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 builds the plan that ties it together. This guide explains what MLTSS is, the five 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 five NJ FamilyCare health plans
- Who qualifies: clinical and financial
- What MLTSS covers
- Paying a family member (the Personal Preference Program)
- How to enroll
- 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, with the program's stated goal being to keep people in the least restrictive setting that's safe, which usually means supporting people at home when possible rather than defaulting to a nursing facility.
Because it's managed care, every MLTSS member is assigned a care manager. The care manager assesses your needs, builds your plan of care, and authorizes the services in it.
The Five NJ FamilyCare Health Plans
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 of New Jersey
- Wellpoint (rebranded from Amerigroup in January 2024)
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 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 your plan authorizes depends on your assessed needs and plan of care. 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 program is designed to fund care in the least restrictive setting that meets the person's needs.
Paying a Family Member: the Personal Preference Program
One of the most useful features for families is the participant-directed option, the Personal Preference Program (PPP). Instead of receiving services only through agency staff, an eligible member can hire, schedule, and direct their own personal-care workers, and in New Jersey those workers can include many family members. 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
Enrolling in MLTSS is a two-track process, and both tracks have to be completed.
- Clinical screening: if you're 21 or older, contact your county Aging and Disability Resource Connection (ADRC) to be screened for a nursing-facility level of care. For applicants under 21, the NJ Division of Disability Services handles this at 1-888-285-3036.
- Financial application: file with your County Board of Social Services, which reviews income, assets, and the look-back.
Once both are approved, you choose an MLTSS plan and a care manager begins your 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 five NJ FamilyCare plans, 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
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 overseeing your plan of care.
Yes, through MLTSS. There's no separate nursing-home Medicaid program in New Jersey; nursing-facility care is one of the settings MLTSS covers, once you meet the clinical (nursing-facility level of care) and financial eligibility tests.
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).
Yes. MLTSS includes a participant-directed option, the Personal Preference Program, that lets a member hire and direct their own workers, including many family members. New Jersey is relatively generous here: under the family-relative exception (N.J.A.C. 10:60-3.8), even a spouse can be paid in some cases, unlike many states. The main bar is the parent of a recipient who is a minor child.
As of 2026: Aetna Better Health of New Jersey, Fidelis Care, Horizon NJ Health, UnitedHealthcare Community Plan of New Jersey, and Wellpoint. You choose your plan and can change it.
Learn More
- Your Guide to New Jersey Medicaid (NJ FamilyCare)
- New Jersey Medicaid Eligibility and Income Limits
- How to Apply for New Jersey Medicaid
- How to Get Paid to Care for a Family Member in New Jersey
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.