Managed Long-Term Care (MLTC) is a system that provides long-term care services, including nursing home and home health services, for Medicaid recipients through private companies. The state of New York uses Medicaid funds to hire managed care companies to provide recipients with long-term care services. New York is transitioning more and more Medicaid recipients to managed care programs. In New York City and in many other parts of the state, if you are over 21, have Medicaid and Medicare, and need long-term care services, then you must enroll in a managed long-term care program.
There are two basic types of long-term care plans in New York: MLTC Plans and Program for All-Inclusive Care for the Elderly (PACE) Plans. MLTC Plans cover long-term care services and other health services like prescriptions, medical equipment, and dentistry. Participants choose primary care physicians and use their Medicaid and Medicare benefits for payment. PACE participants receive their services from a team of professionals like physicians, nurses, and social workers, whose role is to coordinate individualized care. PACE participants must be at least 55 years old and receiving Medicaid.
Once your loved one has been approved for Medicaid (either for Community Long Term Care or Nursing Home Care) you must select an “MLTC” for their services. These companies have become more difficult to deal with over the years and are often loaded with more red tape than the Department of Social Services was to get your family member approved for Medicaid!
Elder Care Advisors of Long Island, LLC has been navigating this slippery slope for many years and are aware of the ones to choose vs. the ones to avoid. We are also well versed in dealing with the unexpected “requests for additional documentation” that family members and loved ones are presented with which seem to prolong the approval process for services. We are here to help you navigate your selection process in the MLTC world and work with you to expedite your family member’s enrollment and implementation of necessary and timely services.