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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/new-jersey/plans/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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NCQA LTSS Distinction Seal

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Individual & Family ACA Marketplace Plans Disclaimer
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The benefits described may not be offered in all plans or in all states. Some plans may require copayments, deductibles and/or coinsurance for these benefits. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. Plan specifics and benefits vary by coverage area and by plan category. Please review plan details to learn more.

UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in AL, KS, LA, MO, NJ, and TN; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of South Carolina, Inc.; UnitedHealthcare of Texas, Inc.; UnitedHealthcare of Oregon, Inc. in WA; and UnitedHealthcare of Wisconsin, Inc.  Administrative services provided by United HealthCare Services, Inc. or its affiliates.

This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company, whichever is applicable. By responding to this offer, you agree that a representative may contact you.

1 Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Virtual visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be available at all times, or in all locations, or for all members. Check your benefit plan to determine if these services are available. Data rates may apply. Certain prescriptions may not be available and other restrictions may apply.

2 Tier 2 prescriptions for $5 or less not available on all medications. 3-month fills apply to select maintenance medications only. Applicable formulary requirements such as prior authorization and quantity limits may apply to your pharmacy benefits. Walgreens discount valid until 12/31/24. Discount valid only for in-store purchases of eligible Walgreens brand health and wellness products by current members eligible for the UnitedHealthcare discount program. Discount cannot be used online. For a full list of Walgreens brand health and wellness products and exclusions, please visit www.walgreens.com/smartsavings.

Last Updated: 04.18.2024 at 12:11 AM CDT

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. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotline 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 provider'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. Nurse Hotline not for use in emergencies, for informational purposes only.

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. 

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.

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® 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. 

UnitedHealthcare Senior Care Options (HMO SNP) plan

UnitedHealthcare Senior Care Options (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 and does not have any other comprehensive health Insurance, except 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 Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.

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.