State programs
Medicaid managed long-term services and supports (MLTSS)
Medicaid managed long-term services and supports, or MLTSS, is a way states deliver long-term care through managed care plans. The state pays each plan a fixed monthly amount per member. The plan arranges services such as in-home help. MLTSS mainly serves older adults and adults with disabilities.
Why it matters for your family
In a managed program, a health plan, not the state, arranges and pays providers. Families usually choose a plan and receive a service coordinator. Some states cover only long-term care this way. Others include most Medicaid services, or fully combine Medicare and Medicaid. Texas STAR+PLUS and Virginia Cardinal Care are examples. A common mistake is to assume all caregivers are covered. Providers often must be in the plan's network. Ask the plan which agencies it works with, and how to ask for a different coordinator. Families can also ask how to change plans if the service is poor.
Source: medicaid.gov
Related terms
- STAR+PLUS (Texas)STAR+PLUS is a Texas Medicaid managed care program for adults with disabilities and adults age 65 or older.
- Cardinal Care (Virginia Medicaid)Cardinal Care is the name for Virginia's Medicaid and related health coverage programs, including Medicaid, FAMIS, and Plan First.
- MyCare OhioMyCare Ohio is Ohio's managed care program for adults age 21 or older who have both Medicare and Medicaid.
- Care coordinatorA care coordinator is a person who organizes a person's care among doctors, agencies, and family.
- Home and community-based services (HCBS) waiverA home and community-based services (HCBS) waiver is a Medicaid program that pays for care at home or in the community instead of in a nursing home.
- Dual eligibleA dual eligible is a person who has both Medicare and Medicaid.
