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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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Spanish
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Arabic
Nuer

NCQA LTSS Distinction Seal

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NJ FamilyCare

Disclaimer Information
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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, or use your preferred relay service for more information. 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

This 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. The service is not an insurance program and may be discontinued at any time.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan) information, please contact our Member Services at 1-877-542-9236 (TTY 711,) from 7 a.m. to 8 p.m. Monday through Friday (voice mail available 24 hours a day/7 days a week) for help at no cost to you.

Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio (plan Medicare-Medicaid), comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al 1-877-542-9236 (TTY 711) de lunes a viernes de 7 a.m. a 8 p.m. (correo de voz disponible las 24 horas del día, los 7 días de la semana).

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays, and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

UnitedHealthcare Connected® (Medicare-Medicaid Plan)

UnitedHealthcare Connected® (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits and/or copayments may change on January 1 of each year.

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al 1-800-256-6533, TTY 711, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes (correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.

Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro. Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan)

es un plan de salud que tiene un contrato tanto con Medicare como con el programa MassHealth (Medicaid) para proporcionar los beneficios de ambos programas a sus miembros.

 

UnitedHealthcare Connected benefit disclaimer 

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits and/or copayments may change on January 1 of each year.

You can get this document for free in other formats, such as large print, braille, or audio. Call 1-866-633-4454, TTY 711, 8 am - 8 pm., local time, Monday - Friday (voicemail available 24 hours a day/7 days a week). The call is free. You can call Member Engagement Center and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.

Language Line is available for all in-network providers. 

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al 1-866-633-4454, TTY 711, de 8am. a 8pm, hora local, de lunes a viernes (correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.

Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro. Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

You can get this document for free in other formats, such as large print, braille, or audio. Call Member Services, 8 a.m. - 8 p.m., local time, Monday - Friday (voicemail available 24 hours a day/7 days a week). The call is free.

You can call Member Services and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.

Language Line is available for all in-network providers.

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al Servicios para los miembros, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.

Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro.

Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

UnitedHealthcare Senior Care Options (HMO SNP) Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

Availability of non-english disclaimer

ATTENTION: If you speak an alternative language, language assistance services, free of charge, are available to you. Call 1-800-905-8671 TTY 711, or use your preferred relay service.

ATENCIÓN: Si habla Español, hay servicios de asistencia lingüística disponibles para usted y que no tienen cargo. Llame al 1-800-905-8671 TTY 711, o utilice su servicio de retransmisión preferido

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) until 2017 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.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non- contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

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.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 TTY 711, or use your preferred relay service.

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.

This site contains documents in PDF format. PDF (Portable Document Format) files can be viewed with Adobe® Reader®. If you don't already have this viewer on your computer, download it free from the Adobe website.

Last Updated: 07.26.2021 at 02:38 PM CDT

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