Why Should You Consult With a Medicaid Eligibility Attorney?
Written by Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a New Jersey Medicaid Attorney
Why Seek Legal Advice for Medicaid in New Jersey?
As life expectancies rise and long term care costs increase dramatically, the challenge quickly becomes how to pay for these services. Many people cannot afford to pay $7,500 to $13,000 per month or more for the cost of a nursing home, assisted living residence or home based care, and those who can pay for a while may find their life savings wiped out in a matter of months, rather than years.
Fortunately, the NJ Medicaid Program is there to help. In fact, in our lifetime, Medicaid has become the long term care insurance program of the middle class. But eligibility to receive Medicaid benefits requires that you pass certain tests on the amount of income and assets that you have.
The reason for Medicaid planning is that without the proper advice, many people spend more than should or are required to, or they transfer property and savings inappropriately and are faced with months or years of ineligibility, jeopardizing their family’s financial security. In many cases homes and resources are lost but could have been saved if done properly and within the appropriate time frames and guidelines.
HOW TO BECOME ELIGIBLE FOR NJ MEDICAID
To be eligible for New Jersey Medicaid, a person must meet these general requirements:
- Be a resident of New Jersey
- Be a U.S. Citizen or qualified legal resident alien
- Meet specific income and resource limitations
- Meet medical needs standards
New Jersey Medicaid also has a number of special long-term programs designed to meet the specific medical needs of individuals who would not otherwise qualify for benefits.
These programs include:
- Medically Needy Medicaid programs for the aged, blind or permanently disabled. These programs provide for a nursing home level of care for persons whose income and assets exceed current eligibility standards. The program is commonly referred to as Managed Long Term Support Services (MLTSS).
- (MLTSS) is Managed Long Term Support Services for long-term care at home and in the community or in an assisted living residence. It provides numerous support services including personal aides to help with a person’s activities of daily living (ADL’s) like bathing, medication administration, toileting, meal preparation, home cleaning, etc. It also covers medical expenses, pharmacy and prescription needs, physical and speech therapy, diagnostic evaluations, etc.
Since 1996, the NJ Department of Health and Senior Services has administered all Medicaid and Managed Long Term Support Services and programs for eligible beneficiaries.
Benefits of Using an Elder Care Attorney
to Qualify for NJ Medicaid Eligibility
Actual Client Testimonial
Mr. Niemann and his office successfully handled the filing of a Medicaid application for my Mom. They coordinated all the paperwork and detailed financial requirements requested by the County Board of Social Services. His office was courteous and professional to me and my family throughout the process. They answered our questions and responded back to us in a timely manner. The guidance and advice of Mr. Niemann and his staff is sincerely appreciated.
-Christopher Collins, New York City
Fred is an amazing and dynamic person. I have attended a few of his work shops and CEU events over the years and his interactive discussions have been both educational and entertaining. He is one of the few lawyers out there that I do trust and does whatever he says he is going to (Accountability) who ever I have referred his way has always thanked me for connecting them and this is why I continue to work w/ Fred. Great person, excellent ethics, and very knowledgeable. I highly recommend him.
—Steve Weiss, Regional Director of Professional Relations, Senior Bridge
I knew I needed an attorney, but could I afford one? Would he or she be experienced and someone I could trust and talk to openly and in confidence?
I was referred to Fredrick P. Niemann. I was warmly greeted and my appointment promptly kept. I was given all the time I needed to ask questions and talk about my needs and concerns. I was quoted a fee that was appropriate and reasonable for my matter. My attorney gave me answers and advice. He was a counselor at law and in life. Calling Hanlon Niemann was the right decision.
—Nick Alfano, Morganville, NJ
The Hidden Dangers and Traps When Applying For Medicaid
ASSET TRANSFERS TO ACHIEVE MEDICAID ELIGIBILITY: BEWARE OF THE TRAPS!
Federal law states that when assets are improperly transferred by individuals anticipating long-term care in a nursing home, assisted living residence or at home under a community-based waiver program (MLTSS), penalties and periods of ineligibility must be imposed before the state will pay for the individual’s care.
States like New Jersey are allowed to “look back” at your finances and income to find transfers going back 5 years prior to the date you are institutionalized or, if later, the date you apply for Medicaid.
This 5 year look back period applies to all transfers including gifts, presents, charitable donations, etc. It also applies to transfers into trusts.
If a transfer of assets has been made for less than fair market value, New Jersey must withhold payment for nursing home (and certain other long-term care services) for a period of time referred to as the penalty period.
The length of the penalty period is determined by dividing the value of the transferred asset(s) by the average monthly private-pay rate for nursing facility care in the State. The calculation of penalty periods is complicated and requires professional advice. Contact Fredrick P. Niemann toll-free at (855) 376-5291 or email@example.com for answers, including eligibility for Medicaid for long term care at home or at a licensed NJ nursing home or assisted living residence.
Here’s An Example of a Penalizing Transfer
Example: You have a CD worth $100,000. New Jersey says if you make a gift of the CD within 5 years of applying for Medicaid you will be penalized $10,000+ (based on the penalty divisor which is adjusted annually) per month and you will have to private pay the nursing home (or other care facility/caregiver) for 10 months ($100,000 ÷ $10,000 is 10 months). There is no limit to the length of the penalty period. It will always be a simple math equation of gift amount divided by the penalty divisor which will equal the penalty period. Some penalties can last for years.
However, for certain types of transfers, Medicaid does not impose penalties. Exceptions to the general rule include:
- Transfers to a spouse, or to a third party for the sole benefit of the spouse;
- Transfers by a spouse to a third party for the sole benefit of the spouse;
- Transfers to certain disabled individuals, or to trusts established for those individuals commonly called Supplemental Needs Trust or a Special Needs Trust;
- Transfers for a purpose other than to qualify for Medicaid; and “Transfers where imposing a penalty would cause undue hardship.
Understanding penalty periods, the concept of gifting under NJ law and the timing of your Medicaid application requires years of experience. Please do not attempt to do this on your own.
Contact Fredrick P. Niemann, Esq. on any questions concerning eligibility for NJ Medicaid or applying for Medicaid approval.
Call toll free (855) 376-5291 or email him at firstname.lastname@example.org to set up an office consultation at your convenience.
A caring, sensitive, experienced Elder Law attorney who works daily in Medicaid eligibility planning.