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What’s Included with Your Plan

At HomeFirst, our 5-Star Managed Long-Term Care Plan is designed to help you live safely and independently at home with the long-term services, support, and care coordination you need.

This section provides a clear overview of your covered long-term care services (the care and support available to you) and your coverage (how, when, and to what extent those services are provided), so you can make the most of your HomeFirst plan.

Benefits at a Glance

Care Management

Benefits

  • A care manager — usually a nurse or social worker — who builds your care plan with you and your doctor, arranges appointments, and helps coordinate transportation to them.

Coverage

  • $ 0 to you. Provided automatically to every member — no prior authorization needed.
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Health Care at Home

Benefits

  • Help with everyday activities and skilled care, right where you live. This could include a home health aide, personal care, nursing, physical, occupational, and speech therapy, medical social services, private duty nursing, and respiratory therapy. You can also choose Consumer Directed Personal Assistance Services (CDPAS), where you pick and manage your own aide — even a friend or family member.
  • Home-delivered meals and supports such as home maintenance, chore help, and respite care are covered, too.

Coverage

  • $0 to you. This is part of what Medicaid calls Long-Term Services and Supports (LTSS). Services must be medically necessary, and your Care Management Team must approve them before you start.
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Shield with a check icon Support and Care in the Community

Benefits

  • Care and connection in your community through two different types of day programs, depending on your clinical and social needs: Adult Day Health Care or Social Day Care Services

Coverage

  • $0 to you. Services must be medically necessary and approved before you start. Social Day Care can be part of your care plan, but it cannot be your only service.
learn about day programs
Nursing Home Care

Benefits

  • Care in a participating nursing home or skilled nursing facility, including Veterans Home placement for eligible veterans, their spouses, and Gold Star Parents.

Coverage

  • $ 0 to you. Covered for permanent placement. Service authorization required. After about three months of permanent placement, care may transition to regular Medicaid.
Stethescope graphic Medical Equipment & Supplies

Benefits

  • Durable medical equipment, medical and surgical supplies, enteral nutrition products, orthotics, prosthetics, orthopedic footwear, and hearing aid batteries.

Coverage

  • $0 to you. Covered when medically necessary and authorized by the plan.
Nutrition & Meal Services

Benefits

  • Home-delivered or congregate meals (for example, at a senior center) and nutrition assessment and counseling.

Coverage

  • $0 to you. For members who are unable to plan, shop for, or prepare meals due to illness, disability, or advanced age. Prior authorization required.
Shield with a check icon Personal Emergency Response System (PERS)

Benefits

  •  An electronic device that lets higher-risk members get help quickly in an emergency.

Coverage

  • $0 to you. Service authorization required.
Dental Care

Benefits

  • Preventive care such as exams, cleanings, X-rays and essential services such as fillings, crowns, root canals, dentures and more.

Coverage

  • $0 to you. Dental services are provided through our in-network partner, DentaQuest. Certain services may require service authorization.
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Eye graphic Vision

Benefits

  • Eye exams, eyeglasses, and medically necessary contact lenses.

Coverage

  • $0 to you. Covered by HomeFirst through Superior Vision. Routine vision services don’t require authorization.
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Ear graphic Hearing

Benefits

  • Audiology exams, hearing aid evaluations, fitting, and repair.

Coverage

  • $0 to you. Service authorization required for hearing benefits.
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Shield with a check icon Foot Care- Podiatry

Benefits

  • For medically necessary foot care for conditions like diabetes or ulcers.

Coverage

  • $0 to you. Routine hygienic care (such as nail trimming) is not covered without a medical condition; service authorization is required.
Telehealth Services

Benefits

  • Care is delivered through secure video and communication technology

Coverage

  • $ 0 to you. No service authorization required.

Additional Plan Notes:

Extras

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Wellness Programs & Rewards

Wellness Incentive Program and other member wellness activities

Members may earn rewards for completing eligible health and wellness activities

Learn More About Your Wellness Incentive
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Member to Member

Engagement and support program

Provides additional social support and peer interaction within the Elderplan community.

Learn More
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Support Beyond Your Benefits

Your plan offers additional programs that support your health and independence beyond your covered benefits.

Learn how Senior Planning Services (SPS) and the Social Care Network (SCN) can help you understand your benefits, plan for the future, and connect with community resources—all at no cost for eligible members.

Explore Support Programs
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