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 all of your services.

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 three eligibility requirements 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: age or disability, 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. The state delivers it through NJ FamilyCare's contracted managed care organizations, and you enroll in one of their plans. The plan then coordinates all of your services across whatever setting you're in, from your own home to a nursing home. The state describes MLTSS as designed to expand home and community-based services, promote community inclusion, and ensure quality and efficiency.

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 is not yet open statewide. That MLTSS page counts six PACE organizations serving parts of ten counties, while the Division of Aging Services' PACE page lists eight agencies whose service areas cover all or part of thirteen counties. In January 2026 the Department of Human Services announced funding to expand PACE to all 21 counties, but it cautioned that permitting, licensing, construction and final inspections take 18 to 24 months on average, so new sites in the awarded counties will open in stages. Check your own county and ZIP code against the current list of operating PACE agencies. PACE also requires being 55 or older and needing a nursing-home level of care while being able to live safely in the community with its services. 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 contracted 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)

Not every plan serves every county. On DMAHS's health-plans page, Fidelis Care's list of counties served leaves out Hunterdon County, which the other four plans include, so ask which NJ FamilyCare plans are available in your county before you choose.

DMAHS's Personal Preference Program page also lists a sixth plan to contact about that program: Aetna Assure Premier Plus (D-SNP), a dual-eligible plan (see our guide to New Jersey's integrated dual plans). If your loved one is enrolled in it, that plan is where to request a personal care assessment for the Personal Preference Program.

Before you pick a plan, check whether your preferred doctors, home-care agencies, and facilities are in its network.

Who Qualifies: Age or Disability, Clinical, and Financial

MLTSS has three separate requirements, and you must meet all of them. The state's April 2026 application guidance names only two, clinical and financial eligibility, but DMAHS's MLTSS page adds a third.

Age or disability. You must be 65 or older, or be under 65 and determined blind or disabled by the Social Security Administration or the State of New Jersey. An adult under 65 without that determination does not qualify for MLTSS, however much help with daily activities they need.

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. The house you live in and the vehicle you use don't count toward that $2,000, but the home exclusion has limits: New Jersey won't pay for long-term care when the applicant's home equity exceeds its cap (New Jersey elected the federal maximum, indexed each year), unless a spouse, a child under 21, or a disabled child lives there. Resources are counted as of the first day of the month. Income over the cap can be handled with a Qualified Income Trust, and under the spousal-impoverishment protections a married applicant's spouse keeps the greater of $32,532 or half the couple's combined countable resources, capped at $162,660 unless New Jersey's own regulation authorizes more., 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
Age or disability 65 or older, or under 65 and determined blind or disabled by Social Security or the State
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 (the home you live in, subject to an equity cap, and your vehicle don't count)
Community spouse Keeps the greater of $32,532 or half the couple's combined countable resources, capped at $162,660 unless New Jersey's regulation authorizes more
Look-back 60 months on asset transfers

What MLTSS Covers

MLTSS covers long-term services across settings, coordinated by your care manager. DMAHS publishes the list itself: MLTSS includes access to all NJ FamilyCare Plan A benefits, care management, home and vehicle modifications, home-delivered meals, respite, personal emergency response systems, mental health and addiction services, assisted living, community residential services, and nursing home care. The detailed limits on each service are set by the MLTSS contract and your health plan, so ask your care manager what your individualized plan of care includes.

Paying a Family Member: the Personal Preference Program

NJ FamilyCare also offers a 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. To qualify, a member must be NJ FamilyCare eligible, approved for personal care assistant (PCA) services and need them for at least six months, and able to direct their own services or have an authorized representative who can; a health-plan member asks the plan for a PCA assessment to enroll. 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. NJ FamilyCare's own site warns that rules to qualify will change starting fall 2026, so confirm the current process with your county office when you apply.

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, if you prefer (it isn't required), 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

Start care through your health plan

Once both determinations are approved, your NJ FamilyCare health plan's care manager helps you coordinate your services through an 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 that serve your county. If a plan stops working for your family, ask NJ FamilyCare or your care manager about the rules for switching. When choosing, look at which plan's network includes your providers and facilities, and ask each plan how its care managers work with members on the plan of care.

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 all of your services at home, in assisted living, in community residential services, or in a nursing home, with a care manager helping you coordinate them 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 age-or-disability, clinical (nursing-facility level of care), and financial requirements, 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 stay on fee-for-service for the duration of that stay.

Who qualifies for MLTSS?

People who meet all three requirements: being 65 or older (or under 65 and determined blind or disabled by Social Security or the State), a clinical test (a nursing-facility level of care: hands-on help with three or more daily activities, or supervision and cueing with three or more because of cognitive deficits), and the financial test ($2,982/month income and $2,000 in countable 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, and PPP's own rules let a participant hire family members, a spouse included: when a participant hires a spouse or household member, the spouse's earnings count as household income and may affect SSI, SNAP or rental-assistance eligibility. DMAHS says one PPP worker cannot be authorized for more than 40 hours a week, and a budget that buys more requires a secondary employee; the PPP rules make an exception for a worker who lives with the participant and qualifies for the IRS live-in exception.

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), though not every plan serves every county. DMAHS's Personal Preference Program page also lists Aetna Assure Premier Plus (D-SNP) as a sixth plan to contact about that program.

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 that pay or support family caregivers in 2026, and unlike Pennsylvania, NJ's PPP can pay a spouse. 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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