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Managed Long Term Care (MLTC) for Dual-Eligibles, Explained

Managed Long Term Care (MLTC) is New York's system for Medicare/Medicaid dual-eligibles, mandatory in Nassau and Suffolk since 2013.

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Short answer

New York's dual-eligible (Medicare and Medicaid) long-term-care delivery system is Managed Long Term Care (MLTC), which has two lines of business relevant to seniors: standard MLTC/Medicaid Advantage Plus plans, and PACE (Program of All-Inclusive Care for the Elderly) for members age 55 and older.

What MLTC coordinates

MLTC plans coordinate long-term services and supports -- home care, adult day care, nursing home care and ancillary/ambulatory services -- for enrollees who need nursing-home-level care but can remain in the community. PACE additionally combines Medicare and Medicaid financing under one plan for members 55 and older.

Is it mandatory here?

Yes. Mandatory MLTC enrollment has applied in Nassau and Suffolk counties since the transition period that began in 2013, for Medicaid recipients aged 21+ who need community-based long-term care for more than 120 days.

MLTC also carries a Long Island-specific detail worth knowing: the “special income standard for housing expenses” available to certain MLTC enrollees is $1,701 for the Long Island region, a different figure than in NYC or upstate regions.

Source: NYSDOH Managed Long Term Care overview

Questions families ask

What is the MLTC special income standard for Long Island and why does it matter for Medicaid home care?

The special income standard for housing expenses, available to certain individuals enrolled in a Managed Long Term Care plan, varies by NYSDOH region - for the Long Island region specifically, it is $1,701.00. This regional figure is higher than most upstate regions (for comparison, the Central New York region's is $426 and the Western region's is $341), reflecting Long Island's higher housing costs, and remains in effect until updated federal poverty levels are published.

How much does assisted living cost in New York State?

According to CareScout's 2025 Cost of Care Survey, the median cost of an assisted living community (private one-bedroom) in New York State is $225 per day, or about $7,110 per month and $85,320 per year. This is a statewide median - CareScout's published state-level data tables do not break out a separate Long Island or metro New York figure.

What does a nursing home cost per day in New York?

CareScout's 2025 Cost of Care Survey puts the New York State median at $511 per day ($15,528/month, $186,333/year) for a semi-private room and $550 per day ($16,729/month, $200,750/year) for a private room, both based on 365 days of care. These are statewide figures; CareScout does not publish a separate Long Island-specific nursing home rate.

How much does hourly in-home caregiving cost in New York?

CareScout's 2025 Cost of Care Survey reports a New York State median of $35 per hour for what it now calls non-medical caregiver services, a category that merged the formerly separate homemaker services and home health aide categories in 2025 due to price convergence. Based on a 44-hour week, that works out to roughly $6,673 per month or $80,080 per year. Private duty nursing, a higher-acuity service, runs a New York State median of $120 per hour.

What does adult day care cost in New York, and could it help delay a move to assisted living?

CareScout's 2025 Cost of Care Survey puts New York State's Adult Day Health Care median at $144 per day, or about $3,120 per month based on five days a week, $37,440 per year. That's up from $113 per day in the 2024 survey, an increase of roughly 27 percent year over year, the largest percentage jump among CareScout's surveyed New York categories.

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