The Managed Long Term Services and Supports (MLTSS) program is part of HealthChoice Illinois, the statewide Medicaid managed care program. MLTSS pays for personal care, adult day care, and transportation assistance (as well as many other supportive services) for elderly, Medicaid-eligible, Illinois residents.
Services are provided via a network of providers, referred to as a health plan. At the time of this writing, there are eight health plans that are available throughout the state: Aetna Better Health of Illinois, Blue Cross Community Family Health Plan, CountyCare Health Plan (in Cook County only), IlliniCare Health, Harmony Health Plan, Meridian Health Plan, NextLevel Health (in Cook County only) and Molina Healthcare.
Health plans by county can be compared here.
After selecting a health plan, participants work with a health plan care coordinator to get the services they need.
Managed Long Term Services and Supports is a mandatory program for seniors and physically disabled persons who are enrolled in both Medicaid and Medicare (dual eligible) and reside in a nursing home or receive long-term home and community based services.
Alternatively, one can opt to enroll in the Medicare-Medicaid Alignment Initiative Program instead.
For Illinois residents, age 65 and older, Medicaid’s financial eligibility criteria are as follows.
In 2023, the income limit for an individual applicant is $1,215 / month (100% of the current Federal Poverty Level). For a couple with both spouses applying, the income limit is $1,643. However, when only one spouse is applying, the non-applicant spouse’s income is not considered. In addition, the applicant spouse can transfer up to $3,715.50 a month to the non-applicant spouse as a spousal income allowance.
The asset limit for an individual is $2,000, and $3,000 for couples when both spouses are applying. For a couple with only spouse applying, the non-applicant spouse is allowed $112,344 in assets.
However, several assets are exempt from these figures. This includes an applicant’s primary home, as long as he or she (or his or her spouse) lives in it and the equity value is under $688,000, household furnishings, personal items, and a pre-paid burial plot, among other resources.
Being over the limit for income and / or assets does not automatically disqualify an individual from Medicaid. One can consult a professional Medicaid planner for advice on how to reallocate income and / or assets for exemption purposes. However, this process is complicated and shouldn’t be attempted without professional assistance. Giving away assets or selling them for less than fair market value can result in a denial of Medicaid.
In addition to care coordination, a variety of services are available and may include the following:
Additional information about HealthChoice Illinois’ Managed Long Term Services and Supports program can be found on the Illinois Department of Healthcare & Family Services website.
To enroll in MLTSS, one can call Client Enrollment Services at 877-912-8880.