Long-Term Services and Supports (LTSS)

A variety of services and supports help elderly individuals and/or individuals with disabilities meet their daily needs for assistance and improve the quality of their lives. Examples include assistance with bathing, dressing, and other basic activities of daily life and self-care, as well as support for everyday tasks such as laundry, shopping, and transportation. Long-term services and supports (LTSS) are provided over an extended period, predominantly in homes and communities, but also in facility-based settings such as nursing facilities.

First Choice VIP Care Plus (Medicare-Medicaid Plan) members, who are determined by the State Medicaid Agency to be eligible for one of the home- and community-based services (HCBS) waivers offered under our plan, may receive certain LTSS services provided in the member's home or community, when they are authorized by the member's Care Coordinator. For more information on how to get these services, please contact Member Services or your Care Coordinator.

LTSS benefits which are provided in the member's home and community include, but are not limited to:

• Home-delivered meals.
• Personal care services.
• Adult day health care.
• Case management.
• Nursing home transition services (Home Again).

LTSS provided for an extended period of time in a skilled nursing facility are also covered for our members who demonstrate the need for these services after their enrollment in First Choice VIP Care Plus.

Members who may not initially qualify for HCBS waiver services may be eligible to receive certain waiver-like services (personal care, respite, companion, and specific bath safety equipment), if they meet specific criteria.