Illinois Medicaid Managed Long-Term Services and Supports (HealthChoice Illinois MLTSS)

Illinois’s Managed Long-Term Services and Supports (MLTSS) program delivers Long-Term Care Medicaid (nursing facility care and home and community waiver services) through HealthChoice Illinois managed care plans for dual-eligible adults who are not in an integrated Medicare-Medicaid plan. This page is part of our Illinois Long-Term Care Medicaid guide.

Figures change periodically. Double-check current amounts before relying on them.

At a glance

MLTSS in brief

Put simply, responsibility for MLTSS sits with Illinois Department of Healthcare and Family Services (HFS), through HealthChoice Illinois plans. It serves 21 and older with Medicare and Medicaid, receiving LTSS, and the care requirement is: Receives nursing facility or HCBS waiver services. On waiting lists, the current picture is: No. Each of these points is covered in more depth below, alongside the general Illinois rules from our state guide. Families weighing MLTSS against other Illinois options can use the related pages at the end to compare programs side by side.

What the program is

In MLTSS, a person’s Medicare stays separate, and the HealthChoice Illinois plan covers Medicaid long-term services and supports and behavioral health. A care coordinator helps arrange services. Since January 1, 2026, dual-eligible adults can instead choose a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP), which combines Medicare and Medicaid; people receiving LTSS who do not choose one are enrolled in MLTSS.

In a managed long-term services and supports program, the state pays a health plan a monthly amount to arrange all of a member’s long-term care, at home, in assisted living or in a nursing home. The member chooses a plan from those offered in their area, and the plan assigns a care coordinator or case manager. Eligibility rules still come from the state, and members can appeal if a plan reduces or denies services. See Managed long-term services and supports.

Who qualifies in 2026

A person generally must meet all of these conditions:

• Has full Illinois Medicaid and Medicare
• Is 21 or older
• Receives nursing facility care or HCBS waiver services
• Is not enrolled in a FIDE SNP

Financial eligibility. Applicants for MLTSS must meet Illinois’s long-term care Medicaid financial rules. Figures shown above are the 2026 Illinois long-term care limits from our state guide. Exempt items generally include the home within the equity cap, a car, household goods and a modest burial fund. When one spouse applies for MLTSS and the other stays at home, the spouse at home keeps a protected share of the couple’s assets and may receive part of the applicant’s income. See Spousal impoverishment rules.

What services it can pay for

What a participant receives under MLTSS follows the care plan. Possible services include:

• Nursing facility care
• HCBS waiver services (for example, Community Care Program services)
• Supportive Living Program services
• Behavioral health services
• Care coordination
• Non-emergency transportation

Not every participant gets every service; the plan reflects assessed need and the help family already gives. A change in health is a reason to request a reassessment.

How to apply

Applying usually involves two decisions: one about money (financial eligibility for Medicaid) and one about care needs. In plain terms, the steps are:

1. Apply for Long-Term Care Medicaid.
2. Once approved for LTSS, watch for enrollment materials from Illinois Client Enrollment Services.
3. Choose an MLTSS plan or a FIDE SNP.
4. Your plan’s care coordinator contacts you.

Before contacting Illinois HFS, see Applying for a waiver and the documents checklist for what to gather.

Waiting lists

There is no waiting list for MLTSS enrollment.

See Waiver waiting lists for general tips.

How it relates to nursing home Medicaid

MLTSS is a delivery system, not a separate eligibility category. Nursing home and waiver eligibility rules stay the same.

What is the same as nursing home Medicaid. Illinois’s financial rules for MLTSS track the nursing home rules closely. The five-year look-back for gifts generally applies, so a gift or transfer for less than fair value can cause a period when Medicaid will not pay for long-term care services. After death, estate recovery can reach services paid from age 55 on. Some participants pay a monthly share of income toward services.

Income in a nursing home. In 2026, Illinois lets a nursing home resident keep $60 a month for personal needs; the rest of their income mostly pays toward care. Details are in our state guide.

Tips for families

• Begin before it is urgent. Every step of MLTSS takes time, and an early request protects your place.
• Document everything, from forms and letters to who you spoke with at Illinois HFS and when.
• Watch the deadlines on notices. A denial or cut can be appealed through a fair hearing, and a timely request can keep services going meanwhile.
• Report changes promptly, including income, assets, a move or a new living arrangement.
• Expect yearly reviews of both Medicaid eligibility and the care assessment. See Renewals.
• Think about the spouse at home. Couples have extra protections, but they have to be claimed. A certified Medicaid planner or a legal aid office can explain how the rules apply to a particular family.

Common questions

What happened to MMAI? Illinois’s Medicare-Medicaid Alignment Initiative ended on December 31, 2025, and was replaced by FIDE SNPs on January 1, 2026.

Do I have to be in MLTSS? Dual-eligible LTSS members not in a FIDE SNP are generally enrolled.

Does MLTSS change my Medicare? No. Medicare stays separate.

Related pages

• Illinois Long-Term Care Medicaid guide
• Illinois FIDE SNP
• Managed long-term services and supports
• Three kinds of Long-Term Care Medicaid
• PACE programs

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.