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Managed Long-Term Care (MLTC)

Man talking with friends

Managed Long-Term Care (MLTC) provides services and supports to help people with long-lasting health problems or disabilities stay in their homes and communities.

Our number one priority is to help you manage your condition and live in the comforts of your own home as independently as possible, for as long as possible. We do in-home assessments and develop a person-centered Plan of Care, which means you will have an active role in planning your services. You’ll also have a care manager who will assist you in your care needs and accessing services.

Is MLTC right for you?

You are eligible to enroll in MLTC if you:

  • Are 18 or older
  • Are eligible for Medicaid
  • Live in Brooklyn, the Bronx, Manhattan, Queens or Staten Island
  • 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 Services

What you get with Empire

Covered services

When you join our plan, you keep all your current Medicaid benefits. Below is a partial list of Empire MLTC services. These benefits are covered when you join our MLTC program, so you never have any copays.

  • Adult day health care
  • Care management
  • Consumer Directed Personal Assistance Services (CDPAS)
  • Dentistry
  • Durable medical equipment
  • Enteral and parenteral supplements
  • Hearing aids/hearing aid batteries
  • Home health care
  • Meals (home-delivered or congregate)
  • Medical social services
  • Medical/surgical supplies
  • Nonemergency transportation
  • Nursing home care (Institutional Medicaid eligibility rules apply)
  • Nutritional counseling
  • Occupational therapy
  • Optometry/eyeglasses
  • Personal emergency response system
  • Physical therapy
  • Podiatry
  • Private duty nursing
  • Prosthetics and orthotics
  • Private duty nursing
  • Respiratory therapy
  • Social day care
  • Speech therapy
  • Social supports and modifications to the home

Respecting you and your choices

Consumer Directed Personal Assistance Service (CDPAS)

The 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 voluntary and provided through your Medicaid benefit at no cost to you.

Learn about CDPAS

Coordinated services

Coordinated services are those services that are not covered by your enrollment in Empire MLTC. You either get these services through Medicare or through fee-for-service Medicaid. Your care manager is here to assist you by arranging and coordinating these services for you.

  • Hospitalization
  • Physician care
  • Specialist care
  • Lab tests
  • Prescription drugs
  • Behavioral health

Prior approvals

For some covered services, you may need a physician’s order and/or prior approval from Empire before you receive them. Your care manager can assist you with getting these services.

  • Adult day health care
  • Audiology/hearing aids
  • Dentistry
  • Durable medical equipment
  • Enteral and parenteral supplements
  • Hearing aid batteries
  • Home health care
  • Home-delivered/congregate meals
  • Medical/surgical supplies
  • Nonemergent transportation
  • Nursing home care
  • Nutritional counseling
  • Optometry/eyeglasses
  • Orthotics
  • Outpatient therapy
  • Personal care
  • Personal Emergency Response System
  • Private-duty nursing
  • Prosthetics
  • Respiratory therapy
  • Social day care
  • Social supports and home modifications

Already a member? We’re glad you chose Empire.

We want you to understand your benefits and receive the best possible care. Here are some resources to help.

Member handbook

Complete benefit information can be found in your member handbook.

Personal care manager

Your care manager is here to answer your questions and work with your providers to make sure that you have the right care at the right time. To reach your care manager, call Member Services at 1-800-950-7679 (TTY 711). You can call Monday through Friday from 8 a.m. to 8 p.m. Eastern time.

24/7 NurseLine

If you have medical questions and cannot reach your care manager, you can always call our 24/7 NurseLine and speak directly to a nurse. Call 1-800-950-7679 (TTY 711) any time, day or night.

 
 
NurseLine illustration

24/7 NurseLine

Whether it’s 3 a.m. or a Sunday afternoon, health issues come up. That’s why you can always call our 24/7 NurseLine and speak directly to a nurse. Call 1-800-950-7679 (TTY 711) anytime, day or night.

Tell us what you think

We’re always looking for ways to improve your plan. Our Member Advisory Council meets at least four times a year, so you can:

  • Tell us how we can better serve you
  • Give feedback about your plan
  • Hear what’s happening in the MLTC Community

To learn more, call Quality Management Member Liaison Evelyn Miranda at 1-212-563-5570, ext. 66576, or email evelyn.miranda@empireblue.com