FAQS

What does MLTC stand for?

MLTC stands for Managed Long Term Care.

What is Managed Long Term Care?

Managed Long Term Care (MLTC) is a system that streamlines the delivery of long-term services to people who are chronically ill or disabled and who wish to stay in their homes and communities.

Who provides these MLTC services?

These services such as home care or adult day care are provided through managed long term care plans, such as EverCare Choice, that are approved by the New York Department of Health. The entire array of services to which an enrolled member is entitled can be received through the MLTC plan the member has chosen.

Is enrollment mandatory?

The State of New York mandates that residents that are dual eligible (eligible for both Medicaid and Medicare) and over twenty-one (21) years of age and have been determined to be eligible for Long Term Placement in a nursing home or reside in the community and are in need of community based long-term care services for more than 120 days and your nursing home or residence is located in the counties of Rockland, Orange or Dutchess, among others, you must enroll in a Managed Long Term Care Plan (“MLTCP”).

What if I don’t have to enroll, but want to?

You may voluntarily enroll if you are age eighteen (18) through twenty (20) and you are dual eligible and have been assessed as eligible for nursing home level care and as needing community based long-term care services for more than 120 days; or if you are only Medicaid eligible and age eighteen (18) and older and have been assessed as eligible for nursing home level of care and as needing community based long-term care services for more than 120 days.

Enrollment in EverCare Choice is voluntary, and there are other MLTC Plans that you could join. In order to be eligible for enrollment in EverCare Choice, you must be:

  • At least 18 years of age
  • A resident of and living in Dutchess, Orange, or Rockland County
  • Eligible for Medicaid (as determined by your Local Department of Social Services)
  • Eligible for the Plan, as determined by the eligibility assessment tool designated by the State of New York Department of Health
  • Determined eligible for Long Term Placement in a nursing home or living in the community and capable of returning to or remaining in your home without jeopardy to your health and safety at time of enrollment if you are currently living in the community
  • In need of long-term care services and care management from EverCare Choice for greater than 120 days. You must need—and receive—at least one of the following services from EverCare Choice to qualify for initial and ongoing enrollment:
    • Nursing services in the home
    • Private duty nursing
    • Therapies in the home
    • Home health aide services
    • Personal care services in the home
    • Adult day health care
    • Consumer Directed Personal Assistance Services
    • Skilled nursing care in a network facility

How do I know if I am eligible to enroll in EverCare Choice?

You are eligible to enroll in EverCare Choice if:

  • You meet the age requirements above.
  • You are a resident of Dutchess, Orange, or Rockland counties.
  • You are eligible for Medicaid benefits in the county you reside in.
  • You received a conflict free evaluation by Maximus New York State Medicaid Choice and were assessed as eligible.
  • You are capable at the time of enrollment of returning to or remaining in your home and community without jeopardy to your health and safety.
  • You are expected to require at least one (1) of the following services covered by the MLTC plan for more than 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 health care;
    • Private duty nursing; or
    • Consumer Directed Personal Assistance Services (CDPAS).

What if I don't understand the process of enrolling?

Contact one of our excellent EverCare Choice MTLC Member Services Representatives to answer any questions you may have toll-free at 877-255-3678.

What time can I call?

EverCare Choice MLTC is open for business Monday through Friday, 8:30 am – 5:00 pm.

Why should I choose EverCare Choice MLTC as my MLTC?

We are so glad you asked!

There are many reasons… but let me tell you about some:

First, EverCare Choice has been in operation for 17 years! Our staff has vast clinical experience, extensive knowledge of community support services, and an excellent track record in their advocacy of those under our care. Our members have peace of mind knowing their care is individualized and our number one priority.

Second, we are truly a healthcare organization – have always been – and we think that’s really important! We love that most of our staff live close to those under their care… we feel it keeps us connected. Being part of the community means that our offices, nurses, and providers all have long–standing relationships with each other.

Third, unlike many of our competitors, we are a not–for–profit organization. That means we are the type of organization that does not earn profits for its owners. All of the money earned by or donated to a not–for–profit organization is used in pursuing the organization’s objectives.

Fourth, we don’t just say we are caring, kind, and compassionate, we ARE! That is what we live for …that is what we do! We are true caretakers – that’s what makes us very proud!