What to Look for When Choosing a Managed Long-Term Care Plan

Does the Plan Offer the Services You Need?

Start with your individual care needs. Think about the help you need today as well as services you may need in the future.

Depending on your eligibility and assessed needs, long-term care services may include personal care, home health care, nursing, therapies, adult day health care and other services and supports.

Ask each plan which services it covers, how it will assess your needs, and how it will develop your plan of care.

Are Your Providers in the Plan's Network?

If you already receive care from home care agencies, specialists or other long-term care providers, find out whether they participate in the plan's network.

You may also want to look at the overall size and availability of the plan's provider network. Access to providers in your community can make it easier to get the services you need.

Before enrolling, ask what happens if a provider you currently use is not in the plan's network.

How Will the Plan Coordinate Your Care?

Care coordination is an important part of Managed Long-Term Care.

Ask how the plan will get to know you and your individual needs. Find out whether you will have a dedicated care manager or care team and how often they will communicate with you.

Your care team should help you understand your plan of care, coordinate authorized services and connect you with resources that can help you remain safely in your home and community.

How Easy Is It to Get Help When You Need It?

Consider what it will be like to work with the plan after you enroll.

Ask how you can reach your care manager and Member Services, what assistance is available when you have questions and what you should do if your needs change.

If you or someone helping with your care prefers a language other than English, ask about interpretation, translation and other language assistance services. You may also want to ask about accommodations for hearing, vision or other accessibility needs.

How Does the Plan Handle Changes in Your Care Needs?

Long-term care needs can change over time. You may need more assistance after a hospitalization, for example, or your ability to complete everyday activities may change.

Ask how the plan reassesses your needs and what you should do if you believe your current services are no longer enough.

It is also helpful to understand how the plan makes decisions about services, how it will notify you of those decisions, and what options you have if you disagree with a decision about your care.

What Additional Support Is Available?

Look beyond individual services and ask what other support the plan provides.

For example, does the plan help connect members with community resources? Does it provide education or support for family caregivers? Are there programs that can help members stay socially connected or support their overall well-being?

These services may not be the first thing you consider when comparing plans, but they can make a difference in your overall experience.

Make a Choice That Fits Your Needs

No single Managed Long-Term Care plan is right for everyone. Your health needs, providers, preferred language, location, family support and personal preferences can all play a role in deciding which plan works for you.

Take the time to ask questions and compare your options. Most importantly, make sure you understand how the plan will provide and coordinate the long-term care services and support you need to continue living safely and independently in your community.