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Long-Term Services and Supports (LTSS) Eligibility

Long-term services and supports (LTSS) eligibility

The Iowa Department of Human Services decides eligibility for long-term services and supports provided through:

  • A waiver.
  • In facilities.
  • Habilitation.

AmeriHealth Caritas Iowa will help enrolled members apply for a level of care determination when their condition shows possible eligibility.

LTSS referrals

AmeriHealth Caritas Iowa wants you to get the care you need. Changes in your health might make you eligible to get more services. These are services people need for months or years to get or stay healthy, like:

  • Medical services.
  • Habilitation.
  • Rehabilitation.
  • Home care.
  • Social services.

You may get these services in your home or in a community-based setting. Facility-based LTSS are services you get in a nursing facility or other care setting.

As a member, you will get a full assessment of your needs. This includes your need for community-based or facility-based LTSS. During this assessment, your case manager will ask you questions over the phone or in person at your home.

Your caregivers or personal representatives might help with this assessment. Your case manager will also work with your PCP, specialists, and other health care providers. This will help paint a picture of your needs.

Everything you need will be in your care plan. Your care plan will show which services you need. It will tell you how often you will need them. It will tell you the providers who can help you.

If you, a friend, or family member notices a change in your health at any time, you can call your case manager at 1-855-332-2440 (TTY 1-844-214-2471). This will let us make sure your care plan meets your needs.