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NJ FamilyCare Managed Long Term Services and Supports (MLTSS)

Managed Long Term Services and Supports (MLTSS) programs are focused on serving frail, elderly, and disabled individuals. It is important to understand that the program combines traditional health care benefits (doctor visits, hospital stays, labs) and long term services and support (providing help in home or community with daily living activities).

For more information on MLTSS, visit the State of New Jersey's MLTSS page.

This plan is available in the following counties: This plan is available statewide.

NJ FamilyCare is a comprehensive health insurance program that provides a wide range of services. In addition to NJ FamilyCare Services (NJFC), MLTSS members will also receive the following benefits:

  • Care Management
  • Home and Vehicle Modifications
  • Home Delivered Meals
  • Personal Emergency Response Systems
  • Mental Health and Addiction Services
  • Assisted Living
  • Community Residential Services
  • Nursing Home Care

If you would like a copy of the member handbook or provider directory, please call Member Services at 1-800-941-4647 (TTY: 711).

Who is Eligible?

Members who have been assessed for long-term services and supports and have met both financial and clinical eligibility requirements established by the State for MLTSS to receive care management and supportive services are eligible.

The purpose of MLTSS is to enable individuals who are at the nursing home level of care to receive person-centered services in the least restrictive and most integrated setting.

The link below takes you to another website. Once there, select "NJ UnitedHealthcare Community Plan" to access a list of in-network dentists.

If you would like a copy of the member handbook or provider directory, please call Member Services at 1-800-941-4647 (TTY: 711).

Search for a dental provider for MLTSS

New Jersey Smiles Program

New Jersey Smiles Directory (June 2013)

Choose a county:
Atlantic
Bergen
Burlington
Camden
Cape May
Cumberland
Essex
Gloucester
Hudson
Hunterdon
Mercer
Middlesex
Monmouth
Morris
Ocean
Passaic
Salem
Somerset
Sussex
Union
Warren

Pharmacy Lookup Tool

Please call MLTSS at 1-800-645-9409, TTY: 711 and speak to Care Management.

Please see the state of NJ's FAQ

Co-Payments The amounts of money you pay directly to the provider for the service you receive. Certain NJ FamilyCare beneficiaries are required to pay a co-payment.

NJ FamilyCare-A state health insurance program for people with low income who meet certain eligibility requirements. Programs can vary from state to state.

Medicaid/MLTSS Managed Long Term Services and Supports (MLTSS) programs are focused on serving frail, elderly and disabled individuals. It is important to understand the program combines traditional health care benefits (doctor visits, hospital stays, labs) and long-term services and support (providing help in home or community with daily living activities).

Medicare A federal health insurance program for people who are 65 or older, disabled persons or those with end-stage renal disease. Medicare eligibility is not based on income, and basic coverage is the same in each state.

SSI Supplemental Security Income

healthfinder®
Since 1997, healthfinder® has been recognized as a key resource for finding the best government and nonprofit health and human services information on the Internet. healthfinder® links to carefully selected information and Web sites from over 1,700 health-related organizations.

www.state.nj.us/humanservices
This link will take you to the Department of Human Services for the state of New Jersey.

www.state.nj.us
This link will take you to New Jersey's official state home page.

www.cms.hhs.gov
This will link you to other State Children's Health Insurance Programs (SCHIP)

www.njhelps.org
The NJ Helps DHS Services Home Page is designed to give consumers a one-stop shopping resource for the wide range of programs and services provided by the Department of Human Services and its partners, to assist individuals, families and communities in New Jersey.

www.njfamilycare.org

This will link you to the NJFamilyCare website.

www.nj.gov/nj/community/senior
This will link you to the Aging & Disability Resource Connection (ADRC). The New Jersey Division of Aging and Community Services (DACS) administers programs designed to make it easier for seniors to get the help they need to support their well-being and maintain themselves in the community for as long as possible with independence, dignity and choice.

www.state.nj.us/njparentlink
This will link you to The Early Childhood Parenting and Professional Resource Center. The goal of the website is to improve the accessibility, coordination and delivery of information and services to parents of young children, and to improve communication capabilities for ongoing service collaborations and policy development.

Member Handbooks
Member Handbook (English)
Member Handbook (Español)

News Bulletins
National Flu Campaign Questions and Answers: English  | Español

Notice of Privacy Practices
We have a Notice of Privacy Practices that tells you how health information about you may be used and shared. We are required by law to let you know that the Notice is available, and how you can get a copy of it. You can download a copy of our Notice of Privacy Practices below.
NOTICE OF PRIVACY PRACTICES
AVISOS DE PRÁCTICAS DE PRIVACIDAD DEL PLAN DE SALUD

Member Rights
As a member of UnitedHealthcare, you have certain rights concerning health care. Click here for more information in English or Español.

Seasonal Flu Facts
Questions and answers regarding the seasonal flu vaccine.
Click here, for more information.

Quick Facts About H1N1
We want to help you understand some important facts about the novel H1N1 Flu so you can help protect you and your family. Click here for more information.

Social Security Number Privacy
Protecting personal information is important to UnitedHealth Group companies, so we protect the confidentiality of Social Security numbers that we receive. Read Bulletin Details Click here for more information.

Take Charge of Your Health: Get a Flu Shot
Flu season is here. The flu can be very serious. Getting a flu vaccine is your best protection against the flu. The best time to get your flu shot is October through December. You should talk to your doctor about having a flu shot. Or you can call our Customer Service Center.

Third Party Liability
A guide to understanding health coverage in New Jersey if you have Medicaid and Medicare and/or other health insurance.
Click here for more information.

Protect Your Children from Lead Poisoning
Lead poisoning can cause serious health problems. You can't see it or smell it. Here's what you need to know to keep your kids out of danger. Click here for more information.

Citizenship Documents Required
There are new laws that may require you to show proof of citizenship in order to renew your health coverage. Click on a document below to read about what you will need:

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Nuer

Learn More

NJ FamilyCare

Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete Plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call 1-800-905-8671 TTY 711 for more information. Benefits, features and/or devices vary by plan/area. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.  

Nurseline Disclaimer

The NurseLine service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your doctor's care. Your health information is kept confidential in accordance with the law. Access to this service is subject to terms of use.

Availability of Non-English Disclaimer

ATTENTION: If you speak [insert language], language assistance services, free of charge, are available to you. Call 1-800-905-8671 TTY 711.

ATENCIÓN: Si habla [ingrese el idioma], hay servicios de asistencia lingüística disponibles para usted y que no tienen cargo. Llame al 1-800-905-8671 TTY 711.

Star Ratings Disclaimer

Every year, Medicare evaluates plans based on a 5-star rating system.

Formularies

The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

NCQA

UnitedHealthcare Connected has a Model of Care approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) through YEAR based on a review of UnitedHealthcare Connected’s Model of Care. UnitedHealthcare Connected has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until YEAR based on a review of UnitedHealthcare Connected’s Model of Care.

Important Provider Information

The Choice is Yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

For more detailed information on provider directory data, you may use the following link:

Important Provider Information URL: https://www.uhc.com/legal/provider

American Disabilities Act Notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Declaration of Disaster or Emergency

If you’re affected by a disaster or emergency declaration by the President or a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.

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Last Updated: 06.19.2019 at 01:15 PM CDT

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