What is Medicaid Long-Term Care Program?

The Statewide Medicaid Managed Care Long-Term Care Program. can be complicated, but what you need to know is that these terms are used within three agencies involved in the Medicaid application process, the Agency for Healthcare Administration (AHCA), Department of Children and Families (DCF), and the Department of Elder Affairs (DOEA).

You may not hear them throughout your application, but knowing the terms can sometimes help you filter through the departments when applying, following up, or trying to get answers quickly.

The two different programs that fall under “Statewide Medicaid Managed Care”:

• The Long-Term Care (LTC) Managed Care Program for those who are:
  • 65 yrs or older and need nursing facility level of care
  • Determined by the Comprehensive Assessment and Review for Long-Term Care Services (CARES) unit at the DOEA to be at nursing home level of care and meet one or more established clinical criteria.
  • 18 yrs or older, deemed “disabled” by SSA DDS, and need nursing facility level of care
  • In hospice
  • In institutional care
  • Aging out of Children’s Medical Services, but meet the following:
    • Received care before age 21 under the program
    • Cognitively intact
    • Medically complex
    • Technologically dependent
    • Medicaid pending for Long Term Care Managed Care HCBS waiver services
• The Managed Medical Assistance (MMA) Program

Services or Activities:

Each managed care plan contracted with AHCA to provide long-term care services must, at a minimum, provide the following services:

These services are available based on medical necessity, or must be deemed necessary in order to delay or prevent nursing facility placement.

Issues with your Medicaid Services?

File a complaint here,  to ensure Medicaid Long Term Care consumers have multiple ways to get information, make complaints, file grievances, or appeals.

Need more information regarding the Long Term Care Waitlist?

Please contact your local Aging and Disability Resource Center. Click here for the direct contact information of the ADRC in your region. You can also call the statewide Elder Helpline at 1-800-96-ELDER for immediate assistance.

AyudaCon.com seeks to provide information in both English and Spanish with a focus on topics relevant to normal people applying for public benefits. As always, AyudaCon.com wants you to know that the information you need is out there and available. It is mostly in English and can require time to locate or understand. Contact us to see how we can provide bilingual assistance with your Medicaid concerns.