MLTC stands for Managed Long Term Care, a type of Medicaid health plan designed for people who need ongoing help with daily activities like bathing, dressing, or eating for more than 120 days. Instead of piecing together services on your own, an MLTC plan coordinates everything from home health aides to medical equipment to adult day care under one roof. The program is most commonly associated with New York State, where it operates as a major pathway for people to receive long-term care at home rather than in a nursing facility.
How MLTC Plans Work
MLTC plans operate on what’s called a capitated model. Medicaid pays the plan a fixed amount per member each month, and the plan is responsible for arranging and covering all of the long-term care services that person needs. You’re assigned a care manager who coordinates your care, schedules services, arranges transportation, and helps make sure nothing falls through the cracks.
The core idea is to keep people living in their communities rather than moving into nursing homes. States across the country have adopted similar managed long-term services and supports programs as a strategy for expanding home and community-based care, but New York’s MLTC system is one of the largest and most structured.
Three Types of MLTC Plans
New York offers three distinct MLTC plan types, each covering a different combination of services depending on your insurance and care needs.
- MLTC Partial Capitation covers long-term care services only. You must be 18 or older and have Medicaid. Your regular medical care (doctor visits, hospital stays, prescriptions) is still handled separately through Medicaid fee-for-service or another plan. This is the most common type.
- Medicaid Advantage Plus (MAP) bundles long-term care services together with full medical and Medicare coverage in a single plan. You need both Medicaid and Medicare to qualify, and you must be 18 or older. MAP plans also cover behavioral health services, though the range varies by plan.
- PACE (Program of All-Inclusive Care for the Elderly) is the most comprehensive option. It wraps Medicare, Medicaid, long-term care, prescription drugs, and behavioral health into one program. PACE requires you to be 55 or older and to meet a nursing home level of care. It also covers services that the other plan types may not, including crisis intervention, peer mentoring, substance abuse programs, and community integration counseling.
What Services Are Covered
All MLTC plans arrange and pay for a broad set of health and long-term care services, as long as they’re medically necessary. The core benefits include:
- Home care: nursing visits, home health aides, personal care assistance with bathing, eating, and dressing
- Therapies: physical, occupational, speech, respiratory, and other rehabilitation therapies
- Daily living supports: home-delivered meals or meals at a day center, social day care, adult day health care
- Medical supplies and equipment: wheelchairs, walkers, prosthetics, orthotics, personal emergency response systems
- Other health services: dental care, eye exams and glasses, hearing aids, podiatry, nutrition counseling, medical social services
- Home modifications and supports: chore services, environmental modifications to make your home safer
- Transportation: non-emergency rides to medically necessary appointments
- Nursing home care: if community-based care is no longer sufficient
MAP and PACE plans layer on additional medical coverage, including doctor visits, hospital stays, and prescription drugs. PACE plans offer the widest range of supplemental services, with options like respite care for family caregivers, moving assistance, and home visits from medical staff.
Who Qualifies for MLTC
Eligibility has two parts: financial and clinical.
On the financial side, you must qualify for Medicaid. New York uses income and asset limits that are updated annually. As of January 2025, an individual can have up to roughly $28,000 to $31,000 in annual income (depending on the specific eligibility category) and up to about $37,650 to $42,312 in countable resources. For couples, those limits are higher. If one spouse needs MLTC and the other remains in the community, the community spouse can keep resources between $74,820 and $157,920, which protects them from having to spend down nearly everything.
On the clinical side, you must be assessed as needing community-based long-term care for more than 120 days. Specifically, you need at least limited help with physical tasks across more than two activities of daily living (things like walking, bathing, toileting, dressing, eating, or transferring in and out of a bed or chair). If you have a dementia or Alzheimer’s diagnosis, the threshold is slightly lower: you need at least supervision with more than one activity of daily living. For PACE, the requirement is stricter. You must qualify for a nursing home level of care.
How to Enroll
Enrollment starts with an independent clinical assessment. New York uses the New York Independent Assessor Program (NYIAP) to evaluate whether you meet the clinical threshold. This assessment is done by an entity that has no financial relationship with any MLTC plan, so the evaluation isn’t influenced by the plan that would end up covering you.
Once you’re assessed as eligible, you choose an MLTC plan. When comparing plans, look at which home care agencies and providers are in each plan’s network, whether your current aide or doctor participates, what the plan’s service area covers, and any additional benefits the plan offers beyond the required minimum. New York publishes plan directories and comparison tools through its enrollment resources.
Self-Directed Care Through CDPAP
One option available within MLTC is the Consumer Directed Personal Assistance Program (CDPAP), which lets you hire and manage your own caregivers rather than receiving aides assigned by a home care agency. This means you can choose a family member or friend as your paid caregiver. You (or a designated representative) are responsible for recruiting, training, and supervising your workers. CDPAP is administered through your MLTC plan, and you can contact your managed care organization for help with the registration and enrollment process. A single statewide fiscal intermediary, Public Partnerships LLC, handles payroll and administrative functions for CDPAP workers.
MLTC vs. Regular Medicaid
Standard Medicaid covers doctor visits, hospital stays, and prescriptions, but it doesn’t coordinate long-term home care the same way. Without an MLTC plan, getting home health aides, adult day care, and other ongoing supports requires navigating multiple providers and approvals independently. MLTC consolidates that into one plan with a dedicated care manager. For anyone who needs consistent, ongoing help at home, MLTC is the primary vehicle through which New York delivers those services. In fact, most people in the state who need community-based long-term care are required to enroll in some form of managed long-term care rather than receiving those services through traditional fee-for-service Medicaid.