3 Managed Medicaid Plan Types that Cover In-Home Care

Maximize Your Coverage: A Guide to Choosing the Best Medicaid Managed Care Plan

Senior couple discussing how to choose the best managed Medicaid plan type

Choose the managed Medicaid plan type that works best for you and your loved ones!

If you or your loved one has a long-lasting medical condition or disability — you may be considering enrolling in a Medicaid Managed Care Plan.

But which one? Not all Medicaid plans cover long-term in-home care. Knowing which ones cover the benefit is essential to avoid plan-selection remorse. Read on to find the best one for you and your family.

1. MLTC Plans

First, we will cover the plan type that provides its enrollees the most flexibility, the Managed Long Term Care Plan or “MLTC” for short. If Medicaid were a pizza, the MLTC would manage just a slice of that pie.

Enrollees may still utilize their free Medicaid or Medicare for benefits that are not listed, which is why this is considered the most flexible plan type out of the four we will be reviewing.

MLTC plans are intended for long-term care for more than 120 days. Take note that you have to be 21 years or above to enroll in one of these plans.

The MLTC plan’s primary focus is on home and long-term care services. 

Home health aides, physical therapists, and nurses help provide services as long as they are deemed medically necessary by the plan. Some specialty health services are also covered benefits in these plans, most notably audiology, dental, optometry, and podiatry.

Aside from that, they also provide social day care, personal emergency response, home modifications, and non-emergency transportation to medical appointments. As we stated before, you have the most freedom with MLTC plans.

2. MAP Plans

The next Managed Medicaid Care plan type we will cover is Medicaid Advantage Plus Plans, or “MAP” for short.

Medicaid Advantage Plus Plans are for people who want all their Medicaid/Medicare medical needs covered/managed within one plan — doctors, hospital, and home care. MAP plans covers both Home Health Aide services and also the CDPAP benefit. The long-term care services offered are the same as MLTC, but several Medicare services are also covered.

Here’s just a few:
• Doctor office visits
• Specialty care
• Clinic visits and hospital stays
• Mental health services
• X-ray and other Radiology services
• Chiropractic care
• Medicare part D drug benefits
• Ambulance services

3. PACE Plans

The next Medicaid Managed Care plan type we will cover is the Program for All-Inclusive Care for the Elderly, or “PACE” for short.

Many individuals who select this plan type are interested in receiving community-based services and also seek a centralized dedicated care team under one roof. To enroll, you need to be at least 55 years old.

PACE primarily revolves around the enrollee’s adult day health center that promotes care and socialization among plan members.

Compared to the other plans, PACE services are handled by an interdisciplinary provider team. This team is comprised of professional and paraprofessional staff. They assess the member’s needs, develop care plans, deliver services, and ensure that all member’s social and medical requirements will be addressed.

Some of the Medicaid and Medicare services covered under this program are:

• Dentistry
• Emergency services
• Hospital care
• Home Health Aide service and CDPAP
• Laboratory/x-ray services
• Meals
• Medical specialty services
• Nursing home care
• Nutritional counseling
• Occupational therapy
• Physical therapy
• Prescription drugs
• Primary care (including doctor & nursing services)
• Recreational therapy
• Social services
• Social work counseling
• Transportation

You are free to choose which plan works for you. Before making a final decision, discuss your options with the people who help you make medical decisions, like immediate family members and physicians.

If you need help finding the right plan, fill out the form below, we’re eager to help!

couple embracing after receiving in-home care and cdpap


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