By Fredrick P. Niemann, Esq. a New Jersey Medicaid Attorney
The Medicaid program in New Jersey is about to change.  This time I’m pleased to report the change is for the better.  It’s been reported that individuals with “higher” incomes will be permitted to qualify for long-term care services at home or in an assisted living residence, not just a nursing home as is the present case.  The change has been sought by elder law attorneys for over a decade.

 

Medicaid is a government-sponsored health insurance program for needy individuals.  In fact, it is a program for the middle class as well.  Unlike Medicare and most policies of health insurance, Medicaid will pay for the costs of custodial long-term care, such as care in a nursing home or assisted living residence.

 

In order to qualify for Medicaid in New Jersey, an individual must have limited resources, not exceeding $4000 under the medically needy program.  In Medicaid vocabulary, “resources” are assets, such as bank accounts, stocks, bonds and mutual funds.
If an individual needs long term care, he or she will have to spend down their assets to below the resource limit.  As an alternative to simply spending his or her assets, the individual could contact an elder law attorney like Fredrick P. Niemann at Hanlon Niemann and plan for Medicaid eligibility, therefore preserving a portion of his resources.
Resources are not, however, the only part of the Medicaid-eligibility.  An individual also must have a limited amount of income.  For one program of Medicaid, known as Global Options, the individual’s gross income cannot exceed $2,094 a month.  If the individual’s income is one penny above $2,094 a month, he will not qualify for Medicaid under current New Jersey law.

 

The $2,094 a month limit is called an “income cap”.  Currently, in order to qualify for Medicaid long-term care services in an assisted living residence or at home, an applicant’s income must be below the income cap.  (The Medicaid income cap program has a $2,000 resource limit).
There is another program of Medicaid that provides long-term care services under which an individual’s income can exceed the income cap; however, this program of Medicaid currently does not pay for care in an assisted living residence or at home.  This program of Medicaid will only pay for long-term care services provided in a nursing home.
So, if an applicant is at home and has gross income of $2,100, he would not qualify for Medicaid; he would only qualify for Medicaid if he moved into a nursing home.  If the same applicant had income of $1,900 a month, he would qualify for Medicaid long-term care services at home, in an assisted living residence or in a nursing home.

Contact me personally today to discuss your Medicaid eligibility matter.  I am easy to talk to, very approachable and can offer you practical, legal ways to handle your concerns.  You can reach me toll free at (855) 376-5291 or e-mail me at fniemann@hnlawfirm.com.