Medicaid Long-Term Care in New Jersey

When it comes to long-term care services, Medicaid is a crucial resource for many New Jersey residents. Medicaid is a federal and state-funded program that provides assistance to low-income individuals and families who need help paying for medical care. In New Jersey, individuals who meet the Medicaid long-term care eligibility requirements can take advantage of a variety of long-term care services, including nursing home care, home health care, and assisted living services. These programs are referred to as Medicaid Managed Long Term Services and Supports (MLTSS).

Nursing Home Care

For many individuals who require long-term care, nursing home care is a necessary option. Medicaid in New Jersey covers nursing home care for eligible individuals who require round-the-clock skilled nursing care.

Home Health Care

Many individuals prefer to receive long-term care services in their own homes. Medicaid in New Jersey also covers home health care for eligible individuals. Home health care services can include nursing care, physical therapy, occupational therapy, and other services that are necessary for an individual’s health and well-being.

Individuals who are eligible for NJ FamilyCare Plan A, approved for Personal Care Assistant Services, and are able to self-direct services can take advantage of the Personal Preference Program (PPP). Individuals utilizing PPP can choose the home care services they want; hire workers that they know and trust, including friends, relatives, or neighbors; and schedule services according to their individual needs.

Assisted Living Services

Assisted living services can provide a great option for individuals who need some assistance with daily tasks but do not require the round-the-clock care provided in a nursing home. Medicaid in New Jersey covers assisted living services for eligible individuals. Assisted living services can include assistance with activities of daily living, medication management, and other services that are necessary for an individual’s health and well-being.

Qualifying for Medicaid in New Jersey

To qualify for Medicaid in New Jersey, an individual must meet certain financial and medical requirements. Financial requirements include income and asset limits, while medical requirements include a demonstration of medical need for long-term care services.

Individuals who receive SSI already qualify to receive Medicaid in New Jersey. Elderly, blind, or disabled individuals who do not receive SSI must have a monthly income of less than $1,677 ($2,268 for couples) to qualify for Medicaid. However, elderly, blind, or disabled individuals who require assisted living or home health services can qualify for Medicaid if their income is less than $2,742 (or $5,484 for couples).

For individuals seeking long-term care assistance through New Jersey Medicaid, it is important to also be aware of the asset limits that determine eligibility. As of 2023, the asset limit for an individual applying for Medicaid long-term care services is set at $2,000. For married couples, if only one spouse requires long-term care services, the asset limit for the applicant is still $2,000, while the community spouse (the spouse not requiring care) is allowed to retain up to $148,620 in assets, known as the Community Spouse Resource Allowance (CSRA). It’s crucial to note that certain assets, such as the primary residence (with an equity limit of $858,000), one vehicle, and certain personal belongings, are exempt from these limits.

Individuals who exceed the income or asset limit for Medicaid but incur substantial medical expenses may qualify for New Jersey’s Medically Needy Program. The Medically Needy Program is a spend-down program that allows you to deduct medical expenses up to a certain amount from your income so as to allow you to qualify for Medicaid.

Individuals 21 years or older can meet the Medicaid long-term care medical eligibility requirements if they require hands-on assistance with at least three daily living activities, such as bathing, dressing, toileting, eating, bed mobility, or other activities.

Applying for Medicaid can be a complex process. Luckily, an experienced New Jersey Elder Law attorney can help you with the application process by ensuring that you apply for the benefits that you need, navigating complicated legal provisions to protect family assets, and protecting your rights. Additionally, hiring an attorney can save time and help avoid costly penalties.

Conclusion

In conclusion, Medicaid in New Jersey offers a variety of long-term care services for eligible individuals, including nursing home care, home health care, and assisted living services. It is important to understand the eligibility requirements for each of these services and to explore all options available when it comes to long-term care. An experienced attorney familiar with local New Jersey laws can help make sure you are taking advantage of Medicaid to the maximum extent possible. With the help of Medicaid, individuals and families can access the care they need to live healthy and fulfilling lives. Don’t wait; contact us at the Chamberlain Law Firm today via our contact page or by calling us at (201) 249-6716.