Getting Started with HomeFirst Managed Long-Term Care Plan
In order to enroll in any managed long-term care plan (MLTCP), you must first establish eligibility.
Step One: Review Eligibility Information
In order to enroll, one must:
- Be 18 or older
- Qualify for Medicaid
- Live in one of the five boroughs of NYC, Dutchess, Nassau, Orange, Putnam, Rockland, Sullivan, Ulster or Westchester counties
- Be able to remain at home without jeopardy to health and safety
- Need continuous community-based long-term care services for more than 120 days (e.g., in-home nursing, therapies, home aide, personal care, Consumer Directed Personal Assistance Services, private duty nursing, or Adult Day health care)
Step Two: Contact HomeFirst
If you meet the eligibility criteria your next step is to contact HomeFirst Monday through Friday from 8:30 a.m. to 5 p.m. at 1-866-386-4177. An enrollment representative will confirm that you meet the eligibility requirements based on age, geographic location of your residence, and Medicaid eligibility. At this time we can also answer any additional questions by phone to help you determine if HomeFirst is an option for you. Once eligibility is confirmed, our enrollment representative will help you schedule your in-home clinical assessment.
Step Three: Schedule Clinical Assessment
We will schedule an in-home assessment, during which our Registered Nurse will obtain your health history, perform a clinical assessment, and provide you with detailed information about our plan and provider network.
Our Registered Nurse will talk with your doctor to develop a plan of care that is tailored to your needs.
Step Four: Membership Begins
The enrollment submission deadline for the following month is the 20th of every month or the nearest business day if the 20th falls on a weekend. Enrollment will begin on the first day of the month after your application is processed. Enrollment is voluntary and you may choose to withdraw your application at any time.
HomeFirst receives a set payment per month from Medicaid to cover services for enrollees. The services not part of HomeFirst benefits continue to be covered by fee for service Medicaid and/or Medicare. All services are coordinated, even those not included in the MLTCP benefit package.
HomeFirst is a product of Elderplan, which offers a variety of affordable health plans for Medicare, Medicaid and dual eligible recipients at every level of health. Elderplan is a health plan with Medicare and Medicaid contracts.