What Is Managed Long-Term Care (MLTC) in New York?
For New Yorkers who need ongoing help with everyday activities, long-term care does not always mean moving into a nursing facility. Many people receive long-term care services in their own homes and communities.
Managed Long-Term Care (MLTC) is a New York Medicaid system designed to help eligible individuals receive and coordinate long-term services and supports while remaining at home or in their community whenever appropriate.
MLTC can include services such as personal care, home health aide services, nursing, therapy and other forms of long-term support. The exact services available depend on a person’s eligibility, assessed needs, Medicaid coverage and MLTC plan.
For additional information about Medicaid-funded care, visit Sincere Care Agency’s New York Medicaid Resource Center.
What Does Managed Long-Term Care Mean?
Managed Long-Term Care is not a home care agency itself. It is a way New York Medicaid organizes and coordinates long-term care services for eligible individuals.
According to the New York State Department of Health’s MLTC overview, MLTC is intended to coordinate community-based long-term services and supports for people with chronic health conditions or disabilities who want to remain in their homes and communities.
An MLTC plan may be responsible for coordinating covered long-term care services, working with participating providers and determining which covered services are authorized based on the member’s assessment and plan of care.
This is an important distinction:
The MLTC plan coordinates and authorizes covered services. A home care agency provides authorized home care services when appropriate under the person’s coverage and plan of care.
What Services Can an MLTC Plan Cover?
The services available through MLTC vary according to the plan, the individual’s eligibility and the services that have been authorized.
Depending on the person’s needs, covered long-term care services may include:
Personal care assistance
Home health aide services
Nursing services in the home
Physical, occupational or other qualifying therapies
Adult day health care
Medical equipment and supplies
Consumer-directed personal assistance services, when applicable
Other covered community-based long-term services and supports
New York’s MLTC program specifically includes community-based services such as personal care, home health aide services, nursing and therapies among the services that may be used to meet ongoing long-term care needs.
You can learn more about Medicaid-funded services in Sincere Care’s guide to what New York Medicaid covers.
Who May Qualify for MLTC in New York?
MLTC eligibility depends on the type of plan, the individual’s Medicaid status, functional needs and current New York State program requirements.
In general, an individual seeking MLTC must meet applicable Medicaid eligibility requirements and be assessed as needing qualifying long-term services and supports.
For certain MLTC plans, current New York rules require an individual to be expected to need qualifying community-based long-term services and supports for more than 120 days.
Examples of qualifying services can include:
Personal care services in the home
Home health aide services
Nursing services in the home
Certain therapies provided in the home
Adult day health care
Private-duty nursing
Consumer-directed personal assistance services
Eligibility is determined through the appropriate New York Medicaid and assessment process. A home care provider does not make the official MLTC eligibility determination.
For general Medicaid eligibility information, see Sincere Care Agency’s New York Medicaid FAQ.
What Are the MLTC Minimum Needs Requirements in 2026?
New York changed certain MLTC eligibility requirements effective September 1, 2025. These rules remain important for people seeking new MLTC enrollment in 2026.
For MLTC Partial Capitation and certain other affected enrollment pathways, an individual generally must be assessed as needing community-based long-term services and supports for more than 120 days and satisfy New York’s Minimum Needs Requirements.
Under the current requirements, an applicant generally must be assessed as needing:
At least limited assistance with physical maneuvering for more than two Activities of Daily Living (ADLs); or
For an individual with a qualifying Alzheimer’s disease or dementia diagnosis, at least supervision with more than one ADL.
New York also maintains special rules for some people who were already enrolled or receiving applicable services before the new requirements took effect. These are referred to as Legacy Status rules.
Because these rules can depend on enrollment history, plan type and individual circumstances, families should use the New York State Department of Health’s current MLTC information when evaluating official eligibility requirements.
What Are Activities of Daily Living?
Activities of Daily Living, commonly called ADLs, are basic everyday activities that allow a person to care for themselves safely.
Examples can include:
Bathing
Dressing
Toileting
Eating
Walking or moving around the home
Transferring between a bed, chair or other position
Personal hygiene
The amount and type of assistance someone needs with these activities can be an important part of a long-term care assessment.
Needing help at home, however, does not by itself guarantee approval for a particular program or number of care hours. Eligibility and service authorization are determined through the applicable Medicaid assessment and plan process.
How Does the MLTC Assessment Process Work?
An individual seeking certain Medicaid long-term care services may need an assessment before MLTC enrollment or home care services can be authorized.
New York uses the New York Independent Assessor Program (NYIAP) for certain long-term care assessments and eligibility determinations. The assessment process evaluates functional needs and whether applicable program requirements are met.
Depending on the individual’s circumstances, the process may include:
Confirming Medicaid eligibility through the appropriate government agency.
Completing required long-term care assessments.
Determining whether current MLTC eligibility requirements are met.
Selecting or enrolling with an appropriate MLTC plan when required.
Completing the plan’s assessment and service-authorization process.
Arranging authorized services with participating providers.
The exact process can vary. Families should rely on official New York Medicaid and MLTC resources for current assessment and enrollment instructions.
Does Having Medicaid Automatically Mean Someone Qualifies for MLTC?
No.
Medicaid eligibility and MLTC eligibility are related, but they are not the same determination.
A person can have New York Medicaid without automatically qualifying for Managed Long-Term Care or home care services. Long-term care generally requires additional assessment of the individual’s medical, functional and daily living needs.
Likewise, approval for Medicaid does not automatically determine:
Whether MLTC enrollment is appropriate
What type of home care may be covered
How many hours of care may be authorized
Which providers may deliver the services
Those decisions are made by the responsible Medicaid agency, assessment program or MLTC plan according to applicable program rules.
Sincere Care explains this distinction further in its New York Medicaid FAQ.
How Does MLTC Work With a Home Care Agency?
Once long-term care services have been assessed and authorized, an eligible individual may receive care from an approved participating provider.
For example, an MLTC plan may authorize personal care or home health aide services based on the individual’s assessed needs and plan of care. The home care agency then provides the authorized services according to that plan.
Through agency-directed home care, the home care agency may handle responsibilities such as:
Recruiting and screening caregivers
Coordinating caregiver schedules
Supervising agency caregivers
Providing care consistent with the approved plan of care
Communicating about agency-provided services
Sincere Care Agency provides licensed agency-directed home care services for eligible New Yorkers. If services have been authorized through Sincere under an individual’s coverage, our team can explain our intake process and coordinate approved care.
What Is the Difference Between MLTC and CDPAP?
MLTC and the Consumer Directed Personal Assistance Program (CDPAP) are related to Medicaid long-term care, but they are not the same thing.
An MLTC plan can coordinate long-term care benefits and may authorize different types of covered services depending on eligibility and assessed need.
CDPAP is a consumer-directed model in which eligible participants or their designated representatives take responsibility for selecting and directing their personal assistants.
With agency-directed home care, the licensed home care agency manages caregiver staffing and supervision instead.
Sincere Care Agency provides agency-directed home care and educational information about these different care models. Sincere does not administer CDPAP enrollment, payroll or fiscal-intermediary functions.
Learn more in Sincere Care’s guide to CDPAP and PPL First in New York.
Can You Choose Your Home Care Agency With MLTC?
Provider choices depend on the individual’s MLTC plan and its participating provider network.
Before selecting a home care agency, the member or family should confirm with the MLTC plan that:
The requested home care service has been authorized
The provider participates with the applicable plan
The provider can deliver the authorized service in the person’s location
Any required plan procedures have been completed
If your coverage authorizes services through Sincere Care Agency, our intake team can explain the next steps for beginning our agency-provided home care services.
What Happens if a Person’s Care Needs Change?
Long-term care needs can change over time.
A person may need more or less assistance because of changes in mobility, health, cognition, living arrangements or the ability to complete activities of daily living.
MLTC members are reassessed according to applicable New York and plan requirements. When care needs change, the individual or their representative should contact the MLTC plan to discuss the appropriate process for requesting a review.
The plan or responsible Medicaid entity—not the home care agency—determines whether covered services or authorized hours should change.
Frequently Asked Questions About MLTC in New York
Is MLTC the same as Medicaid?
No. Medicaid is the underlying government health coverage program. MLTC is a system used to coordinate certain long-term services and supports for eligible Medicaid recipients.
Does MLTC cover home care?
MLTC may cover authorized home and community-based long-term care services, including personal care and home health aide services, depending on the member’s eligibility, assessment, plan and approved care needs.
Do I automatically qualify for MLTC if I need help at home?
No. Needing assistance at home does not automatically establish MLTC eligibility. Applicants must meet applicable Medicaid, assessment and program requirements.
What does the 120-day requirement mean?
For certain MLTC enrollment pathways, the individual must be expected to require qualifying community-based long-term services and supports for more than 120 days.
Who determines how much home care someone receives?
The responsible Medicaid plan or other authorized Medicaid entity determines covered services and authorized care based on applicable assessments, program requirements and the person’s individual needs.
Can Sincere Care Agency determine whether I qualify for MLTC?
No. Sincere Care Agency does not make Medicaid or MLTC eligibility determinations, conduct official eligibility enrollment or authorize home care hours.
Sincere can explain its own agency-provided home care services and intake process after the appropriate Medicaid and plan decisions have been made.
Learn More About Medicaid Home Care in New York
Managed Long-Term Care can help eligible New Yorkers receive ongoing services and support while remaining in their homes and communities. Because eligibility, assessments and service authorization depend on individual circumstances and current New York State rules, families should use official government resources when making decisions about MLTC enrollment or program eligibility.
For official program information, visit the New York State Department of Health Managed Long-Term Care program page or review the state’s current MLTC eligibility requirements.
If you already have New York Medicaid and are looking for agency-provided home care, Sincere Care Agency can explain our services, review your existing coverage information as it relates to our services and discuss our intake process.
Sincere Care Agency is a private licensed home care provider and is not a government agency. Sincere does not issue Medicaid benefits, determine Medicaid or MLTC eligibility, enroll individuals in MLTC plans or authorize covered services. Eligibility, enrollment and benefit decisions are made by the appropriate government agency, assessment program or Medicaid plan.
