HomeFirst Managed Long-Term Care Plan
(MLTCP)
Welcome to HomeFirst Managed Long-Term Care
Proud to be a 5-star Plan
Events in Your Area
Make the Most of Your Plan
How to maximize your benefits
General FAQs
How do I get the services I need?
Your Care Management Team will work with you to understand your needs, create a personalized plan of care, and arrange covered services. If your needs change, simply contact your Care Manager and they’ll help coordinate the care and support you need.
Who is my Care Manager, and how can they help?
Your Care Management Team is your primary point of contact for coordinating covered services, answering questions about your care, and helping you access the support you need. If you’re unsure who your Care Manager is, Member Services can help connect you.
Who should I call if I need help?
Whether you have questions about your benefits, need to request a service, or want help understanding your coverage, we’re here for you. Your Care Management Team and Member Services are just a phone call away and ready to help you every step of the way.
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.
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.
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.
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.
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.
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.
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.
Hearing
Benefits
- Audiology exams, hearing aid evaluations, fitting, and repair.
Coverage
- $0 to you. Service authorization required for hearing benefits.
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:
- Leaving HomeFirst: Being in this plan is your choice. You can leave whenever you want. Learn more about disenrolling from your plan.
Core Plan Documents
Member Forms
Get Care with HomeFirst Managed Long-Term Care
Everything you need to access covered services, understand your Coverage, and get the most out of your HomeFirst Managed Long-Term Care plan. Select a category below to learn how your Coverage works, find participating providers, or access resources and directories.
Always carry your HomeFirst Member ID card. Show your HomeFirst Member ID card and your New York State Medicaid card every time you receive covered services or visit a participating provider. This helps ensure your services are covered and your care is coordinated.
Find a Provider or Search Your Coverage
