Guaranteed Managed Long-Term Care Services
In addition to offering our array of Specialized Services, ICS Community Care MLTC also coordinates and pays for the following guaranteed Medicaid Managed Long-Term Care Services:
Adult Day Health Care
A place people can go to during the day to receive assistance with their activities of daily living and socialize. It is usually located within a senior center or nursing home. People who attend may also receive the following services: nursing support; primary care physician; physical, speech, and occupational therapy; nutritional counseling; dentistry; podiatry; and medication administration.
A core service for a MLTC plan, care coordination is commonly provided by a care manager, working on an interdisciplinary team (i.e. nurse, social worker, physical or occupational therapist and support staff). Care coordination is the act of the team working with the individual to create a care plan that identifies their social, medical, and functional needs. It also includes the coordination of all services in the care plan—including community-based services and physician services—and monitoring the care plan to make sure it always meets the individual’s needs.
Consumer Directed Personal Assistance Services (CD-PAS)
A home care program for people who receive assistance with their activities of daily living and other home care services from a Personal Assistant who is selected, employed and supervised by the individual receiving services.
Routine, preventive, and restorative care for the teeth such as cleanings, gum scaling, fillings, bridgework, or dentures.
Durable Medical Equipment (e.g., wheelchairs, prosthetics)
Devices and equipment needed in the treatment of a specific medical condition. DME may also be used to support functioning in activities of daily living. Includes, but is not limited to: mobility devices such as wheelchairs, walkers, canes, and scooters; beds; bathroom equipment; adaptive aids such as reachers; and all repairs. A covered MLTC service.
Eye Exams, Glasses and Other Vision Services
Optometric services, including eye exams, eyeglasses, and contact lenses.
Hearing Exams, Hearing Aids and Hearing Aid Batteries
Audiology services, including hearing exams; hearing aid evaluation; selecting, fitting, and dispensing of hearing aid; hearing aid repair; and replacement of batteries when necessary.
Home Care (e.g., home health aides, home attendants, personal assistants)
Home care encompasses a broad spectrum of both health and social services that can be delivered in a home environment to people with disabilities or chronic conditions, including senior adults. These services include home care aide services as well as skilled nursing services, physical therapy, occupational therapy, speech therapy, medical social services and nutritional services.
Home Delivery of Meals and Meals in Group Settings (e.g., senior centers)
Provides meals to members according to their plan of care.
Home Safety Modifications/Accessibility Improvements
Supports the medical needs of an individual, including, but is not limited to, home improvements and modifications, appliances and assistive devices, and independent living skills training.
Provided by a paraprofessional who assists with cleaning, laundry, and other housekeeping duties.
Medical and Surgical Supplies
Items for health use in the treatment of a specific medical condition such as: diabetic supplies, dressing and other wound care supplies, urinary catheters, incontinence supplies, and nutritional supplements.
Nurse on Call (24/7)
An RN is on call for ICS Community Care members 24 hours a day, 7 days a week, to help solve clinical as well as service-related issues that arise.
Nursing Home Care
24 hours of nursing, medical, and rehabilitation services provided in a skilled nursing facility to people who need help after a hospitalization or who can no longer live independently because of a chronic physical or mental condition.
Includes an assessment by a qualified nutritionist of a member’s dietary needs.
Personal Emergency Response System (PERS)
PERS is an electronic device on a necklace or bracelet to get help in the event of an emergency.
Physical, Occupational and Speech Therapies (at home or in the community)
Also known as rehabilitation services; include evaluations, diagnosis, and treatments.
Podiatry, Orthotics and Orthopedic Footwear
Routine foot care, such as treatment of corns and calluses, and nail trimming as well as non-routine care such as incisions, excisions, repair of tendons, and treatment of dislocations.
Procedures and techniques that rehabilitate and maintain an individual’s ability to breathe.
Skilled Services (including Nursing and Medication Management)
Home care services provided by a physical therapist, occupational therapist, speech therapist, registered nurse, licensed practical nurse or home health aide. Skilled services help people stay in their home and include, but aren’t limited to: medication management, glucose monitoring, rehabilitation therapies, home infusions and nebulizer treatments.
Social Day Care
A place people can go to during the day to socialize and participate in other recreational and therapeutic activities. It is usually located within a senior center or nursing home. Social Day Care, unlike an Adult Day Program, does not offer skilled services.
Includes the use of public buses or trains, Access-A-Ride, a car service, an ambulette, or an ambulance to transport someone to a medical appointment, or to an adult or social day care program that is part of an individual’s care plan.
You are free to select the providers of your choice for the services (below) that continue to be covered directly by your Medicare, Medicaid fee-for-service, or a commercial insurer. Although these services are not paid for by ICS Community Care, if you need assistance, your ICS Care Manager can help you to identify appropriate providers, arrange appointments, make referrals, and arrange transportation.
- Inpatient Hospital Services
- Outpatient Hospital Services
- Physician Services
- Laboratory Services
- Radiology and Radioisotope Services
- Emergency Transportation
- Prescription and Non-Prescription Drugs
- Certain Medical Supplies
- Chronic Renal Dialysis
- Mental Health Services
- Alcohol and Substance Abuse Services
- NYS Office for People with Developmental Disabilities
- Family Planning Services