New York Managed Long-Term Care (MLTC)

As an Anthem Blue Cross and Blue Shield HP MLTC plan member in New York, you get many benefits to help you live independently at home.

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

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

  • Adult day health care
  • Audiology/hearing aids
  • Care management
  • Consumer Directed Personal Assistance Service (CDPAS)
  • Dentistry
  • Durable medical equipment
  • Home care
  • Home-delivered or congregate meals
  • Medical social services
  • Nonemergency medical transportation
  • 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
  • Speech therapy
  • Social and environmental supports

 

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

Call your care manager at 855-661-0002 (TTY 711), Monday through Friday from 8 a.m. to 5 p.m. Eastern time.

If you have medical questions and can't reach your care manager, call our 24/7 NurseLine at 855-661-0002 (TTY 711) anytime, day or night.

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.

Get even more with Medicaid Advantage Plus (MAP)

 

MAP is a Managed Long-Term Care plan for people who have both Medicare and Medicaid. To join this plan, you must enroll with Anthem Medicare. 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.