Eligibility, cost and service area

Who’s 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:

• People who want to remain in their home with long-term care services
• People who may be willing to use the providers in the Fallon Health Weinberg network 

Monthly payments

As a Fallon Health Weinberg-MLTC member, you do not pay anything unless the County Department of Social Services determines that you have a monthly spend down and/or surplus amount. You will have a monthly spend down and/or surplus amount if your monthly income exceeds the monthly amount of income that the Medicaid Program allows..

Service area

Fallon Health Weinberg-MLTC's service area is Erie and Niagara counties, NY.

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.