MLTSS Income & Resource Limits for 2024

The Chamberlain Law Firm

As an experienced attorney, I understand how overwhelming the Medicaid Managed Long-Term Services and Supports (MLTSS) application process can be. In this article, the New Jersey Medicaid attorneys at The Chamberlain Law Firm will explain the MLTSS income & resource requirements. By understanding these requirements, you can determine whether you or a loved one may qualify for this crucial healthcare program.

What is Medicaid and MLTSS?

Medicaid is a state and federal government-funded healthcare program that provides essential health services to eligible low-income individuals and families. The program covers various services, including primary care, hospitalization, and prescription drugs. You can learn more about New Jersey’s Medicaid offerings here.

MLTSS refers to a specific Medicaid program focused on long-term care. In New Jersey, MLTSS is administered through New Jersey’s NJ FamilyCare program. MLTSS covers anything covered by NJ FamilyCare Plan A, care management, home delivered meals, respite, assisted living, and more.

How Much Can You Make to Qualify for MLTSS in New Jersey?

The Medicaid income requirements vary between states. In New Jersey, the income limits for different Medicaid programs vary, and are based on the Federal Poverty Level (FPL). For most Medicaid programs, the income limits depend on factors such as household size, age, and disability status.

For MLTSS, New Jersey imposes a hard monthly income “cap” of $2,742 per month. However, if your income exceeds this amount, it is still possible to qualify. By working with an attorney, you can set up a Qualified Income Trust (QIT). With a QIT, your excess income is deposited into a trust account and is used to pay for medical expenses and care services.

Spousal Allowances

Additionally, if you are married, you can take advantage of the Community Spouse Maintenance Allowance and Spousal Housing Allowance. In New Jersey, the Community Spouse Maintenance Allowance is $2,465 and the Housing Allowance is $739.50. 

So what does this mean? Say you apply for MLTSS and your income exceeds $2,742 (the income cap), but your spouse’s income is below $2,465/month. You can then “transfer” your income to your spouse to bring their monthly income up to $2,465. Further, any of your spouse’s housing expenses exceeding the Housing Allowance are added to their base allowance of $2,465.

Resource Limits

Medicaid also imposes a limit on the value of assets, or “resources,” that you own. Resources may include bank accounts, retirement accounts, stocks, and anything else that can be easily converted to cash. In New Jersey, the asset limit for an individual applying for MLTSS is set at $2,000. 

For married couples, it is a bit more complex. Generally, the community spouse (the spouse not requiring care) is allowed to retain up to $148,620 in assets. This is known as the Community Spouse Resource Allowance (CSRA).

If the value of your assets exceed the resource limit, do not lose hope. An attorney can help you spend-down assets while complying with the five year lookback period. Also, your attorney will make sure you avoid any unnecessary transfer and penalty periods. We’ll talk more about these things in a bit.

Additional Factors Affecting Eligibility

In addition to income limits, other factors affect your eligibility for MLTSS in New Jersey:

  1. Residency: You must be a resident of New Jersey.
  2. Citizenship: You must be a U.S. citizen, a U.S. national, or a qualified non-citizen.
  3. Social Security Number: You must provide a valid Social Security Number (SSN) or proof of application for an SSN.

Applying for Medicaid

To apply for Medicaid in New Jersey, you can submit an application online, by mail, or in-person at your local County Welfare Agency or Social Services office. Be prepared to provide documentation to verify your income, citizenship, residency, and other pertinent information.

In New Jersey, applying for MLTSS involves a comprehensive assessment of your financial and medical eligibility. A crucial aspect of this process is the five year look-back period. This is when Medicaid reviews any transfers or gifts of assets made within the 60 months prior to the application date. This examination aims to identify any attempts to reduce assets to meet Medicaid’s financial eligibility requirements. If any such transfers are discovered, a penalty period may be imposed, delaying the start of Medicaid coverage for long-term care services. 

Keep in mind that eligibility rules for long-term care may differ from those for regular Medicaid. Therefore, it’s essential to consult with an experienced attorney to navigate the process smoothly.

Expert Legal Assistance for Medicaid Eligibility

Understanding and navigating the Medicaid income requirements in New Jersey can be challenging. Our experienced attorneys are experts on MLTSS applications and are here to guide you through the process and help you determine your eligibility. Please reach out to us today at The Chamberlain Law Firm today by calling us at (201) 273-9763 for a consultation and let us help you secure the healthcare coverage you deserve.

This article is for informational purposes only. It is not intended as legal advice. In the event you would like to speak with a lawyer about the specifics of your case, contact The Chamberlain Law Firm at (201) 273-9763 to schedule a consultation.

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