You decide what Plan you want. You can also ask to change Plans at any time. All Plans provide Medicaid home care and other community long term care services. These are the services you are required to receive from a Plan. Some Plans also provide Medicare services, including doctor office visits, hospital care, pharmacy and other health—related services. In the next section , you will learn more about the three types of Plans and the services they provide.
Discuss your Plan options with your family, doctor, or the person who helps you make your health care decisions. Your first step is to pick the type of Plan you want. In the next few pages, three Plan Members describe their type of Plan and they also tell you why they chose it.
You can then decide which Plan you prefer. As a Plan member, you are free to keep seeing your Medicare or Medicare Advantage doctor or other provider of services not covered by the Plan. PACE health services are provided by a Team that includes doctors, nurses, social workers and others. Now that you know the type of Plan you want; New York Medicaid Choice can help you select a Plan with the providers you have now. Your Member Handbook includes the services your Plan provides and other important information.
Your Care Manager will also work with you and anyone else you want to involve, to assess your service needs and develop a Plan of Care. Your Plan of Care will describe the services you will get from your Plan. During the first 60 days in a Plan, your Care Manager will arrange for you to keep the same services you had before you joined the Plan.
You may ask to change Plans at any time. If you want to change Plans, contact the Plan you want to join. Our counselors will be glad to assist you.
Your Plan must continue to arrange and pay for your services until your new Plan takes over. If someone needs assistance with selecting a plan, they can call NY Medicaid Choice directly at This will help ensure that they remain the provider for the home attendant once the change is made.
Similar to new enrollments, ostensibly, a change can be effective for the coming month if everything is completed by the 20th of the previous month. Here too, this is not always the case in reality.
If someone is hoping to change plans for the coming month, having their assessment completed earlier in the month can enhance their chances of the change going through. It is important to be aware that just because a plan sends a nurse to evaluate you to switch to them, that does not obligate you to go through with the change.
If you are not satisfied with the services being offered by the new plan, you may choose to decline the change. We provide free assistance with enrolling in Managed Long-Term Care.
If you would like assistance for yourself, a loved one, or a client, please give us a call. Call Us Now! Navigation menu. Managed Long Term Care MLTC Managed long-term care MLTC is a system that streamlines the delivery of long-term services to people who are chronically ill or disabled and who wish to stay in their homes and communities.
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 days. Your browser does not support iFrames. Age Requirements: 18 years and older Coverage Required: Medicaid Benefit package is long term care and ancillary services, including home care and nursing home care. Age Requirements: 55 years and older Coverage Required: Medicaid, Medicare and Private Pay Benefit package includes all medically necessary services-primary, acute, and long term care.
Age Requirements: 18 years and older Coverage Required: Medicaid and Medicare Benefit package includes primary, acute, and long term care services excludes specialized mental health services.
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