Managed Long-Term Care (MLTC)

We know what you're going through. And we can help.

When you or your parents have conditions that require a nursing-home level of care, but would rather live at home, we can make that possible. At Empire, we’ve been managing Medicaid long-term care plans for 10 years. We understand there is no one plan that fits all. Everyone has their own unique needs. So we do in-home assessments and develop personalized plans for people with Medicaid that:

  • Allow people to stay at home safely
  • Get them the care they need
  • Let them live their lives to the fullest
What you get with Empire Medicaid

Delivering care in the home — not the nursing home

Many people with debilitating conditions or illnesses need assistance on a day-to-day basis in order to safely remain in their home. To meet this need, Empire offers a Managed Long-Term Care (MLTC) program for Medicaid-eligible New Yorkers over age 18 who wish to receive needed services in the comfort of their home.

These benefits are covered when you join our MLTC program, so you never have any copays.

You keep all the Medicaid benefits you currently have access to when you join our plan and keep your independence in the home you love. Below is a partial list of Empire Managed Long-Term Care services. Call Empire for a complete list of covered services, full eligibility requirements and details about the MLTC program.

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

*Institutional Medicaid eligibility rules apply.

Choose Empire BlueCross BlueShield HealthPlus

We’re experienced with helping coordinate your long-term care services. We’re dedicated to ensuring positive member experiences by listening to their needs, giving them personal service, and treating them with the kindness and respect they deserve. Call 1-800-950-7679 (TTY 711) to find out more about MLTC and the Empire difference!

The services you need to stay at home are just one call away at 1-800-950-7679.

Eligibility

Empire BlueCross BlueShield HealthPlus is a New York Managed Care Organization (MCO). With us, you can get Long-Term Care (LTC) services from one of the nation’s leaders in helping LTC members live the way they want to live.

You are eligible to enroll in Managed Long-Term Care if you:

  • Are 18 or older
  • Are eligible for New York Medicaid as determined by the NYC Human Resources Administration (HRA)
  • Live in Brooklyn, the Bronx, Manhattan, Queens or Staten Island
  • Have a chronic illness or disability that makes you eligible for services usually provided in a nursing home
  • Are able to live at home without jeopardy to your health or safety
  • Have or are willing to change to a doctor who is willing to work with us
  • Require at least one of the following services for at least 120 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 care
    • Social day care

Already a member, and have questions?

Call Member Services at 1-800-950-7679 (TTY 711). Member Services is open Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 9 a.m. to 5 p.m. We are happy to help you with your health care!

Member Handbooks

Your member handbook is your go-to guide for health services. It tells you how you can get the most from Empire BlueCross BlueShield HealthPlus. You’ll find answers to these items:

  • Your benefits
  • How to get help after your doctor’s office closes
  • How to choose a primary care provider
  • Renewing your coverage
  • How to reach Member Services if you have a question

Member Handbooks

Notice of Privacy Practices

Frequently Asked Questions

What is Managed Long-Term Care?

Managed Long-Term Care (MLTC) is a program designed to help people with chronic illnesses who need help to stay in the home and community as long as possible.

Do I have to enroll in a Managed Long-Term Care plan?

No, you are not required to join an MLTC plan unless you have received a letter from Medicaid stating that you must join a plan.

Who is eligible for Managed Long-Term Care (MLTC) services?

People with Medicaid who:

  • Have chronic conditions or serious disabilities that make you eligible for nursing home level of care
  • Are able to stay at home at the time you join the plan
  • Are expected to need long-term care services for more than 120 days
  • Are at least 18 years or older
  • Live in the service area (the Bronx, Brooklyn, Manhattan, Queens and Staten Island)

How does your plan help me?

Each member has his or her own care manager who will contact him or her periodically to see how he or she is doing. That means you have one person you work with who will help you. The care manager is either a Registered Nurse (RN) or a social worker who is trained in managing chronic conditions.

Do you need Medicare?

No, you do not have to have Medicare to be eligible. The MLTC program is for nondual eligible persons (Medicaid only) and dual eligible persons (Medicaid and Medicare).

What is included in MLTC?

MLTC offers health and long-term care services (as long as they are medically necessary). Some of these services include:

  • Home care
  • Physical and speech therapies
  • Vision
  • Dental
  • Hearing
  • Respiratory therapy
  • Personal care
  • Personal Emergency Response Systems
  • Podiatry
  • Social day care
  • Adult day health care
  • Nonemergency transportation

What does MLTC not cover?

There are six key things we don’t cover:*

  • Hospitalization
  • Physicians
  • Specialists
  • Lab tests
  • Pharmacy benefits
  • Behavioral health

You either get these services through Medicare or through fee-for-service Medicaid.

Are there copays?

No. When you join our MLTC program, you never have any copays for our covered services.

Do you lose your Medicaid benefits when you join our plan?

No. As an MLTC member, you are eligible for Medicaid and keep all the benefits you may currently enjoy.

Can I keep my doctor?

Because it’s not a covered benefit, you access the same doctor or specialist the way you do now. If you also qualify for Medicare, you usually can keep the same primary care physician and specialists for your acute care.

How do you sign up?

Give us a call at 1-800-950-7679. We’ll schedule your in-home visit with a Registered Nurse, who will explain the program, assess your needs and answer any questions you have about the program. If you need help with Medicaid eligibility, we can assist you.

Other questions? Call 1-800-950-7679 and get answers.

We’re here from 8 a.m. to 8 p.m. local time — we’ll answer any questions you have about the program and do everything we can to help you. Our staff is as diverse as New York itself, and we are available to speak multiple languages to assist you.