MAP Care Management Services

Centers Plan for Medicaid Advantage Plus offers comprehensive Care Management for members who are in need of long-term care and health care services. The goal is to help members remain safe and be as independent as possible in the community.

To be eligible for our plan you must be eligible for Medicare and Full Medicaid Benefits. Must be capable, at the time of enrollment of returning to or remaining in your home and community without jeopardy to health and safety, based upon criteria provided by New York State Department of Health; and

• Must be eligible for nursing home level of care (as of the time of enrollment)
• Must require care management and be expected to need at least one of the following covered services for more than 120 days from the effective date of enrollment:
  • Nursing services in the home;
  • Therapies in the home;
  • Home health aide services;
  • Personal care services in the home;
  • Adult day health care; 
  • Private duty nursing;
  • Consumer Directed Personal Assistance Services

When you enroll…  

The Care Management Team will provide you support to help you achieve your personal health goals. The Care Management Team works together with you, your family or caregivers, and your doctors to develop a person-centered plan of care to help you gain access to services that meet your needs. 

A member of your Care Management Team will help coordinate your care in a number of ways which may include:

• Helping you identify in-network healthcare providers;
• Scheduling appointments with your doctor or a laboratory (lab);
• Arranging for non-emergent transportation to medical appointments;
• Helping you order medically necessary supplies; and/or
• Arranging for home care services.

Care Management is an ongoing process. If your needs change, your plan of care will change to make sure that it includes all of the services you currently need. A Registered Nurse (RN) will meet with you at least once every 6 months to conduct a formal reassessment (if there is a significant change in your status, the RN will meet with you sooner). To make monitoring your care and evaluating your needs easier, it is important that you talk with the members of your Care Management Team to let them know what you need.

Together you and the Care Management Team will identify your health challenges, barriers, goals, interventions, and identify methods to help you achieve your goals. A member of CPHL’s Care Management Team is available 8 am to 8 pm, seven days a week, to answer questions about your care plan, and to assist you in accessing both covered and non-covered services. Call 1-833-274-5627, or for TTY/TDD users, call 711. See Section 4 of the MAP Member Handbook for a list of covered and non-covered services.

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