Managed Long Term Care | NY Medicaid

Extra care to help you live independently in NY

Managed Long-Term Care (MLTC) provides services and support to NY Anthem members with long-lasting health problems or disabilities.

MLTC services include help with everyday tasks like bathing, dressing, getting around the house, making meals, or doing household chores. A designated care manager will help you find the services you need. They'll do an in-home assessment, develop a personal care plan, and coordinate benefits with your other healthcare providers.

Already a member? To pay your surplus, use the link below.

Pay my surplus

Who's eligible for MLTC?

You may be eligible for MLTC through Anthem if you:

Are 18 or older.

Are eligible for Medicaid.

Live in the Bronx, Brooklyn (Kings), Manhattan (New York), Queens, Staten Island (Richmond), Nassau, Suffolk, or Westchester County.

Have a chronic illness or disability that makes you clinically eligible for enrollment, based on an assessment.

Are expected to need at least one (1) of the following community based long-term care services for more than 120 continuous days from the effective date of enrollment:

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
Consumer Directed Personal Assistance Service (CDPAS)

Interested in becoming an MLTC member?

Call 855-800-4683 (TTY 711) to find out more about MLTC and how to enroll with Anthem.

What you get with Anthem

Benefits of Anthem MLTC coverage include:

Adult day health care
Care management
Dentistry
Durable medical equipment not covered by Medicare
Enteral and parenteral supplements
Hearing aids/hearing aid batteries
Home health care not covered by Medicare
Home-delivered or congregate meals
Medical social services
Medical/surgical supplies
Nursing home care not covered by Medicare (Medicaid eligibility rules apply)
Nutritional counseling
Personal care
Personal emergency response system
Private duty nursing
Social day care
Social supports and changes to the home
Vision care

Be sure to review the Anthem MLTC member handbook for a complete list of benefits. For some services, a doctor's order and/or approval from Anthem may be required.

Consumer Directed Personal Assistance Service (CDPAS) provides in-home services for people who:

Are self-directing or have someone to make choices about their care.
Need community-based long-term care services.

Being a self-directing member means you or a person you choose are responsible for making decisions about and managing your CDPAS services. These services are provided through your MLTC plan.

Learn about CDPAS

Coordinated services are services that aren’t covered by your Anthem MLTC plan. You get these services through Medicare or through fee-for-service Medicaid. Your care manager is here to assist you by arranging and coordinating services for you such as:

Hospitalization
Physician care
Specialist care
Lab tests
Prescription drugs
Behavioral health

Our care management team works to help make healthcare less complicated for our MLTC members. We manage all your physical, behavioral health, and long-term care services through care coordination. These services include:

Your care manager

You'll have your own care manager who'll get to know you, your family, and your care team. They will help you:

Access the right long-term care services in the right setting.
Receive necessary medical supplies and equipment.
Find doctors and other resources close to home.
Make good healthcare choices.

Your care team

Your care team includes a care manager, doctors, and family. We’ll work together to help manage your health.

Your care plan

You'll get a care plan designed just for you. Your care manager will work with you to decide what care and services are needed to meet your healthcare goals.

Your health plan support

Our team of experienced nurses and social workers know your community. They can help you decide on treatment options, find local resources, and learn how to get the most from your benefits.

Some services need preapproval or prior authorization. This means you or your doctor must ask Anthem to approve those services or benefits before you get them. These services include:

Adult day health care
Audiology/hearing aids
Consumer Directed Personal Assistance Service (CDPAS)
Dentistry
Durable medical equipment
Home care
Home-delivered or congregate meals
Medical social supplies
Nursing home care (Residential Healthcare Facility)
Nutrition services
Occupational therapy
Optometry/eyeglasses
Personal care
Personal Emergency Response System
Physical therapy
Podiatry
Private duty nursing
Respiratory therapy
Social day care
Social and environmental supports
Speech therapy

Not yet a member? Choose Anthem.

We can help you apply. Call 855-800-4683 (TTY 711), or visit us in person. Find a Community Service Center near you.

Enroll

Understanding your benefits

We want to make sure you receive the best possible care and understand your benefits. Here are some resources to get started:

Member Handbook - Managed Long-Term Care (English)

Member Handbook - Managed Long-Term Care (Spanish)

Member Handbook - Managed Long-Term Care (Chinese)

Member Handbook - Managed Long-Term Care (Russian)

Member Handbook - Managed Long-Term Care (Bengali)

Member Handbook - Managed Long-Term Care (Korean)

Dental Benefits Handbook Insert (English)

Dental Benefits Handbook Insert (Spanish)

Dental Benefits Handbook Insert (Chinese)

Dental Benefits Handbook Insert (Russian)

Dental Benefits Handbook Insert (Bengali)

Dental Benefits Handbook Insert (Korean)

Review all member materials

Get even more with Medicaid Advantage Plus (MAP)

The MAP Program is designed for people who have Medicare and Medicaid and who need health services and Community Based Long Term Services and Supports (CBLTSS) like home care and personal care to stay in their homes and communities as long as possible. You’ll get your Medicaid home care and long-term care services, plus your Medicare services—all coordinated in one plan. Find out if you're eligible and learn more about MAP today.

Ready to join MAP? Call 1-855-593-0908 to enroll. Already a member? Call 1-833-713-1080 for help.