New Jersey Medicaid Eligibility

Here’s a comprehensive guide on Medicaid long-term care eligibility in New Jersey:

1. Income Eligibility: In order to qualify for Medicaid long-term care in New Jersey, your income must be at or below 300% of the federal poverty level. As of 2023, this means your income must be below $3,494 per month for an individual and $4,711 per month for a couple. If your income is above this level, you may still qualify for Medicaid if you have high medical expenses.

2. Asset Eligibility: In addition to income, there are also asset limits for Medicaid long-term care eligibility in New Jersey. As of 2023, an individual’s countable assets cannot exceed $2,000, while a married couple’s countable assets cannot exceed $3,000. Certain assets, such as your primary residence, a vehicle, and personal belongings, are exempt from the asset limit.

3. Medical Eligibility: To be eligible for Medicaid long-term care in New Jersey, you must also have a medical need for long-term care services. This means you must have a physical or cognitive impairment that requires assistance with activities of daily living, such as bathing, dressing, and eating. You will need to undergo a medical evaluation to determine your eligibility.

4. Citizenship and Residency: You must be a U.S. citizen or have legal immigration status to be eligible for Medicaid long-term care in New Jersey. You must also be a resident of New Jersey and provide proof of residency.

5. Application Process: To apply for Medicaid long-term care in New Jersey, you can apply online through the NJ FamilyCare website or in person at your county Board of Social Services. You will need to provide documentation of your income, assets, medical need, citizenship, and residency.

6. Look-Back Period: New Jersey has a five-year look-back period for Medicaid long-term care eligibility. This means that any asset transfers or gifts made within the past five years may be subject to penalties and affect your eligibility. It’s important to plan ahead and consult with a Medicaid planning professional to avoid any issues with the look-back period.

7. Medicaid Managed Care: In New Jersey, Medicaid long-term care services are provided through managed care organizations (MCOs). Once you are approved for Medicaid long-term care, you will be assigned to an MCO that will coordinate your care and provide services such as home health care, assisted living, and nursing home care.

Overall, Medicaid long-term care eligibility in New Jersey can be a complex and confusing process. It’s important to consult with a Medicaid planning professional or elder law attorney to help navigate the eligibility criteria and application process.