Long-term care for those with Medicare and Medicaid, and Medicaid recipients

Fallon Health Weinberg Managed Long Term Care (MLTC) is a plan for individuals who need long-term care services and who have Medicaid or are eligible. This is a mandatory program for those dually eligible for Medicare and Medicaid over the age of 21 needing home and community based long term care services. The program is voluntary for those who need long term care services and are not eligible for both Medicare but are eligible for Medicaid. The program is designed to keep participants living safely, and independently in the comfort of their own home.

There may be no cost to members. Members with excess income may have a “spend down.”

Who is eligible?

To be eligible to join Fallon Health Weinberg-MLTC, you must:

  • Be at least 21 years old
  • Live in Erie or Niagara County
  • Require home and community-based services for more than 120 days
  • Be capable, at the time of enrollment, of safely remaining in your home without jeopardy to your health and safety
  • Have Medicaid or be Medicaid eligible
  • Call 1-855-222-8350 to have a Conflict-Free Evaluation and Enrollment Center (CFEEC) nurse visit you to determine your eligibility.

Fallon Health Weinberg-MLTC may be a good fit for you if you:

  • Prefer to keep your current doctors
  • Receive home care and long-term care services at home

To join a Medicaid Community-Based Managed Long Term Care Program, a Conflict-Free Evaluation and Enrollment Center (CFEEC) nurse must first visit you to determine your eligibility.

Effective March 2015, New York State implemented an independent and conflict-free long term services and supports evaluation system for new applicants residing in Erie and Niagara County who are in need of community based long term care services. New York State has partnered with a company called Maximus and they will serve as the independent and conflict-free entity providing evaluations, education and enrollment services. Managed Long Term Care (MLTC) plans receiving calls from Medicaid or pending Medicaid recipients seeking a plan assessment of reenrollment must be directed to the Conflict-Free Evaluation and Enrollment Center (CFEEC) at 1-855-222-8350.

Take the next step

Contact us

1-866-882-8185 (TTY 711)

8 a.m.–5 p.m., Monday–Friday

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