Managed Long Term Care (MLTC)

What's New

The 2026 Medicaid Advantage Plus (MAP) Member Handbook is now available. - (Web) - (PDF)

The Dual Default Medicare File Process - MLTC Presentation - (PDF) is now available.

MLTC Policy 25.05: Enhanced MLTC Plan Oversight of Contracted Social Adult Day Cares (SADCs)

MLTC Policy 25.04: Minimum Needs Requirement Update to the Eligibility Requirements for Managed Long Term Care Enrollment

The Medicaid Advantage Plus (MAP) Integrated Appeals and Grievances Demonstration will conclude on December 31, 2025, the Department has included the Phase-out Plan below.

Phase-Out Plan

Please submit any comments to MLTCinfo@health.ny.gov with subject line:  MAP Integrated Appeals and Grievances Phase-Out Plan.

Managed long-term care (MLTC) is a program that streamlines the delivery of long-term services and supports to people who are chronically ill or disabled and wish to stay in their homes and communities. Community based long term services and supports (CBLTSS) 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.

New York continues to transform its MLTC program to one that ensures care management for all through enrollment in a MLTC plan. Individuals may enroll through mandatory or voluntary pathways, depending on the individual's needs and enrollment requirements.

CBLTSS includes nursing services in the home, therapies in the home, home health aide services, personal care services in the home, adult day health care, private duty nursing, or Consumer Directed Personal Assistance Services (CDPAS).

MLTC Overview

Enrollment in a MLTC plan is mandatory for those who:

  • Are dual eligible (Medicaid and Medicare), age 21 and older and are receiving community based long term care services and supports for more than 120 days, unless excluded.
  • Reside in the following counties:
    1. Effective 2012-2013 - NYC, Albany, Erie, Monroe, Nassau, Onondaga, Orange, Rockland, Suffolk & Westchester
    2. 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
    3. 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 individuals, age 18 through 20, who have been assessed as in need of community based long term care services for more than 120 days and assessed as eligible for nursing home level of care;
  • non-dual eligible individuals, age 18 and older, who have been assessed in need of community based long term care services for more than 120 days and assessed as eligible for nursing home level of care.

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