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Benefits Overview

Comprehensive Long Term Care members receive Medicaid benefits and Long Term Care benefits.

These tables list the services covered by our Plan. Remember, services must be medically necessary in order for us to pay for them.

If there are changes in covered services or other changes that will affect you, we will notify you in writing at least 30 days before the effective date of the change.

If you have any questions about any of the covered services, please call your care manager or Member Services.

NOTE: Services marked with an asterisk (*) are behavioral health in lieu of services. This means they are optional services you can choose over more traditional services based on your individual needs.

Your Long Term Care Participant Direction Option

You may be offered the Participant Direction Option (PDO). You can use PDO if you use any of these services and live in your home:

  • Attendant care services
  • Homemaker services
  • Personal care services
  • Adult companion care services
  • Intermittent and skilled nursing care services

PDO lets you self-direct your services. This means you get to choose your service provider and how and when you get your service. You have to hire, train and supervise the people who work for you (your direct service workers).

You can hire family members, neighbors or friends. You will work with a case manager who can help you with PDO.

If you are interested in PDO, ask your case manager for more details. You can also ask for a copy of the PDO Guidelines to read and help you decide if this option is the right choice for you.