Deciding on long-term care is significant, but it doesn’t have to feel overwhelming. Whether you’re planning for yourself or a loved one, understanding what long-term care is, when it’s needed, and the available options will help you make the best choice. 

What Is Long-Term Care?

Long-term care includes a range of services designed to support individuals who need assistance with medical and non-medical needs due to a chronic illness, disability, or age-related challenges. The type of services you receive depends on the care required and the setting in which it will be provided. 

Long-Term Care Services May Include:

• Assistance with Activities of Daily Living: Help with bathing, dressing, eating, and mobility.
• Medical Support: Skilled nursing care, medication management, and rehabilitation therapies.
• Specialized Programs: Disease-specific programs for COPD, CHF,  Diabetes, and Dementia.
• Care Management: Provides effective planning and coordination of services to help ensure individuals living at home or residents of a skilled nursing center receive the care they need. 

When Is Long-Term Care Needed?

Long-term care might be needed at home or as a resident of a skilled nursing center if: 

• You’re struggling with daily tasks like bathing, dressing, cooking, or transferring from your bed to a chair alone.
• Caregivers feel overwhelmed and need extra support.
• Staying safely at home, even with support, becomes a concern due to falls or confusion.
• You have a chronic health condition that is worsening, requiring more frequent medical attention.
• A health care provider recommends ongoing professional round-the-clock inpatient care.

Where Can You Receive Long-Term Care?

Depending on your medical condition and support system, long-term care can be provided at home or in a skilled nursing center. 

At Home

A long-term care plan can help you or a loved one receive ongoing assistance with activities of daily living, care coordination, medication management, and additional support at home. To enroll, you must have or be eligible for Medicare and Medicaid or Medicaid only and meet established clinical criteria. 

In a Skilled Nursing Center

Also known as nursing homes or Centers for Rehabilitation and Nursing Care, these centers provide inpatient medical and nursing care, social work, and spiritual support, as well as specialized programs such as memory care, in a supportive environment for residents who require round-the-clock care. 

What are Long-Term Care Plans?

Medicare Advantage Long-Term Care and Medicaid Managed Long-Term Care plans are designed to provide their members with the long-term care services, support, and care coordination needed to help them remain safely home.

Key Features of Long-Term Care MLTC Plans:

• Eligibility Requirement: You must have or qualify for Medicaid or Medicare and Medicaid and meet the clinical criteria for long-term care.
• Care Management: Provides comprehensive coordination. A dedicated care manager will collaborate with you,  your loved one, personal care worker and treating physician to develop and execute a personalized care plan. They will oversee and manage all aspects of your care.
• Covered Services: Services will vary depending on the type of long-term care plan. However, all plans provide care management, personal care workers, home health care, including various forms of therapy, transportation, and durable medical equipment like walkers, rollators and wheelchairs. The amount of support will also vary depending on your condition. 
• Focus on Independence Focus: Provides the care coordination, nursing, rehab, and home health aide support necessary to help you remain safe and independent at home for as long as possible.

Which Type of Long-Term Care Is Right for You?

Choosing between long-term care at home and inpatient care in a skilled center will depend on your needs, preferences, and resources.

Consider staying at home with support from a long-term care plan if you:  

• Want to receive the services and care you need at home.
• Have or qualify for Medicaid, or Medicare and Medicaid and meet medical eligibility criteria.
• Can live safely at home with professional support and caregiver assistance.

You may want to consider long-term care at a skilled facility if you:

• Require 24/7 medical supervision and care.
• Have advanced neurologic or mobility challenges.
• Need memory care for advanced dementia or a cognitive disorder.
• Can no longer remain at home safely.

How to Get Started with a Long-Term Care Plan

If you’re considering a long-term care plan, the first step is to determine if you have or are eligible for Medicaid or Medicare  &Medicaid. Your local Social Security office should be able to help you determine your eligibility.

If you have or qualify for Medicaid or Medicare and Medicaid and prefer to receive care at home, you may want to learn more about the two long-term care plans offered by Elderplan/HomeFirst, a participating agency of MJHS Health System.. 

MJHS also offers long-term care at our two not-for-profit skilled centers:  MJHS Menorah Center in Manhattan Beach, Brooklyn, and MJHS Isabella Center in the Washington Heights section of Upper Manhattan.

Reference: https://www.health.ny.gov/health_care/managed_care/mltc/