NJ Medicaid Info   Where are Medicaid Applications filed?

 

In New Jersey Medicaid Applications are filed at the County Board of Social Services. The counties maintain outreach offices in certain locations, otherwise the application must be filed at the county office.

 

May applications be filed by mail?

New Jersey Medicaid applications may not be filed by mail.

 

What type of documents are required in connection with an application?

Required documentation begins with a birth certificate for the NJ Medicaid Applicant, a marriage certificate if the applicant is or has been married and a death certificate of the spouse or divorce decree if the marriage has been dissolved by death or divorce. In addition, three years of complete financial records may be required.

 

What if I am unable to locate a birth certificate, marriage certificate, death certificate or divorce decree?

 

All of these items can be obtained from the Registrar of Vital Statistics or from court records. If it is absolutely impossible to obtain these records, other forms of evidence may be accepted.

 

How does the applicant prove that it is medically necessary that he be receiving the care being provided?

 

A PAS is ordered by the facility. Medicaid sends a nurse to examine the applicant to determine whether or not the care is medically necessary. The applicant or the applicant's representative must be sure that the facility orders the PAS. New Jersey has an unwritten rule that the examination will take place within 30 days from the date the PAS is ordered.

 

How does Medicaid know that the information I am providing is complete?

 

Medicaid has a computer match with the I.R. S. Medicaid will receive information concerning 1099's sent by all financial institutions.

 

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How long does it take to process a Medicaid Application?

 

The length of time necessary to process a Medicaid Application varies from county to county and is dependent on the nature of the financial data being submitted. In some counties, an application can be approved within 45 - 60 day. In other counties, it takes 6 months or more to a year. In special situations, the application has to be approved in Trenton and this can take 18 months or longer.

 

Who pays the nursing home while the Medicaid Application is pending?

 

At the time of approval of the Medicaid Application, Medicaid will inform the applicant of the applicant's monthly share of cost. The applicant must pay this share to the facility while the application is pending. When the application is approved, Medicaid will pay the nursing home retroactively to the date of eligibility. 

 

In New Jersey, is the Medicaid Application process time consuming?

 

Medicaid demands proof of every financial transaction going back to January 1, 2006 and in some instances, Medicaid goes back for 5 years prior to the application. Accurate records should be gathered and a complete Medicaid application furnished to the County Board of Social Services to make the processing simpler. If records are inaccurate or incomplete or if a Medicaid application package is disorganized, the Medicaid Agency will continue to insist on additional information and the application will be delayed indefinitely. Submission of a complete Medicaid Application requires many hours of time. It is estimated that a professional assembling a Medicaid Application spends approximately 25-40 dedicated and undisturbed hours assembling and organizing the information. A person unfamiliar with the process will spend many times that amount of time.

 

Is the cost of paying a professional such as a law firm to prepare and file a Medicaid Application in New Jersey a legitimate spend down for Medicaid eligibility purposes?

 

Yes. The cost of professional assistance in preparing and filing a Medicaid Application is paid by the Medicaid applicant as part of the spend down process. The legal fee paid to our office, for example, is credited toward the applicant’s eligibility.

 

Contact Fredrick P. Niemann, Esq. on any questions concerning eligibility for NJ Medicaid or applying for Medicaid approval.  Call (888) 800-7442 or email him at fniemann@hnlawfirm.com.

 

 

Medicaid Attorneys serving these New Jersey Counties:

 

Monmouth County, Ocean County, Essex County, Cape May County, Mercer 

County, Middlesex County, Bergen County, Morris County, Burlington County, 

Union County, Somerset County, Hudson County, Passaic County