In New Jersey, almost all Medicaid long-term care is delivered through one program: MLTSS, short for Managed Long Term Services and Supports. Instead of a standalone nursing-home benefit, you enroll in a managed care plan that coordinates and pays for your care.

MLTSS covers care wherever you live, at home, in assisted living, in a community residential setting, or in a nursing facility, and a care manager helps you coordinate it all through an individualized plan of care. This guide explains what MLTSS is, the health plans that run it, the two kinds of eligibility you have to meet, what it covers, how it can pay a family caregiver, and how to enroll.

In This Guide

  • What MLTSS is
  • The NJ FamilyCare health plans that run MLTSS
  • Who qualifies: clinical and financial
  • What MLTSS covers
  • Paying a family member (the Personal Preference Program)
  • How to enroll in NJ MLTSS
  • Choosing and changing your plan

What MLTSS Is

MLTSS is the way New Jersey delivers Medicaid long-term services and supports, and the key word is managed. Rather than paying providers directly for each service, the state contracts with managed care organizations, and you enroll in one of their plans. The plan is then responsible for coordinating and paying for your long-term care across whatever setting you're in. The state describes MLTSS as designed to expand home and community-based services, promote community inclusion, and ensure quality and efficiency, which in practice means supporting people at home where that's possible rather than defaulting to a nursing facility.

MLTSS is not quite the only route, though. The state's own MLTSS page names the Program of All-Inclusive Care for the Elderly (PACE) as another option, open to people who live in a PACE provider's service area. PACE became available in all 21 New Jersey counties in January 2026, so for most families it is now a real alternative to compare rather than a technicality. There is also one legacy carve-out: nursing-facility residents who were considered custodial care on Medicaid before MLTSS launched on July 1, 2014 remain NJ FamilyCare fee-for-service for the duration of that stay.

Care management is one of the services MLTSS includes. As a member you have access to a care manager who helps you coordinate your medical care, your long-term services and supports, behavioral health, and your other NJ FamilyCare State plan services through an individualized plan of care.

The NJ FamilyCare Health Plans That Run MLTSS

MLTSS is delivered through New Jersey's statewide NJ FamilyCare managed care organizations. As of 2026 they are:

  • Aetna Better Health of New Jersey
  • Fidelis Care
  • Horizon NJ Health
  • UnitedHealthcare Community Plan
  • Wellpoint (formerly Amerigroup New Jersey)

DMAHS's Personal Preference Program page lists a sixth MLTSS health plan alongside those five: Aetna Assure Premier Plus (D-SNP), the dual-eligible plan that pairs Medicare with NJ FamilyCare MLTSS. If your loved one is enrolled in it, treat it as an MLTSS plan for these purposes.

You choose your plan, and you can change it. Networks and care-management staff differ, so it's worth checking whether your preferred doctors, home-care agencies, and facilities are in a plan's network before you pick.

Who Qualifies: Clinical and Financial Eligibility

MLTSS has two separate eligibility tests, and you must clear both.

Clinical. For adults 21 and older, you must meet a nursing-facility level of care, meaning you need hands-on help with three or more activities of daily living (such as bathing, dressing, toileting, transfers, or eating), or you have cognitive deficits requiring supervision and cueing with three or more of them.

Financial. For 2026, a single applicant's income must be at or below $2,982/month and countable assets at or below $2,000. Income over the cap can be handled with a Qualified Income Trust, and under the spousal-impoverishment protections a married applicant's spouse can keep between $32,532 and $162,660 in assets. New Jersey applies a 60-month look-back on transfers. For the full rules, see our guide to New Jersey Medicaid eligibility and income limits.

Test What it requires
Clinical (age 21+) A nursing-facility level of care: hands-on help with 3+ daily activities, or cognitive deficits needing supervision with 3+
Income (single) At or below $2,982/month (a Qualified Income Trust handles higher income)
Assets (single) At or below $2,000 in countable assets
Community spouse Keeps $32,532 to $162,660 in assets
Look-back 60 months on asset transfers

What MLTSS Covers

MLTSS covers long-term services across settings, coordinated by your care manager. That includes support at home, services in an assisted living residence, care in community residential settings, and nursing-facility care, along with the care management that ties them together. The specific menu of home and community-based services depends on your assessed needs and the plan of care you and your care manager put together. What MLTSS is built to avoid is the old default of moving someone to a nursing home simply because that's where the coverage was; the state describes the program as designed to expand home and community-based services and promote community inclusion.

Paying a Family Member: the Personal Preference Program

One of the most useful features for families is NJ FamilyCare's self-directed personal care assistance option, the Personal Preference Program (PPP), which MLTSS members can use. Instead of receiving services only through agency staff, an eligible member can select the home care services that best suit their needs and hire their own workers, including trusted individuals like friends, relatives, or neighbors, and in New Jersey those workers can include many family members. Plan around the ceiling, though: personal care assistant services are capped at 40 hours per calendar work week and must be prior authorized, with additional hours approved by DDS or DMAHS only case by case, on exceptional circumstances. For how that works and who can be paid, see our guide to getting paid to care for a family member in New Jersey.

How to Enroll in NJ MLTSS

Enrolling in MLTSS is a two-track process, and both tracks have to be completed. The two reviews run concurrently and are coordinated between the agencies.

1
Step 1

Start the clinical screening, through the door that matches your situation

For adults 21 and older, DMAHS's April 2026 MLTSS application guidance gives three different routes, and the right one depends on where you live and whether you're already on Medicaid. If you live in the community and are not already enrolled in a Medicaid program, contact your Area Agency on Aging, the county Aging and Disability Resource Connection (ADRC), at 1-877-222-3737 to schedule the screening exam. If you are already enrolled in a Medicaid program, call the member services number on the back of your health plan or HMO card and ask for a clinical eligibility exam for the purpose of enrolling in MLTSS. If you live in a facility, such as an assisted living facility or nursing home, ask the social worker there to help you schedule it. Whichever door you use, the clinical determination itself is made through the New Jersey Division of Aging Services (DoAS). For children birth through 20, contact the New Jersey Division of Disability Services (DDS) at 1-888-285-3036 to speak with an Information and Referral Specialist.

2
Step 2

File the financial application

Submit the NJ FamilyCare Aged, Blind, Disabled application, either online or in person at your County Social Service Agency (the same office the brochures call the County Welfare Agency), which does the financial evaluation of income, assets, and the five-year look-back.

3
Step 3

Choose your plan and start care

Once both determinations are approved, you choose an MLTSS plan and work with a care manager on your individualized plan of care. See our full guide to how to apply for New Jersey Medicaid.

Choosing and Changing Your Plan

You pick your MLTSS plan from the NJ FamilyCare plans listed above, and you're not locked in forever; New Jersey lets you change plans under its enrollment rules. When choosing, look at which plan's network includes your providers and facilities and ask each plan about its care-management approach, since the care manager is the person you'll work with most.

Frequently Asked Questions

What is MLTSS in New Jersey?

MLTSS (Managed Long Term Services and Supports) is how New Jersey Medicaid delivers long-term care. You enroll in a NJ FamilyCare managed care plan, and that plan coordinates and pays for your care at home, in assisted living, or in a nursing facility, with a care manager helping you coordinate your services through an individualized plan of care.

Does New Jersey Medicaid pay for a nursing home?

Yes, through MLTSS. Nursing-facility care is one of the settings MLTSS covers, once you meet the clinical (nursing-facility level of care) and financial eligibility tests, so there's no separate nursing-home application track to hunt for. Two things sit outside it: PACE is a separate option for people living in a PACE provider's service area, and residents who were already on Medicaid custodial care in a nursing facility before July 1, 2014 stayed on fee-for-service for the duration of that stay.

Who qualifies for MLTSS?

People who meet both a clinical test (a nursing-facility level of care, generally needing help with three or more daily activities) and the financial test ($2,982/month income and $2,000 in assets for a single applicant in 2026, with a Qualified Income Trust for higher income and spousal protections).

Can MLTSS pay a family member to provide care?

Yes, within limits. MLTSS members can use NJ FamilyCare's self-directed option, the Personal Preference Program, which lets a member select the home care services that suit their needs and hire their own workers, including friends, relatives, or neighbors. Outside PPP, N.J.A.C. 10:60-3.8(b) bars family-member personal care assistant services under NJ FamilyCare Plans B and C and grants no exceptions for legally responsible relatives, which that rule defines as a spouse or legal guardian of an adult, or a parent or legal guardian of a minor child. PPP is expressly excepted from that bar, but the rule doesn't spell out which relatives PPP may then hire, so whether a particular relative, a spouse above all, can be hired is a question to settle with the member's health plan before anyone counts on the income. Paid hours are capped at 40 per calendar work week and must be prior authorized.

Which health plans offer MLTSS in New Jersey?

As of 2026: Aetna Better Health of New Jersey, Fidelis Care, Horizon NJ Health, UnitedHealthcare Community Plan, and Wellpoint (formerly Amerigroup New Jersey), plus Aetna Assure Premier Plus (D-SNP), the dual-eligible plan DMAHS lists as a sixth MLTSS health plan. You choose your plan and can change it.

Learn More

MedicaidYour Guide to New Jersey Medicaid (NJ FamilyCare)Your 2026 guide to New Jersey Medicaid (NJ FamilyCare): who qualifies, the MLTSS long-term-care path, 2026 income and asset limits, and how to apply. MedicaidNew Jersey Medicaid Eligibility and Income LimitsWho qualifies for New Jersey Medicaid (NJ FamilyCare) in 2026 and at what income: MAGI limits, the aged/blind/disabled pathway, and asset rules. MedicaidHow to Apply for New Jersey MedicaidHow to apply for New Jersey Medicaid (NJ FamilyCare) in 2026: the online, phone, and county routes, plus what to bring, timelines, and how to appeal. CaregiverHow to Get Paid to Care for a Family Member in New JerseySeven New Jersey pathways pay family caregivers in 2026, and unlike Pennsylvania, NJ does not ban paying a spouse outright. A sourced map of all seven. MedicaidNew Jersey Medicare Savings ProgramsNew Jersey Medicare Savings Programs in 2026: QMB, SLMB, and QI income limits, PAAD and Senior Gold coordination, and how to apply through NJ FamilyCare.

Find personalized help understanding New Jersey MLTSS and starting an application at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.