New Jersey restructured its entire home-care system in 2014 — and the result is one of the few states where you don't have to wait on a list once you qualify.
New Jersey-specific — figures don't apply nationallyMost states run separate HCBS waivers with limited slots and real waitlists, sometimes lasting years. New Jersey doesn't work this way. In 2014, the state eliminated its traditional HCBS Waivers — including the former Global Options Waiver — and replaced all of them with a single program: MLTSS (Managed Long Term Services and Supports).
Rather than separate waiver programs with individual slot limits, MLTSS routes all long-term care — home care, adult day care, assisted living, and nursing facility care — through contracted managed care organizations. Eligibility assessment and service coordination happen through a single managed care plan, not multiple agencies. Demand runs especially high in the densely populated suburban counties of North and Central Jersey — Essex, Bergen, Passaic, Middlesex, and Monmouth — where a large elderly population strongly prefers aging in place.
| MLTSS / Nursing Home | ABD Medicaid | |
|---|---|---|
| 2026 income limit | $2,982/month | ~$1,330/month (100% FPL) |
| 2026 asset limit (single) | $2,000 | $4,000 |
| 2026 asset limit (married) | $3,000 | $6,000 |
Source: NJ Department of Human Services, Division of Medical Assistance and Health Services (DMAHS); figures effective 2026. Note: ABD Medicaid's higher asset limit is genuinely unusual — most states use the same $2,000/$3,000 figure across all three program types.
New Jersey requires a Qualified Income Trust (Miller Trust) for MLTSS and Nursing Home Medicaid income above $2,982/month. Regular ABD Medicaid, by contrast, allows a spend-down option instead.
PAAD (Pharmaceutical Assistance to the Aged and Disabled) helps New Jersey seniors and disabled residents who earn too much for full Medicaid but still need help with prescription costs — worth checking even if you don't qualify for MLTSS.
No — MLTSS is an entitlement with no enrollment caps, unlike traditional HCBS waivers in most other states.
$4,000 single / $6,000 married — higher than MLTSS and Nursing Home Medicaid's $2,000/$3,000.
New Jersey's own prescription drug assistance program for seniors who earn too much for full Medicaid.
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