Medicaid Home Care in New Jersey: MLTSS Eligibility and How to Apply

New Jersey does not run separate home care waivers the way most states do. The state consolidated its Global Options, ACCAP, and CRPD waivers into a single managed-care program called Managed Long Term Services and Supports (MLTSS). Every Medicaid-funded home care service — personal care aides, home modifications, medical day care, home-delivered meals — flows through this one system.

That simplification is good news for families: there is no waitlist for MLTSS home care services in New Jersey. If your parent qualifies clinically and financially, they are enrolled.

The Two Gates: Clinical and Financial

MLTSS approval requires passing two independent screenings that run in parallel.

Clinical eligibility is determined by the Office of Community Choice Options (OCCO). A registered nurse conducts an in-person Pre-Admission Screening at your parent's home. Under N.J.A.C. 8:85-2.1, your parent must meet Nursing Facility Level of Care — meaning they need hands-on assistance with at least three Activities of Daily Living (bathing, dressing, toileting, transfers, locomotion) or have severe cognitive deficits that compromise their safety.

Financial eligibility is determined by your local County Welfare Agency (CWA), also called the County Board of Social Services. The 2026 limits:

• Income: $2,982 per month gross (300% of the federal SSI rate). If your parent exceeds this, a Qualified Income Trust can restore eligibility.
• Assets: $2,000 for a single applicant. Countable assets include bank accounts, CDs, stocks, retirement accounts (New Jersey counts IRAs and 401ks), and secondary real estate.
• Home: Exempt up to $1,130,000 in equity if your parent lives there or intends to return.

Step-by-Step Application Process

1. Call the ADRC at 1-877-222-3737 to reach your county's Area Agency on Aging. An intake specialist completes the Screen for Community Services (SCS) — a scored phone assessment that takes 1 to 3 business days.

2. Organize finances before filing. Spend down countable assets to the $2,000 threshold through approved transactions: paying off debts, prepaying an irrevocable burial trust, or covering home modifications. If a QIT is needed, open the dedicated bank account before submitting the application.

3. Submit the ABD application to your local CWA — online through the NJ FamilyCare portal, in person, or by mail. Include 60 months of bank statements, tax filings, real estate records, and the signed QIT document if applicable.

4. OCCO clinical screening happens while the CWA reviews finances. The CWA sends a CP-2 referral to OCCO, and a nurse visits your parent's home within 15 to 30 days.

5. Select an MCO once both approvals come through. Five managed care organizations operate across New Jersey's 21 counties: Horizon NJ Health, Aetna Better Health, UnitedHealthcare Community Plan, WellCare, and Wellpoint. If your parent does not choose, the state auto-assigns one.

6. MCO care plan assessment follows enrollment. A care manager visits the home, evaluates needs, and drafts the Person-Centered Service Plan — which determines weekly personal care aide hours (capped at 40 hours per week unless extraordinary circumstances apply).

What MLTSS Actually Covers

Once enrolled, your parent's MCO coordinates:

• Personal care assistant services (bathing, dressing, meals, mobility)
• Home accessibility modifications (ramps, grab bars, stairlifts)
• Personal emergency response systems
• Home-delivered meals
• Adult day care
• Medical day care for dementia
• Transition to the Personal Preference Program for family-paid caregiving

Processing Timeline

CWA financial reviews take 45 to 90 days on average, though missing records can push this longer. Clinical screenings typically complete within 15 to 30 days. Services begin within 10 to 15 business days after the care manager's assessment.

The New Jersey Home Care Guide includes a printable document checklist for the ABD application, a QIT setup walkthrough, and an MCO comparison worksheet to help you choose the right plan.

See more New Jersey guides →