Eligibility

Medicaid beneficiaries currently enrolled in New Jersey Home and Community Based Services programs such as the AIDS Community Care Alternatives Program (ACCAP); Community Resources for People with Disabilities (CRPD); Global Options for Long-Term Care (GO); or the Traumatic Brain Injury (TBI) programs will transition into MLTSS. Some beneficiaries living in nursing homes will also transition to MLTSS.

Some Plan members 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.

MLTSS cost share and patient liability

MLTSS members who live in Assisted Living (AL) or Adult Family Care (AFC) settings may be required to pay Room and Board charges to the provider of services.

The amounts of these Room and Board charges are established by the State. Some members living in these settings may also have to pay a cost share. The amount of the cost share will be calculated by the County Welfare Agency, and is in addition to the Room and Board charges.