Some members are eligible for MLTSS. To qualify, you or your loved one will need to meet:
The state’s criteria for needing an institutional level of care
Some financial requirements
You can get MLTSS in your home or assisted living facility. You don’t need to live in a nursing facility or other facility.
If you or your loved one qualifies for MLTSS, here are some benefits:
Here are some MLTSS benefits related to home and assisted living:
Assisted living residence or personal care at home
Assisted Living Program (ALP)
Comprehensive personal care at home
Home-based supportive care
Medication-dispensing device — includes set-up and monthly monitoring
Personal emergency response system (PERS) — includes set-up and monitoring
Private duty nursing (adult)
Here are some MLTSS benefits related to therapy and training:
Cognitive therapy (group and individual)
Occupational therapy (group and individual)
Physical therapy (group and individual)
Speech, language and hearing therapy (group and individual)
Traumatic brain injury (TBI) behavioral management (group and individual)
Here are some MLTSS benefits related to care and services:
Adult family care
Community Residential Services (CRS)
Community transition services
Mental health and addiction services
Nursing facility services
Respite (daily and hourly)
Social adult day care
Structured day program
Supported day services
If you qualify, you’ll work with an Aetna® Care Manager. Your Care Manager will visit you in person. They’ll work with you, your family and friends to assess your health care needs. They’ll also work with your Provider to help plan your care. You’ll have a Care Manager for as long as you stay in the MLTSS program.
You can call your Care Manager anytime for help or to make plans for a face-to-face visit. Your family and friends can also be there. Your Care Manager will visit:
Every 6 months, for members who live in a nursing home
Every 3 months, for members who live in an assisted living facility
Every 3 months, for members who live in their own home or a family home
Is your Care Manager sticking to this schedule? If not, just call us at 1-844-362-0934 (TTY: 711). We can help.
Your Care Manager will never make you move against your wishes. We’ll help you live in the place that meets your needs. This may be at home, an assisted living center or a nursing home.
MFP is a program that helps you move from a long-term care facility (nursing home or state hospital) to a residential setting in the community, such as:
A home you or your family owns or rents
An apartment with an individual lease that includes living, sleeping, bathing and cooking areas
A residence where 4 or fewer unrelated people live (such as adult family care or shared apartment)
To take part in this program, you must:
Have lived in a long-term care facility for at least 3 months
Be eligible for both Medicaid and MLTSS before discharge
Have health needs that community services can meet
Agree to take part by signing a consent form
The MFP program will help you find a place to live, as well as services you may need. To learn more about MFP:
Call your Care Manager
Call MLTSS Member Services at 1-844-362-0934 (TTY: 711)
Visit the MFP program website for the state of New Jersey
Need to learn more about MLTSS? Check these sites from the state of New Jersey:
This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a Provider or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna® plans, refer to our website.
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