Managed Long Term Care (MLTC)
What's New
The National Core Indicators Aging and Disabilities (NCI-AD) Adult Consumer Survey
The New York State Department of Health and our survey vendor, Knowledge Services, will be surveying over 400 people across the state. Your response will help us understand members' experiences receiving home and community-based services (HCBS). The survey is optional and will not impact your Medicaid enrollment or the services or supports you receive.
If you have been contacted to participate and have questions about the survey, please see the Frequently Asked Questions or contact Knowledge Services at: 866-228-5859.
Thank you for your time and participation.
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. These services, such as home care or adult day care, are provided through managed long-term care plans that are approved by the New York State Department of Health. The entire array of services to which an enrolled member is entitled can be received through the MLTC plan the member has chosen.
As New York transforms its long-term care system to one that ensures care management for all, enrollment in a MLTC plan may be mandatory or voluntary, depending on individual circumstances.
MLTC Overview
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 120 days.
- Reside in the following counties:
- Effective 2012-2013 - NYC, Albany, Erie, Monroe, Nassau, Onondaga, Orange, Rockland, Suffolk & Westchester
- Effective 2014 - Broome, Cayuga, Chenango, Columbia, Cortland, Delaware, Dutchess, Fulton, Genesee, Greene, Herkimer, Livingston, Madison, Montgomery Niagara, Oneida, Ontario, Orleans, Oswego, Otsego, Putnam, Rensselaer, Saratoga, Schenectady Schoharie, Steuben, Sullivan, Tioga, Tompkins, Ulster, Washington, Warren, Wayne, Wyoming
- Effective 2015 - Allegany, Cattaraugus, Chautauqua, Chemung, Clinton, Essex, Franklin, Hamilton, Jefferson, Lewis, St. Lawrence, Seneca, Schuyler, Yates
Enrollment in MLTC plan is voluntary for those who:
- Are dual eligible and are 18 through 21 years of age and need community based long term care services for more than 120 days and assessed as nursing home eligible.
- Are non-dual eligible and over 18 years of age and are assessed as nursing home eligible.
To learn more about the migration of long-term care services to a managed care environment, click here for the MRT 90 webpage:
To learn more about the managed long-term care options available, choosing a plan, covered services and enrollee rights, click here:
To see a list of available MLTC plans, click here:
To learn how the different MLTC plans rate, click here:
NYS MLTC Plan Information
Service Authorization, Appeals, and Notices
Health Plan Specific Member Handbook
NYS Model Member Handbooks
- Partial Capitation - (Web) - (PDF)
- Medicaid Advantage (Note: This program ended December 31, 2021.)
- Medicaid Advantage Plus - (Web) - (PDF)
NYS Contracted Health Plan Provider Directories
NYS Contracted Health Plan Ownership and Control Interest Information
NYS Contracted Health Plan Network Adequacy Standards
NYS Social Adult Day Care (SADC) Home and Community Based Services (HCBS) Compliance
