The Long-Term Care Options: Choosing an MLTC plan
There are three Managed Long-Term care models in New York State to choose from. Here is a brief
description of the three models; Medicaid home care applicants will be asked to choose a plan that falls into one of these
MLTC Medicaid Plans (Managed Long-Term
These plans provide long-term care services for those age 21 and older.
These service plans include home health care, nursing and personal care. Additionally, the MLTC plans will also
provide ambulatory services that are medically necessary- ambulatory services include dental care and medical equipment.
MLTC members will continue to received medical services from their current Medicare doctors and the same in-patient
hospital coverage under Medicare - only non Medicare services will be covered by Medicaid. MLTC Medicaid Plan members
will have two cards - a Medicare Card and a Medicaid card.
Medicaid Advantage Plus Plans:
These plans are available to consumers who are eligible for both Medicaid and Medicare, and who wish to have
the same health care plan for most of the Medicaid and Medicare benefits under one roof. Individuals enrolled in
these plans will have "Medicare Advantage" for their Medicare services and "Medicaid
Advantage Plus" for their Medicaid covered services. To be eligible for Medicaid Advantage Plus plans
the consumer must be eligible for nursing home level of care. Members of these plans will have only one card for both
their Medicare and Medicaid coverage.
PACE (Program for all inclusive care for the elderly):
These plans are open to those ages 55 and older, who are otherwise eligible for nursing home admission. Both
Medicaid and Medicare will pay for PACE services. Members are required to use PACE doctors. PACE is responsible for
arranging all primary care, in-patient hospital and long-term care services that are needed by a PACE member.