An MLTC, or Managed Long Term Care plan, is a Medicaid-funded health plan that coordinates home-based and community-based services for people who need ongoing help with daily activities like bathing, dressing, or eating. These plans are specific to New York State and are designed to help people stay in their homes or communities rather than move into a nursing home. To qualify, you generally need to require this level of care for more than 120 days and need physical assistance with more than two daily living activities.
How an MLTC Plan Works
When you enroll in an MLTC plan, the state pays the plan a fixed monthly amount to cover your long-term care needs. The plan then assigns you a care manager, typically a nurse, who assesses your situation and builds a personalized care plan. That plan spells out exactly what services you’ll receive, how many hours per week, which providers will deliver them, and what to do if a caregiver is temporarily unavailable.
Your care manager is your main point of contact. They coordinate your home care services, monitor whether your needs change over time, and adjust your plan accordingly. The care plan also documents your personal goals, your strengths and preferences, and any informal support you have from family or friends. If you also receive behavioral health services through a Health Home program, your MLTC care manager coordinates with that team to avoid overlap.
Services Covered by MLTC
MLTC plans focus on long-term services and supports rather than hospital visits or doctor appointments. The core benefit is home care: personal care aides or home health aides who help with bathing, grooming, meal preparation, mobility, and other daily tasks. Plans also cover adult day care, skilled nursing visits at home, medical equipment like wheelchairs or hospital beds, and other community-based supports that help you live independently.
New York also runs a program called the Consumer Directed Personal Assistance Program (CDPAP), which allows you to hire and manage your own caregivers, including family members. If you’re enrolled in an MLTC plan, CDPAP services are coordinated through the plan. You or a designated representative handle recruiting, training, and scheduling your assistants, while a statewide fiscal intermediary (currently Public Partnership LLC) processes payroll and tax withholdings.
Three Types of MLTC Plans
New York offers three variations, each bundling services differently.
- MLTC Partial (Medicaid Plan): This is the most common type. It covers only your long-term care services. Your Medicare benefits, including doctor visits, hospital stays, and prescriptions, stay completely separate. You keep your existing Medicare doctors and use your Medicare card for those services. This plan is available to people 18 or 21 and older (depending on the county) who have Medicaid, with or without Medicare.
- Medicaid Advantage Plus (MAP): A MAP plan wraps everything together. It combines your Medicare benefits, Medicaid benefits, long-term care, and prescription drug coverage under one organization. You must be 18 or older and have both Medicare and Medicaid. The trade-off is that you need to use doctors and hospitals within the MAP plan’s network.
- Program of All-Inclusive Care for the Elderly (PACE): PACE is built around a day center where you receive medical care, therapies, and social activities from a dedicated team of doctors, nurses, and social workers. You must be at least 55 years old and assessed as needing a nursing-home level of care. PACE is available to people with Medicaid alone or both Medicare and Medicaid.
Eligibility Requirements
Qualifying for an MLTC plan involves both financial and medical criteria.
On the financial side, you need to be eligible for Medicaid. In New York, the 2026 income limit for home and community-based long-term care services is $1,836 per month for a single person. There are also asset limits. If your income exceeds the threshold, you may still qualify through a surplus income program (sometimes called a “spend-down”) or by setting up a qualified income trust. Income limits vary significantly by state for similar Medicaid long-term care programs elsewhere in the country.
On the medical side, as of September 1, 2025, you must be assessed as needing community-based long-term care for more than 120 days and need at least limited physical assistance with more than two activities of daily living. Activities of daily living include things like bathing, dressing, eating, toileting, transferring in and out of a bed or chair, and walking. If you have an Alzheimer’s or dementia diagnosis, the threshold is slightly lower: you need at least supervision with more than one activity of daily living.
How to Enroll
Enrollment goes through New York’s Conflict-Free Evaluation and Enrollment Center (CFEEC). This is an independent entity, separate from the MLTC plans themselves, that evaluates whether you meet the medical criteria for community-based long-term care. The process is designed to prevent conflicts of interest, since the organization assessing your needs isn’t the same one that will be paid to provide your care.
You can start by calling the CFEEC directly, or an MLTC plan can help you with the Medicaid application and then transfer you to the CFEEC for the clinical evaluation. During the evaluation, a nurse conducts a standardized assessment of your functional abilities and care needs. Once the CFEEC determines you’re eligible, you choose which MLTC plan to join. After enrollment, the plan’s own nurse will do a more detailed assessment to build your care plan.
Switching Plans and Lock-In Periods
Your ability to switch plans depends on which type you chose. With a Partial MLTC (Medicaid Plan), you can transfer to a different plan for any reason during your first 90 days. After that, you’re locked in for nine months unless you have a valid reason to change, such as the plan dropping a provider you depend on or failing to deliver authorized services. MAP and PACE plans don’t have the same lock-in period, so you can request a transfer at any time, though Medicare enrollment rules may affect the timing.
MLTC vs. Regular Medicaid Home Care
Before MLTC existed, Medicaid long-term care in New York was managed on a fee-for-service basis, meaning the state paid providers directly for each service. MLTC shifted this to a managed care model where the plan receives a set monthly payment and is responsible for coordinating all your long-term care. For you as an enrollee, the practical difference is having a single care manager who oversees everything rather than navigating multiple providers on your own. The state’s goal with this shift was to expand home and community options, improve service quality, and control costs compared to nursing home placement.
If you need long-term care for fewer than 120 days, or if you don’t meet the minimum needs threshold, you wouldn’t enroll in MLTC. Short-term home care after a hospital stay, for example, is handled through regular Medicaid or Medicare home health benefits instead.