Managed Long Term Care

ElderChoice | Syracuse, NY

ElderChoice is proud to be an approved provider for most of the MLTC Plans throughout Central New York including: Fidelis Care at Home, iCircle, Senior Network Health, and Nascentia Health!

Managed long–term care (MLTC) is a system that streamlines the delivery of long–term care services to people who are chronically ill or disabled and who wish to stay in their homes and communities. These services, such as home care or adult day care, are provided through managed long–term care plans that are approved by the New York State Department of Health. The entire array of services to which an enrolled member is entitled can be received through the MLTC plan the member has chosen.

MLTC Plans are insurance plans that are paid a monthly premium (“capitation”) by the New York Medicaid program to approve and provide Medicaid home care and other services to people who need long-term care because of a long-lasting health condition or disability.  The MLTC plans take over the job that the local CASA or Medicaid offices used to do – they decide whether an individual needs Medicaid home care, how many hours they may receive, and arrange for the care by a network of providers that the plan contracts with.  They also approve, manage and pay for any of the other long-term care services that an individual may require.

As New York transforms its long–term care system to one that ensures care management for all, enrollment in a MLTC plan may be mandatory or voluntary, depending on individual circumstances.

Enrollment in a MLTC plan is mandatory for those who:

• Are dual eligible (eligible for both Medicaid and Medicare) and over 21 years of age and need community based long–term care services for more than 120 days.
• Reside in the counties of NYC, Nassau, Suffolk or Westchester.

Enrollment in MLTC plan is voluntary for those who:

• Are dual eligible and are 18 through 21 years of age and need community based long term care services for more than 120 days and assessed as nursing home eligible.
• Are non–dual eligible and over 18 years of age and are assessed as nursing home eligible.

For referrals and/or more information on these plans and the services they offer, please contact NY Medicaid Choice directly at 888-401-6582