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Plans & Benefits: Managed Long Term Services & Supports (MLTSS)

We know what you're going through. And we can help.

When you or your parents have conditions that require a nursing home level of care but would rather live at home, we can help you achieve this. At Amerigroup, we’re experienced in managing NJ FamilyCare long-term services and supports. We understand there is no one plan that fits all. Everyone has their own unique needs. So we do in-home assessments and develop personalized health care plans for people with NJ FamilyCare that:

  • Allow people to stay at home safely
  • Get them the care they need
  • Let them live their lives to the fullest
MLTSS in New Jersey

The Amerigroup MLTSS program helps members live independently in their homes and communities. MLTSS also looks at the needs of people in nursing facilities. For them, independent living is not always a choice. MLTSS programs help those in the community get services to help them with their everyday lives. These include activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

These services include helping people with:

  • Eating
  • Dressing
  • Toileting
  • Managing a home
  • Preparing food
  • Medication management

Each member’s needs vary greatly.

Some needs are complex. They may need services from many providers and systems. Often, getting through the complexities of long term services and supports can be hard for members. This can lead to gaps in care. The Amerigroup MLTSS Care Management Model helps lessen these gaps. Our model identifies, evaluates, coordinates and manages each person’s needs.

This may involve a number of things:

  • Coordinating care
  • Assisting members in accessing community-based resources
  • Providing disease-specific education
  • Any of a broad range of interventions for improving the quality of life and making the best use of health care and community-based resources
MLTSS Services

MLTSS program members will have all of their care managed by Amerigroup.

MLTSS program members will have all of their care managed by Amerigroup. This includes:

  • Physical health
  • Mental health
  • Long-term care needs and services

This is called care coordination. This is done by a care manager. Your care manager will play a vital role in creating a member-centered plan of care.

Here are some of the benefits you get as an MLTSS member:

  • Home-Based Supportive Care • Help with your household chores or errands like doing laundry, preparing meals, light housekeeping or grocery shopping
  • Home-delivered meals • Nutritionally balanced meals delivered to your home
  • Personal Emergency Response System • A call button so you can get help in an emergency when your caregiver is not around
  • In-home respite care • Services provided to members unable to care for themselves that are furnished on a short-term basis because of the absence or need for relief of an unpaid, informal caregiver
  • Inpatient respite care • A short stay in a nursing home or assisted care living facility so your caregiver can get a break or attend to their personal business
  • Home modifications • certain changes to your home that will help you get around more safely in your home, like grab bars or a wheelchair ramp (up to $5,000 per project or per calendar year, and $10,000 per lifetime)
  • Vehicle Modifications • Medically needed vehicle modification (such as electronic monitoring systems to enhance personal safety and mechanical lifts to make access possible) to your vehicle or a family vehicle
  • Assisted Living Facility • A coordinated group of supportive personal and health services, chore services, medication administration, and intermittent skilled nursing services, available 24 hours a day to you if you are enrolled in the MLTSS program
  • Assisted Living Program • The provision of assisted living services if you live in qualified publicly subsidized housing buildings
  • Adult Family Care • Allows up to three unrelated individuals to live in the community in the primary residence of a trained caregiver who provides support and health services for members
Frequently Asked Questions

Here are some answers to questions you might have about Managed Long Term Services and Supports (MLTSS).

Behavioral Health

Members enrolled in MLTSS will have access to behavioral health care. The Amerigroup care manager will coordinate the member’s behavioral health, medical and long-term services and supports benefits. The care manager will also be included in the member’s plan of care.

Behavioral health services include:

  • Acute partial hospitalization
  • Adult mental health rehabilitation
  • Outpatient mental health services
  • Acute inpatient psychiatric hospitalization
  • Opioid treatment services
  • Partial care/psychiatric partial hospitalization
  • Programs for assertive community treatment
Waiver Eligibility & Enrollment

Current Amerigroup members can qualify for Managed Long Term Services and Supports (MLTSS) by meeting these established NJ FamilyCare requirements:

  • Financial Requirements • These include monthly income, as well as total liquid assets. More on NJ FamilyCare financial eligibility.
  • Clinical Requirements • A person qualifies for nursing home level of care. This means the person needs help with activities of daily living such as bathing, toileting and mobility.
  • Age and/or Disability Requirements • These include the following:
    • Must be age 65 years or older
    • Must be under age 65 years of age and determined to be blind or disabled by the Social Security Administration or the state of New Jersey
Who is eligible for the MLTSS program?

You can be an Amerigroup MLTSS member if you:

  • Live in the Amerigroup service area
  • Meet the clinical eligibility requirements for nursing facility care. For example, you need help with daily living like:
    • Bathing
    • Dressing
    • Eating
    • Walking
  • Have a chronic condition requiring nursing services
  • Meet NJ FamilyCare financial eligibility requirements

Get the benefits you need — doctor care, hospital care, long-term care and more.

You can visit NJ FamilyCare online to learn more. Or call us at 1-877-453- 4080 (TTY: 711) to find out more and how to choose Amerigroup. We’ll set up a time to see if you qualify.

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Important Links/Caregiver Resources

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