Medicaid Managed Care and Managed Long Term Care 

Medicaid Managed Care (MMC) 

Managed Care plans focus on preventive health care and provide members with a medical home for themselves and their families. In many counties, once you are eligible for Medicaid, you can join a plan if there is one available and you want to join. 

**It is usually required that you select health care providers from the managed care plan's network of professionals and hospitals. 

Enrollment in Medicaid managed care is available at any local Department of Social Services.

Managed Care is a term that is used to describe a health insurance plan or health care system that coordinates the provision, quality and cost of care for its enrolled members.  In general, when you enroll in a managed care plan, you select a regular doctor, called a primary care practitioner (PCP), who will be responsible for coordinating your health care. Your PCP will refer you to specialists or other health care providers or procedures as necessary.

Managed care plans pay the health care providers directly, so members do not have to pay out-of-pocket for covered services or submit claim forms for care received from the plan's network of doctors. However, managed care plans can require co-pays paid directly to the provider at the time of service.

Managed Long Term Care (MLTC)

Managed long-term care (MLTC) helps people who are chronically ill or have disabilities and who need health and long-term care services, such as home care or adult day care, stay in their homes and communities as long as possible. The MLTC plan arranges and pays for a large selection of health and social services, and provides choice and flexibility in obtaining needed services from one place.

You are eligible to enroll in managed long-term care if you:

  • have a chronic illness or disability that makes you eligible for services usually provided in a nursing home;
  • are able to stay safely at home at the time you join the plan;
  • are expected to need long-term care services for at least 120 days from the date you enroll;
  • meet the age requirement of the plan (the age requirement for a PACE organization is 55 years old; for most other plans, the age requirement is 65 years old);
  • live in the area served by the plan;
  • have or are willing to change to a doctor who is willing to work with the plan; and
  • have a way of paying that is accepted by the plan. All plans accept Medicaid. Some plans also accept Medicare and private pay.
  • See the Managed Long-Term Care Plan Directory to find out which plans accept Medicaid, Medicare or private pay enrollees.

For more information, please contact a plan in your area so that a Member Services Representative can help you. 

Click here to see the complete list of Providers Venture Forthe is contracted with. 

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