Long term services and support (LTSS)

Long term services and support

Aetna Better Health of Ohio’s managed long-term services and support program can help you stay in your home. It gives you the access to the care and support you need to do the day-to-day activities that you may no longer be able to do without help. This includes medical, personal and social services.

Select from a network of local, quality providers
Our team will help you select providers from a network that best meet your needs. They work with you and your doctors to get you access to the care and services you need. These services may include medical equipment, healthy meals or ways to make your home meet your health care needs.

You might also qualify for a home health or personal care aide to help with activities of daily living (ADL). ADLs include things you do every day such as:

  • Eating
  • Going to the bathroom
  • Getting out of bed
  • Bathing
  • Dressing

We’re here to help
We know you would like to stay in your home. But should you need access to more care than you can get at home, we can help. When this happens, you may need to go to a nursing home. Your stay at the nursing home may be for a short time or a long time. We work with nursing homes to make sure you have choices when you can no longer stay at home. Your care manager will help you and your family with this decision.

Better health is just a phone call away
Have questions about managed long-term services and support? Then, call your care manager or the Care Management hotline at 1-855-364-0974 (toll-free), 24 hours a day, 7 days a week. TTY Relay Ohio 7-1-1.

Do you need help with activities of daily living?

Some people have a hard time with activities of daily living. These include things like getting dressed or eating. If you need help with these activities, you may qualify for home and community-based care. Your care manager can link you to the right resources to see if you qualify. And if you do qualify, your care manager can help connect you with the right services.

Our goal is to bring services to you so that you can live in your current home for as long as possible.

Examples of services that you may qualify for include:  

  • Adult day health
  • Alternative meals service
  • Choices - home care attendant service
  • Chore services
  • Community transition service
  • Emergency response system service
  • Enhanced community living service
  • Home care attendant services
  • Home delivered meals
  • Home medical equipment and supplemental adaptive and assistive device services
  • Home modification, maintenance and repair
  • Homemaker
  • Independent living assistance
  • Nutritional consultation
  • Out-of-home respite
  • Personal care
  • Pest control
  • Social work counseling
  • Waiver nursing service
  • Waiver transportation

Find out if you qualify. Call your care manager or the Care Management hotline at 1-855-364-0974 (TTY: 711) to schedule your in-home evaluation.

A nursing facility (NF) sometimes goes by different names such as nursing homelong-term care facility, or skilled nursing facility

A nursing facility is a licensed facility that provides skilled nursing or intermediate long-term care services. These facilities have a variety of services which help meet both the medical and non-medical needs of enrollees. This helps members who have a chronic illness or disability and cannot care for themselves for long periods of time on their own. 

These facilities provide custodial and non-skilled care, such as assisting with normal, daily tasks like dressing, bathing, and using the bathroom, as well as meals, laundry, and other housekeeping needs.

If you want more information about nursing facilities, call your care manager or the 24-hour Care Management line at 1-855-364-0974 (TTY: 711). Your care manager is there for you!

Self-Directed Care

Aetna Better Health of Ohio offers, as part of home and community based services, the option of self-directed care. Self-directed care makes it easy to take control of your needs. With self-directed care, you work with individuals or agency caregivers for specific services. These services include personal care, a home care attendant, waiver nursing and other home and community based services. 

How does self-directed care work?
By choosing self-directed care, you manage your own care provided by a caregiver:

  • Choose and hire your own caregiver. Your caregiver can be almost anyone— a friend, neighbor, former aide, or, in some cases, a family member. A parent, step-parent, spouse or legal guardian can’t be your paid caregiver. It’s important that the caregiver you choose is right for you and can do a good job.
  • Keep your independence - You set a schedule and plan your care. A care manager will help you monitor your progress and your caregiver’s service.
  • Learn the ropes - You get training and resources. A care manager will meet with you for training. You also will get training on how to handle payroll and other important documents.
  • Make it your responsibility - You train your caregiver and make sure that the agreed-upon care takes place in the manner you expect. You may also take responsibility for negotiating some rates paid to some of your providers. If you don’t like your caregiver, you can find a new one. You also can appoint an authorized representative to act on your behalf and direct your caregiver. The authorized representative cannot be your caregiver.  

What are the qualifications?

You need to:

  • Be an Aetna Better Health of Ohio member.
  • Express interest in this option to the health plan.
  • Be willing and able to attend trainings and direct the caregiver’s activities.
  • Be living in the community and not in a facility.
  • Successfully complete all required trainings.
  • Continue to meet all health plan eligibility requirements.
  • Be approved by your care manager.
  • Supervise the caregiver and follow the rules for self-directed care.
  • Make sure your caregiver completes an Ohio Bureau of Criminal Identification and Investigation background check, and if they have lived in Ohio for less than five years, an FBI background check.

Ready to learn more?
If you want more information about self-directed care, please call your care manager or the 24-hour Care Management line at 1-855-364-0974 (TTY: 711).