Consumer Managed Care Center

For most Medicaid beneficiaries, enrolling in a Managed Long Term Care (MLTC) plan will eventually become mandatory.  It is important to know your care options and rights.

  How will this affect you?

  • Medicaid beneficiaries requiring home care services, such as personal care or home care, for more than 120 days will need to choose a Managed Long Term Care (MLTC) health plan. 

  How will I know if I need to enroll in a plan?

  • Medicaid beneficiaries required to enroll in a MLTC will be notified by the State of New York by mail.

  When will my county require mandatory enrollment?

  • The New York State Department of Health (DOH) has prepared a tentative schedule detailing when the State expects various counties to be affected.  The draft timeline can be found here.  The State is waiting for Federal approval before implementing this policy.  The dates on the draft timeline will change, but the phase-in strategy will likely remain the same.

  Will I lose my aide and/or nurse?

  • In most cases you will need to choose a home care agency that is a participating "network" provider.  This means that the agency and the health plan partner together in delivering care.  If you wish to keep your current aide you should ask the agency for a list of health plans that they work with and choose one of those plans.  Your home care agency and work with you to choose a plan that best meets your medical and home care needs. 

  Will the number of hours and days of care that I receive change?

  • It is possible that the amount of care you receive will change.  The health plan will assess your needs and develop a plan of care.  The authorized level of care could change from what you have been receiving.  You have the right to appeal changes to your care.  This is done first through your health plan and, if your are not satisfied with the result, can appeal to higher levels (click here for more information). 

Patient Resources 

 


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Read: Changes in the Air: New state regulations will move many long-term home care recipients into managed care programs.

 nypcover.nov.11


 
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*DOWNLOAD: HCP Member's Only: Managed Care Consumer Brochure

 

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