Understanding Managed Long Term Care (MLTC) Plans

In order to receive home care services from Medicaid in New York, whether it’s traditional home health aides (aka PCA services) or care provided by family members (aka CDPAP), you will usually need to enroll in an MLTC plan. Managed Long Term Care (MLTC) is a specialized Medicaid insurance plan designed to cater to the needs of individuals requiring home care or long-term care services. In this blog post, we will help you understand what MLTC entails, its benefits, and how seniors or others can benefit from enrolling in an MLTC plan.

What is MLTC?

Managed Long Term Care (MLTC) is a type of Medicaid insurance plan that covers various forms of assistance with daily activities, including personal care, home health aide services, and support for tasks like dressing, bathing, and household chores. It also extends coverage to services like adult day care, therapy, transportation to medical appointments, and even temporary nursing home stays as needed.

How Does MLTC Work?

The “M” in MLTC stands for managed. Individuals enrolled in an MLTC plan must choose a provider offered by a private health insurance company. Medicaid pays these companies to provide long-term care services to their members. To receive coverage, individuals must utilize providers within the plan’s network (such as Harborcare), ensuring access to a comprehensive array of services.

What is Medicaid MLTC

Most people with MLTC have home care services and some additional benefits while allowing you to retain your traditional Medicare coverage for medical care outside the scope of MLTC. This flexibility enables you to continue seeing your existing doctors and accessing medical services as needed through Medicare.

Benefits of MLTC:

Medicaid MLTC offers numerous benefits for seniors and individuals with an . These include:

– Home Care: Including personal care, home health aide, and Consumer Directed Personal Assistance (CDPAP) for daily activities and independence.

– Adult Day Care: Structured activities and socialization opportunities, providing respite for caregivers.

– Private Duty Nursing: Skilled nursing care at home, ensuring personalized medical support.

– Therapy Services: Coverage for physical, occupational, and speech therapy to maintain or improve functional abilities.

– Transportation: Access to transport for medical appointments, ensuring timely healthcare.

– Home Delivered Meals: Nutritious meals delivered to the doorstep for proper nutrition and well-being.

– Medical Equipment and Supplies: Coverage for necessary equipment and supplies for health and safety.

– Hearing Aids and Audiology: Support for hearing loss, including aids and audiology services.

– Eyeglasses and Vision Care: Coverage for vision needs, including eyeglasses and vision care services.

– Dental Care: Access to dental services for oral health needs.

– Podiatry: Coverage for foot and ankle health, promoting mobility.

– Temporary Nursing Home Stays: Coverage for skilled care and rehabilitation in nursing homes when necessary.

Managed Long Term Care (MLTC) provides a vital resource for seniors and individuals requiring long-term care services, offering comprehensive coverage and support under Medicaid insurance. By enrolling in an MLTC plan, seniors can access a wide range of services tailored to their needs while maintaining continuity of care with their existing healthcare providers.

Here are some MLTC plans that may be right for you.