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.
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. 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).
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.
Overview
The MLTC Program includes three lines of business: MLTC Partial Capitation (MLTCP), Medicaid Advantage Plus (MAP) and Program for the All-Inclusive Care for the Elderly (PACE). For more information on each line of business including additional plan requirements, click on the line of business in the table below:
| Title | Description |
| MLTC Partial Capitation (MLTCP) | Age Requirements: 18 years and older Coverage Required: Medicaid This line of business provides community based long term care and ancillary services, including home care and up to 3 months of nursing home care. |
| Medicaid Advantage Plus (MAP) | Age Requirements: 18 years and older Coverage Required: Medicaid and Medicare This line of business provides integrated care including but not limited to behavioral health, primary care, acute, and long term care services. |
| Program for the All-Inclusive Care for the Elderly (PACE) | Age Requirements: 55 years and older Coverage Required: Medicaid, Medicare and Private Pay This line of business provides integrated care including includes all medically necessary services-primary, acute, and long term care. |
Click below for more information.
Enrolling Into a MLTC Plan
- Medicaid Eligibility Requirements
- determined eligible for Medicaid by the Local Departments of Social Services or entity designated by the Department
- Community Health Assessment
- To enroll in a MLTCP plan:
- individuals must be assessed as needing community based long term care services and supports for more than 120 days and meet the Minimum Needs requirements as follows:
- Needs at least limited assistance with physical maneuvering with more than two activities of daily living (ADL); or
- Individuals that have a Dementia or Alzheimer's diagnosis and need at least supervision with more than one ADL
- individuals must be assessed as needing community based long term care services and supports for more than 120 days and meet the Minimum Needs requirements as follows:
- To enroll in a MAP plan:
- individuals must be assessed as needing community based long term care services and supports for more than 120 days and meet the Minimum Needs requirements as follows:
- Needs at least limited assistance with physical maneuvering with more than two activities of daily living (ADL); or
- Individuals that have a Dementia or Alzheimer's diagnosis and need at least supervision with more than one ADL
- individuals must be assessed as needing community based long term care services and supports for more than 120 days and meet the Minimum Needs requirements as follows:
- To enroll in a a PACE plan:
- individuals must be 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
- To enroll in a MLTCP plan:
- Program enrollment criteria
- Each line of business has specific enrollment criteria that individuals must meet to enroll. For additional information, please select the line of business below.
MLTC Partial Capitation (MLTCP) Medicaid Advantage Plus (MAP) Program for the All-Inclusive Care for the Elderly (PACE)
- Each line of business has specific enrollment criteria that individuals must meet to enroll. For additional information, please select the line of business below.
Health Plan Specific Member Handbook, NYS Contracted Health Plan Provider Directories, and NYS Contracted Health Plan Ownership and Control Interest Information
NYS Contracted Health Plan Network Adequacy Standards
- Network Adequacy Standards
- To see if a specific provider participates with a specific managed care organization, please visit here.
NYS Social Adult Day Care (SADC) Home and Community Based Services (HCBS) Compliance
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:
Department Templates including Service Authorization, Appeals, and Notices
To learn more about the migration of long-term care services to a managed care environment, click here for the MRT 90 webpage:
