Managed Long Term Services and Support (MLTSS) San Diego County only
Some members in San Diego county are eligible for MLTSS. To qualify for MLTSS, you must meet the state’s criteria for needing an institutional level of care, as well as meet certain financial requirements. You do not need to reside in a nursing facility or some other institutional facility to get MLTSS. You can get these services in your home or assisted living facility.
If you qualify for LTSS benefits you may be eligible for these services.
- Adult family care
- Assisted living services
- Assisted living residence
- Comprehensive personal care home
- Assisted Living Program (ALP)
- Traumatic Brain Injury (TBI) behavioral management (group and individual)
- Caregiver/participant training
- Chore services
- Cognitive therapy (group and individual)
- Community Residential Services (CRS)
- Community transition services
- Home-based supportive care
- Home-delivered meals
- Medication dispensing device: set up and monthly monitoring
- Mental health and addiction services
- Nursing facility services
- Occupational therapy (group and individual)
- Personal Emergency Response System (PERS): set up and monitoring
- Physical therapy (group and individual)
- Private duty nursing (adult)
- Residential modifications
- Respite (daily and hourly)
- Social adult day care
- Speech, language and hearing therapy (group and individual)
- Structured day program
- Supported day services
- Vehicle modifications
MLTSS care management
Aetna Better Health members who are eligible for MLTSS are assigned a care manager. You will receive care management services for as long as you stay on the MLTSS program. Your care manager will work with you, your representative or guardian (if applicable), and your doctor to help decide which services will best meet your needs.
Role of MLTSS care manager
Our MLTSS care managers visit members where they live. The care manager will ask you about your health and care needs. You can have family and others join in the visit from your care manager.
Any time you need service call your care manager right away for help or to schedule a face‑to‑face visit.
A care manager will get information about your health and care needs. Your care manager will talk to you and others you have invited about how to meet your needs. Remember that your MLTSS care manager will help add to the care you are already getting. It does not take away the help of your family and others.
Your care manager will coordinate the services you need delivered. He or she will make sure you get the services. You should see your PCP for other health care needs. If you need help in getting other health care services, your care manager will help you.