When you join an MLTC plan, you will get a Care Manager. All rights reserved. Learn More . In FIDA-IDD, you would be part of a team that can help you make decisions about your health care. … Their primary care physician (and most types of specialists) need not be in network with their MLTC plan, they can go to any hospital that accepts their Medicare, and they can get radiology and lab tests from any provider that accepts their Medicare. Call ICAN for help. The purpose of the evaluation is to verify that the person seeking enrollment in fact requires long-term care. This chart shows the rates for risk-adjusted percentage of members who rated their Managed Long-Term Care (MLTC) plan as good or excellent, based on the most recent Biennial Member Satisfaction Survey. - Printable Brochure (Korean), Kisa MLTC ye? Members can go to the center to participate in social activities with other plan members. However, you need to make sure your doctors take the plan before you join. Provides long-term help with daily activities for people who are not eligible for Medicare or want to keep it separate. … If you have Medicaid only and need long term care, the rest of this brochure does not apply to you. People who are dual-eligible (meaning they have both Medicare and Medicaid), age 21 and older, and are in need of home care for more than 120 days are required to enroll in a Managed Long-Term Care (MLTC) plan. As a member of VillageCareMAX, you will have a team of health care professionals working with you … MLTC is a type of health insurance called managed care. Scroll to the end to view versions in other languages. If you have additional questions or concerns, contact the Independent Consumer Advocacy Network (ICAN) at 844-614-8800. Subject. TTY: (800) 662-1220. www.agewellnewyork.com. Toll Free 1-800-771 … This person will visit you at least twice a year and help you get the care you need. Once Maximus approves a patient to enroll in MLTC, the patient will be given the opportunity to select a MLTC of their choice. Unlike PACE, there is no center you need to go to for your doctors and other care. Answer a few questions and we’ll get you started. (Note: You can find your Department of Social Services on the NYS Department of Health website.) For logisitical reasons, this is not always the case in reality. Home care (including personal care, home health aide. Call Us Now! Flat Fee Retainers Are Available. … Partial MLTC plans manage the following Medicaid benefits: The following Medicaid benefits remain straight/non-managed Medicaid: It is important to note that, as always, Medicare will remain the primary health insurance for those that enroll in Partial MLTC plans. Depending on your personal preferences, this team can include any family members or friends who help you, your doctor, and your care manager at the plan. Medicaid Managed LongTerm Care plans (MLTC) provide long term services and supports to chronically ill and disabled people who are eligible for Medicaid. PACE combines Medicare, Medicaid and long term care services under one plan. As a result, members can usually only receive services from in-network providers. Medicare and Medicaid recipients are entitled to an extensive list of coverage benefits. A Medicaid Advantage Plus (MAP) plan is a type of integrated Dual-eligible Special Needs Plan (D-SNP) combined with a type of Medicaid managed long-term care (MLTC) plan offered through the same insurance company. Medicaid Advantage Plus: With this plan, you choose one of the doctors from the plan to be your Primary Care Provider (PCP). With these plans, you would no longer use your Medicare card to get medical care. TTY Relay Service: 771. You will need to fill out an application form and provide copies of documents. These plans are responsible for providing home care and other long-term care services (such as adult day care). You keep using your Medicare card or your Medicare Advantage Plan as you do now. You would still have traditional Medicare and Medicaid for your doctors, hospitals, and other medical care. To learn more about FIDA-IDD, see our brochure called A Plan for Me: FIDA-IDD, available online or by calling 844-614-8800. FIDA-IDD also covers waiver services, such as community habilitation, employment supports, and self directed care. If your provider is not in the plan’s network, then your insurance will not pay for you to see them. County and Date Became Mandatory Name of plan/ company Enrollment 6/2014 Enrollment 10/2014 Type of plan WESTCHESTER (Jan. 2013) AGEWELL NEW YORK 293 331 MLTC ALPHACARE 9 18 MLTC ARCHCARE COMMUNITY LIFE 430 436 MLTC CENTERLIGHT 369 310 MLTC ELDERPLAN (HomeFirst) 329 345 MLTC ELDERSERVE 143 163 MLTC FIDELIS CARE AT HOME 252 281 MLTC You can also use the Table of Contents to skip straight to your question. This team helps get you the services you need and makes sure all the parts of your health care are working together smoothly. You will only be able to receive long term care services by joining a plan. This article is based on a brochure about MLTC. And most people with Medicaid must get their long term care through an MLTC program. But all plans of the same kind must cover the same services. If you are not satisfied with the services being offered by the new plan, you may choose to decline the change. - Printable Brochure (Russian). MLTC Medicaid Plans 1-855-467-9351 TTY: 711 www.archcare.org ArchCare Community Life Bronx, Brooklyn, Queens, Manhattan, Staten Island 1-866-586-8044 TTY: 1-800-662-1220 www.agewellnewyork.com AgeWell New York Bronx, Brooklyn, Queens, Manhattan 1-855-456-9126 TTY: 711 www.aetnabetterhealth.com Aetna Better Health Bronx, Brooklyn, … Some Medicare beneficiaries choose to enroll in these plans.) After the plan completes their assessment the patient can be enrolled into MLTC. This “Lock-In” does not affect consumers that wish to enroll in a PACE or MAP plan and these plans do not have a “lock-in” period. Below is … Edison accepts no responsibility for the consequences of any actions taken due to any reliance placed on opinions, advice, or any other information contained herein. Email: ican@cssny.org. Those wishing to enroll in a MLTC plan must go through a two-stage process. AgeWell New York (866) 586-8044. 6. These plans are more convenient because you have only one insurance plan to worry about. Google Reviews. Individuals must be age 18 or older to enroll in a MAP plan. FIDA-IDD is only available in New York City, Nassau, Rockland, Suffolk, and Westchester. Changes in MLTC plans are made on a monthly basis and are effective on the first of the month. Which kind is right for you depends on whether you also have Medicare. Make sure you read all of your mail. DOH has issued MLTC Policy 14.01 governing transfers from mainstream Medicaid Managed Care (MMC) to Managed Long Term Care (MLTC). TIP: If a consumer is happy with the licensed home care services agency (LHCSA) that is sending the home health aide or personal care aide, or the CDPAP Fiscal Intermediary (FI) that is providing their CDPAP services, they can call the LHCSA or CDPAP FI directly and ask for their assistance in switching to a plan with whom they are contracted. In order for the plan to pay for your care, you must go to providers in the plan’s network. If you are Medicaid eligible and need home care services you will be required to join a MLTC Plan if you: Have both Medicaid and Medicare (dual eligible) Need home care, adult day health care, or other long term care for … There are three types of Managed Long-Term Care plans: Partial MLTC, PACE (Programs of All-Inclusive Care for the Elderly), and MAP (Medicaid Advantage Plus). Law Office of Inna Fershteyn and Associates, P.C. Health insurance pays for medical care like doctors, hospitals and drugs. Call ICAN at (844) 614-8800. VillageCareMAX is a Medicaid Managed Long-Term Care (MLTC) Plan that was created to help you to continue to stay at home, and in your community, for as long as possible. MAP plans “manage” all member benefits for both Medicare and Medicaid. Many of the services that you will receive as a member of VillageCareMAX will be provided right in your own home. You can choose a Medicaid MLTC, PACE or MAP plan. Like PACE and MAP, FIDA-IDD combines all of your Medicare, Medicaid and long term care services into one plan. Your Message. The Medicare and Medicaid services, including MLTC, are all covered by one managed care insurance plan called a MAP.