Three Types of Long Term Care Plans

There are three types of Long Term Care Plans

▪ Program of All-Inclusive Care for the Elderly (PACE)

▪ Medicaid Advantage Plus 

▪ MLTC Medicaid Plan 

Note: As of December 31, 2019, the Fully Integrated Dual Advantage (FIDA) program is no longer available in the State of New York. If you have questions about FIDA, please call 1-855-600-3432. (TTY: 1-888-329-1541). FIDA-IDD, which is a program for people with intellectual and developmental disabilities is still active.

What’s the difference between these three types of plans?

All three plan types will provide the home care and other long term care services you need. In the case of PACE and Medicare Advantage Plus you must also use the plan’s doctors, although your existing doctors may agree to participate with the plan.  PACE offers you the option of receiving some services in your home or in its day center and on-site health clinic.  Both PACE and Medicare Advantage Plus will pay for all your Medicare health services at little to no additional costs.  Read below to see which kind of plan you want based on the services you will get directly from the plan.  If you have questions, call New York Medicaid Choice.

Will I also have to use the plan when I need to see a doctor or need any of my Medicare health services?

MLTC Medicaid Plan:  With this plan, you keep seeing the doctors you go to now. You keep using your Medicare card or your Medicare Advantage Plan as you do now. 

Medicaid Advantage Plus:  With this plan, you choose one of the doctors from the plan to be your Primary Care Provider (PCP). You must get all your Medicare health services from the plan.  

PACE:  With this plan, a team of doctors, nurses, social workers, nutritionists, physical, speech and occupational therapists and others will work together to create a care plan that ensures you receive all the health care services you need.  Services are available at home or at the adult day center and on-site clinic.  You can go to the center to participate in social and health maintenance activities and enjoy meals with other enrollees.  The plan will arrange for you to see other specialty health care providers as necessary and will arrange for transportation as well.  All your Medicare health services are covered by PACE.

Which plan is for me?

First, decide which type of plan you want from the list above. Find the plan on the left hand side of this page and click on it to learn about the specific services you will get. You can then call New York Medicaid Choice.  Our counselors will tell you which plan in your area works with the home care agency and other providers you have now or would like to have as a plan member.