• Additional covered services are different
depending on the plan you choose. Some
MLTC plans pay for hospital stays and
doctor visits.
or a full list of covered services, please
F
see http://www.health.ny.gov/health_care/
managed_care/mltc/coverservices.htm
334412/16
Department
of Health
Follow us on:
health.ny.gov
facebook.com/NYSDOH
twitter.com/HealthNYGov
youtube.com/NYSDOH
– Nursing home care and more.
– Social day care and adult day
health care
– Personal emergency response
system
– Home delivered meals
– Non-emergency transportation
to receive medically necessary
services
– Personal care
– Dental services
– Home care
– Care management
• All MLTC plans arrange and pay for the
following health and long-term care
services (as long as they are medically
necessary):
• Managed long-term care (MLTC) helps
people who are chronically ill or have
disabilities and who need health and longterm care services, such as home care or
adult day health care, stay in their homes
and communities as long as possible.
About Managed Long-Term Care
http://www.health.ny.gov/
health_care/managed_care/
mltc/consumer_guides/
Copies of this guide are
available at:
1-866-712-7197
New York State
Department of Health
MLTC Complaint Hotline
If you have a problem with your
health plan, call:
in Western New York
Long-Term Care
Managed
A Consumer’s Guide to
Important Numbers
Western New York
Choosing a managed long-term care (MLTC) plan
that meets your health needs is an important decision. This brochure will
help you make that decision by providing information about the quality
of care offered by the different plans and people’s opinions about the
care and the services the plans provide.
Managed Long-Term Care Plans
in Western New York
Web Sites
There are four types of MLTC plans: Partial Capitation Plans, Program
of All-inclusive Care for the Elderly (PACE), Medicaid Advantage Plus (MAP),
and Fully Integrated Duals Advantage (FIDA). Each plan covers the same
base set of services, with certain plans covering additional services. To be
eligible for any plan, you must meet certain age, health-status, and living
arrangement requirements.
Member Services
Phone Numbers
Allegany
Cattaraugus
Chautauqua
Chemung
Erie
Genesee
Livingston
Monroe
Niagara
Ontario
Orleans
Schuyler
Seneca
Steuben
Wayne
Wyoming
Yates
2016
Partial Capitation Plans
Centers Plan for Healthy Living www.centersplan.com
•
1-855-270-1600• ••
•••
1-800-288-5441•
www.wellcare.com
WellCare Advocate Partial
1-855-282-4642• www.vnsnychoice.org
VNS CHOICE MLTC
1-315-477-4663
www.vnahomecareoptions.org
VNA Homecare Options
1-855-345-6582• www.uhccommunityplan.com
United Health Personal Assist
1-800-894-2464•
www.kaloshealth.org
Kalos Health
1-844-424-7253•
www.icirclecny.org
iCircle
1-888-343-3547
www.fideliscare.org
Fidelis Care at Home
1-866-882-8185• •
www.fallonweinberg.org
Fallon Health Weinberg
www.elderwoodhealthplan.com1-866-843-7526•
Elderwood Health Plan
•
•
•
••
•
•
•
•
•
•
•
•
•••
•
•
••
••• ••••••••
••••
•
••••••••••••••
•
Program of All-Inclusive Care for the Elderly (PACE)
www.rochestergeneral.org1-855-457-4636•
ElderONE
1-716-285-8248•
www.hanci.com
Complete Senior Care
1-716-819-5433•
www.chsbuffalo.org
Catholic Health – LIFE
Fallon Health Weinberg-PACEwww.fallonweinberg.org
Total Senior Care
1-855-665-1113•
www.totalseniorcare.org
1-866-939-8613
•
••
Medicaid Advantage Plus (MAP)
No MAP plans in this region
Fully Integrated Duals Advantage (FIDA)
No FIDA plans in this region
Not every plan may be accepting new enrollment. Please call the plan member services phone number listed above to confirm availability.
334412/16
Department
of Health
• Additional covered services are different
depending on the plan you choose. Some
MLTC plans pay for hospital stays and
doctor visits.
Follow us on:
health.ny.gov
facebook.com/NYSDOH
twitter.com/HealthNYGov
youtube.com/NYSDOH
For a full list of covered services, please
see http://www.health.ny.gov/health_care/
managed_care/mltc/coverservices.htm
– Nursing home care and more.
– Social day care and adult day
health care
– Personal emergency response
system
– Home delivered meals
– Non-emergency transportation
to receive medically necessary
services
http://www.health.ny.gov/
health_care/managed_care/
mltc/consumer_guides/
– Personal care
– Dental services
Copies of this guide are
available at:
– Home care
– Care management
• All MLTC plans arrange and pay for the
following health and long-term care
services (as long as they are medically
necessary):
in Western New York
1-866-712-7197
Long-Term Care
New York State
Department of Health
MLTC Complaint Hotline
• Managed long-term care (MLTC) helps
people who are chronically ill or have
disabilities and who need health and longterm care services, such as home care or
adult day health care, stay in their homes
and communities as long as possible.
If you have a problem with your
health plan, call:
Managed
A Consumer’s Guide to
Important Numbers
About Managed Long-Term Care
Western New York
Yates
Wyoming
Wayne
Steuben
Seneca
Schuyler
Orleans
Ontario
Niagara
Monroe
Livingston
Genesee
Erie
Member Services
Phone Numbers
Chemung
Web Sites
Chautauqua
Managed Long-Term Care Plans
in Western New York
Cattaraugus
that meets your health needs is an important decision. This brochure will
help you make that decision by providing information about the quality
of care offered by the different plans and people’s opinions about the
care and the services the plans provide.
There are four types of MLTC plans: Partial Capitation Plans, Program
of All-inclusive Care for the Elderly (PACE), Medicaid Advantage Plus (MAP),
and Fully Integrated Duals Advantage (FIDA). Each plan covers the same
base set of services, with certain plans covering additional services. To be
eligible for any plan, you must meet certain age, health-status, and living
arrangement requirements.
Allegany
2016
Choosing a managed long-term care (MLTC) plan
Partial Capitation Plans
Centers Plan for Healthy Living www.centersplan.com
1-855-270-1600• ••
•
•••
Elderwood Health Plan
www.elderwoodhealthplan.com1-866-843-7526•
Fallon Health Weinberg
www.fallonweinberg.org
1-866-882-8185• •
Fidelis Care at Home
www.fideliscare.org
1-888-343-3547
iCircle
www.icirclecny.org
1-844-424-7253•
Kalos Health
www.kaloshealth.org
1-800-894-2464•
United Health Personal Assist
www.uhccommunityplan.com
1-855-345-6582• VNA Homecare Options
www.vnahomecareoptions.org
1-315-477-4663
VNS CHOICE MLTC
www.vnsnychoice.org
1-855-282-4642• WellCare Advocate Partial
www.wellcare.com
1-800-288-5441•
•
•
•
•
••
•
•
•
•
•
•
•
•••
•
•
••
••• ••••••••
••••
•
••••••••••••••
•
Program of All-Inclusive Care for the Elderly (PACE)
Catholic Health – LIFE
www.chsbuffalo.org
1-716-819-5433•
Complete Senior Care
www.hanci.com
1-716-285-8248•
ElderONE
www.rochestergeneral.org1-855-457-4636•
Fallon Health Weinberg-PACEwww.fallonweinberg.org
1-855-665-1113•
Total Senior Care
1-866-939-8613
www.totalseniorcare.org
Medicaid Advantage Plus (MAP)
No MAP plans in this region
Fully Integrated Duals Advantage (FIDA)
No FIDA plans in this region
Not every plan may be accepting new enrollment. Please call the plan member services phone number listed above to confirm availability.
•
••
2016
Western New York
A Consumer’s Guide to
Managed Long-Term Care in Western New York
More stars mean better health
plan performance with 5 stars
being the best.
Health Plan
Preventive Care
Prevention
Patient
Safety
Satisfaction with Care
Advanced
Directives
Quality
of Life
HH
HHHH
Rating of
Health Plan
Rating of
Regular
Visiting
Nurse
Rating
of Care
Manager
HH
HHH
Stability or Improvement
Timeliness
of Aide
ADL
Stable or
Improved
Pain
Intensity
Stable or
Improved
Shortness
of Breath
Stable or
Improved
Urinary
Continence
Stable or
Improved
HH
HH
HH
HHH
H
H
Overall
Rating
Partial Capitation Plans
Centers Plan for Healthy Living
H
HHHHH
Fallon Health Weinberg HHH
HH N/A
H N/A N/A N/A N/A
HHH
HHH
HHH
HHH
HH
Fidelis Care at Home
HHH
H
HHH
H
HH
HHH
HHHH
HH
iCircle
HH
H N/A
H N/A N/A N/A N/A
HHH
H
HH
HHH
H
Kalos Health
HH
H N/A
H N/A N/A N/A N/A
HHHH
HHH
HHH
HHHH
HH
United Health Personal Assist
HH
HHH
HH
HHH
HHH
HH
HHHH
HH
HHHH
HHHH
HHH
HHH
HHH
VNA Homecare Options
HH
H
HHH
HH
HHH
HHHH
HHHH
HH
HHHH
HH
HHH
HHHH
HH
VNS CHOICE MLTC
HHH
HHH
HHHH
HHHH
HHH
HHH
HHH
HHHH
H
H
H
H
HH
WellCare Advocate Partial
HH
HHHHH
HH
HHH
HHH
HHHH
HHHH
HHH
H
H
HH
HHH
HH
Catholic Health – LIFE
HHH
HHH
HHHHH
HHH
HHHHH
HHHHH
HHHHH
HHHHH
HHHH
HHH
HHH
HHH
HHHHH
Complete Senior Care
HHH
HHH
HHHHH
HH N/A N/A N/A N/A
HHHH
HHH
HHH
HHH
HHH
ElderONE
HHHHH
HH
HHH
HHH
HHHH
HHH
HHH
HHH
HH
Total Senior Care
HHH
H N/A
H N/A N/A N/A N/A
HHH
HH
HHH
HHHH
HH
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
H
HHH
HHH
HHHH
HHH
HHH
Program of All-Inclusive Care for the Elderly (PACE)
H
HHH
H
HHH
Medicaid Advantage Plus (MAP)
No MAP plans in this region —
Fully Integrated Duals Advantage (FIDA)
No FIDA plans in this region —
N/A Not able to report performance due to small numbers.
Plan performance data are not available for Fallon Health Weinberg-PACE and Elderwood Health Plan due to small numbers.
Ratings are based on a comparison of plan rates to statewide averages. Quality ratings are from information submitted by the Managed Long-Term Care Plans. Member Satisfaction ratings, Advanced Directives, and one component within the Quality of Life domain are from a Department of Health survey.
The quality of care measures used in this guide represent some, but not all, of the measures from Managed Long-Term Care plans. For additional information about the individual measures included in each category, as well as the other quality of care measures available such as nursing home utilization, please see the New York State Department of Health website: http://www.health.ny.gov/health_care/managed_care/mltc