services built into an individualized service plan. Commonly covered supports include:
- Service coordination: a coordinator who helps build and manage your plan and connects you to resources.
- Home and community support services: help with personal care and daily living combined with skill-building for independence.
- Environmental modifications: home changes like ramps, grab bars, or wider doorways to improve safety and access.
- Assistive technology: devices and equipment that support independence.
- Community transitional services: one-time help with the costs of moving from a nursing home back into the community.
- Independent living skills training: coaching to build confidence with everyday tasks.
- Structured day programs, respite, and wellness supports: services that support health, routine, and caregiver relief.
Medicaid and your managed care plan typically authorize everyday hands-on help, such as a home health aide, while the waiver wraps additional community support around it.
What the NHTD Waiver Does Not Cover
Understanding the limits is just as important as knowing the benefits. The NHTD waiver does not pay for:
- Room and board: you are responsible for rent, a mortgage, groceries, and basic living costs.
- Care for people without Medicaid: the waiver is only available to Medicaid recipients.
- Duplicate services: the waiver supplements, rather than repeats, services already available through regular Medicaid.
- Congregate settings: assisted living and similar group residences are not eligible settings for the waiver.
- Hours or services beyond your plan: anything outside your authorized service plan would need another source of payment.
Who Qualifies For the NHTD Waiver?
To take part in the NHTD waiver in New York, a person generally must:
- Be age 18 to 64 with a physical disability, or age 65 or older.
- Have active Medicaid, or qualify for community-based long-term care.
- Be assessed as needing a nursing-home level of care.
- Be able to live safely in the community with the available supports.
If you are still working on the Medicaid piece, our guide on applying for Medicaid home care in New York walks through the assessment and timeline, and our guide on whether Medicaid home care is free in New York covers the 2026 income and asset limits.
How Long Does It Take for a Medicaid Waiver To Get Approved?
Approval is not instant. For the NHTD waiver, families should generally plan for 2 to 6 months from first contact to the start of services.
The timeline depends on several steps: confirming Medicaid eligibility, completing the required assessments, developing an individualized service plan, and selecting approved providers.
Starting the Medicaid application early and keeping your documents organized are the best ways to avoid delays.
Which of the Following Is Not Right for Participants on the Waiver Program?
A few common misunderstandings are simply not true for NHTD participants. It is not correct to say the waiver pays for rent or room and board, that someone can enroll without Medicaid, or that the waiver is available to someone who truly needs full-time institutional care and cannot be safely supported at home. The waiver is specifically for people who have Medicaid, need a nursing-home level of care, and can live safely in the community with the right help.
If any of those do not fit, a different path, such as regular Medicaid home care or private pay, may be the better option.
How All Heart Homecare Helps
As an approved NHTD provider serving Brooklyn, Manhattan, the Bronx, Queens, and Staten Island,
All Heart Homecare can help you understand the waiver, coordinate your services, and transition safely to care at home. If you do not qualify yet, or you need care to start right away, private pay home care is a flexible alternative with no eligibility test, and many families use it while a waiver application is pending.
Use the estimator on this page to see what the waiver could cover and what you would pay, then contact us for a free consultation to get a personalized quote.
This article is for general information only. NHTD waiver rules and eligibility are set by New York State and can change, so please confirm current details when you apply.
Frequently Asked Questions About Is the NHTD Waiver Free
What does the waiver program pay for?
The NHTD waiver pays for community-based services built into an individualized plan, such as service coordination, home and community support services, environmental modifications like ramps and grab bars, assistive technology, community transitional services for moving out of a nursing home, independent living skills training, structured day programs, respite, and wellness supports. It does not pay for room and board.
What is the NHTD waiver program in New York State?
NHTD stands for Nursing Home Transition and Diversion. It is a New York State Medicaid waiver that helps seniors and adults with disabilities move out of a nursing home, or avoid entering one, by funding services that let them live safely and independently in their own homes and communities instead of in an institution.
How long does it take for a Medicaid waiver to get approved?
It usually takes a few months, commonly two to six, from application to the start of services. The timeline covers confirming Medicaid eligibility, completing assessments, developing an individualized service plan, and choosing approved providers. Applying early and keeping documents organized helps avoid delays.
Which of the following is not right for participants on the waiver program?
It is not correct to say the waiver pays for rent or room and board, that a person can enroll without Medicaid, or that it is meant for someone who needs full-time institutional care and cannot be safely supported at home. The waiver is for people who have Medicaid, need a nursing-home level of care, and can live safely in the community with supports.
