What is Managed Long-Term Care and What are My Available Options?

Managed long-term care is an option utilized by those who are disabled or chronically ill and need assistance with activities of daily living (ADL), but wish to remain within their homes and communities. Managed long-term care can be provided through the Program of All-Inclusive Care for the Elderly (PACE) and managed long-term care plans.

PACE is a little-known Medicaid and Medicare program that provides comprehensive health care services to eligible members 55 years and older who are otherwise eligible to be admitted to a nursing home. PACE is available through 110 programs in the United States, eight of which are located in New York State.

According to AARP, PACE provides coverage of in-home care, checkups, doctor and dental services, hospital and nursing home stays, as well as prescription medication and some transportation. PACE is open to those enrolled in Medicaid and/or Medicare; some may need to pay a monthly premium based on coverage. All applicants are screened by a team of doctors, therapists and nurses who will determine whether an individual’s level of health and disability requires the level of care typically provided in a nursing home.

Managed long-term care plans provide long-term care services, such as home health care, nursing home care, ancillary and ambulatory services and are funded through Medicaid. Medicaid members can use their Medicaid and/or Medicare cards to pay for services rendered by their primary physicians. To be eligible for a managed long-term care plan, the individual must qualify for nursing home admission. Most enrollees must be 65 years or older to qualify for a managed long-term care plan; however, there are several plans in New York State that will accept younger applicants.

P&P Medicaid provides assistance to those who are seeking a home care program to meet their needs or the needs of their loved ones. We offer a comprehensive in-home assessment conducted by our case manager, who, with the assistance of a nurse, can help determine program eligibility. Together, the case manager, the client and their family caregivers can develop a comprehensive long-term care strategy that is reassessed on a regular basis.

For those seeking qualification for Medicaid, P&P Medicaid will handle the entire application and document acquiring process and appear on the applicant’s behalf for all interviews with the Department of Social Services (Medicaid). For more information about home care evaluation, Medicaid application or any of our other services, please call us at (516) 541-4770 for a consultation.

Leave a Reply

Your email address will not be published. Required fields are marked *