What is companion care?
Companion care is non-medical caregiving focused on supervision, conversation, meal preparation, light housekeeping, transportation, errands, and the small daily tasks that keep an older adult or person with a disability safe and connected. A companion does not provide hands-on personal care (bathing, toileting, transfers) and does not provide medical care (wound care, injections, medication administration). When those tasks are part of the day, the role becomes a Personal Care Aide (PCA) or Home Health Aide (HHA).
New York regulates home care more aggressively than most states. Licensed Home Care Services Agencies (LHCSAs) must be authorized by the New York State Department of Health, and most workers they employ go through PCA or HHA training even when most of their shift is companion-level work. That is why the line between "companion" and "PCA" is blurrier in New York than elsewhere — many companion-style shifts in New York are technically performed by a PCA-certified worker on the clock.
Pure companion care (no PCA certification, no hands-on care) is most common in private-pay arrangements: families paying directly, private-duty agencies that operate outside the LHCSA framework, and live-in roles where the worker provides supervision and meals. Pay is consistently above the national average because New York City's minimum wage is $16.50/hour, Long Island and Westchester are $16.00/hour, and union scale for unionized home-care workers is higher still.
Most New York companion clients are older adults living in apartments, co-ops, condos, or single-family homes whose adult children live out of state or are working full time. Others are adults with disabilities living independently, post-discharge patients recovering at home, or adults with early-stage cognitive change who still bathe and dress themselves but should not be alone all day.
How much do companion caregivers make in New York?
Companion caregivers in New York typically earn between $18 and $25 per hour in 2026, with significant variation by region. The U.S. Bureau of Labor Statistics lists New York's median wage for home health and personal care aides at roughly $19/hour, with the top 10% earning above $26/hour. Pure companion work (no personal care credential) clusters near the median.
Pay is highest in Manhattan ($22–$30/hour for private-pay companion work), Brooklyn and Queens ($20–$26), Westchester ($20–$25), the North Shore of Long Island ($22–$28), and the Hamptons in summer ($30–$45). Upstate metros pay less: Albany $16–$20, Rochester $16–$19, Buffalo $15–$19. Direct-hire pay is usually $2–$5/hour higher than agency pay because of the missing agency markup.
New York's Consumer Directed Personal Assistance Program (CDPAP) is the most flexible Medicaid program in the country: a Medicaid member can hire almost anyone they trust (most family members and friends are eligible, though spouses generally cannot be paid) and direct their own care. CDPAP pay typically runs $17–$22/hour depending on the Fiscal Intermediary, though the program is undergoing major consolidation. PCAs through licensed home-care agencies typically earn $17–$20/hour in NYC and $16–$18 upstate.
Live-in roles in New York are subject to specific New York Labor Department rules and several recent court decisions: live-in domestic workers are generally entitled to be paid for all hours except scheduled meals and uninterrupted sleep periods (a 13-hour rule applies in many cases). In practice, live-in companions in NYC and Long Island earn $300–$500/day depending on client acuity. Overnight awake shifts pay $20–$28/hour.
Typical hourly pay in New York: $18–$25/hour (NYC private pay $22–$30; CDPAP $17–$22)
Who pays for companion care in New York?
New York has one of the most public-sector-heavy funding mixes in the country thanks to CDPAP and the state's strong Medicaid program. Private pay still dominates the highest-paying segment of the market:
What does a companion caregiver actually do?
A New York companion shift is built around supervision, conversation, daily routines, and small household tasks. Typical duties:
- Conversation, reminiscing, reading aloud, watching news or favorite shows, playing cards or chess — the heart of the job is being a warm, attentive presence
- Preparing meals and sitting down to eat together — major for nutrition, hydration, and fall prevention
- Light housekeeping — dishes, laundry, tidying common areas, making the bed, taking out trash and recycling
- Grocery shopping (often delivery in NYC), pharmacy pickups, dry cleaning, and other errands
- Transportation by car, taxi, or Access-A-Ride to medical appointments, the senior center, church or synagogue, and family visits
- Companionship walks in the neighborhood, around the block, or at a local park
- Medication reminders — telling the client when, not handing pills or administering them
- Supervision for safety — appliances off, doors locked, no fall hazards, the client not wandering
- Helping plan the day, write down appointments, use the phone, video call grandchildren, and operate technology
- Documenting the shift in a notebook or app so the family knows what was eaten, how the client seemed, and anything to flag
Do you need a certification for companion care in New York?
For pure companion work paid by a private family, no certification is required. For agency work through a Licensed Home Care Services Agency or CDPAP, expect a more involved onboarding even though the underlying work is non-medical.
Family member needs care? You may be able to be paid.
New York has several Medicaid and VA programs that let family members get paid to provide care at home — including companion care. See the full state guide:
Read the New York caregiver pay guide →Companion caregiver jobs in New York — FAQ
Can I do companion care in New York without certification?
Yes. Pure companion care — meals, housekeeping, conversation, transportation, supervision — does not require a state-issued certification in New York. You can be hired directly by a family or through a private-duty agency without a CNA or HHA. If you go through a Licensed Home Care Services Agency (LHCSA), the agency may require PCA certification because their state license is tied to providing personal care.
What is the difference between a companion caregiver and a CDPAP personal assistant?
CDPAP personal assistants are paid by New York Medicaid through a Fiscal Intermediary. They can perform hands-on care if needed (no certification is required even for hands-on work under CDPAP). A companion caregiver works for any payer — private family, long-term care insurance, VA, or non-CDPAP Medicaid — and is limited to non-medical, non-hands-on tasks.
How is companion care paid for in New York?
New York has the most diverse funding mix in the country. Private-pay families dominate the high-end market. CDPAP and Personal Care Services through Managed Long-Term Care plans cover Medicaid-eligible older adults. VA Aid & Attendance, long-term care insurance, and the state's EISEP program also pay for companion services. Long-term care insurance reimbursement rates are particularly high in the NYC metro.
Do I need a driver's license to work as a companion caregiver in NYC?
In Manhattan and the inner boroughs of NYC, no — most caregivers use taxis, Access-A-Ride, or the subway with clients. Outside NYC (Long Island, Westchester, upstate), a driver's license is generally required because clients live in single-family homes and need rides to appointments.
Can I become a CDPAP personal assistant for my own parent?
Yes. CDPAP is uniquely flexible: a Medicaid member can hire an adult child, sibling, grandchild, in-law, or close friend as their paid personal assistant. Spouses generally cannot be paid through CDPAP, and legal guardians cannot be paid, but most other family members can. No CNA or HHA certification is required.
How much can I earn as a live-in companion in New York?
Live-in companion roles in NYC and Long Island typically pay $300–$500 per day depending on client acuity. The Hamptons summer market pays the highest — $400–$700/day in season is common. Live-in pay must comply with New York Labor Department rules on hours worked, scheduled meals, and uninterrupted sleep periods.
Is companion care a good first caregiver job in New York?
Yes — it is the most common entry point in the state, and New York's elevated minimum wage and strong Medicaid programs make the starting pay better than in almost any other state. Many New York caregivers start as companions and later add PCA or HHA certification to expand into hands-on work at higher rates.