What Does the Term “Period of Ineligibility” Mean Under NJ Medicaid Law?

HNWApplying for Medicaid Long Term Care Benefits

In order to discourage people from disposing of valuable assets and real estate in order to become eligible for Medicaid nursing home services, NJ regulations impose a period of ineligibility to any applicant who transfers resources for less than fair market value during a sixty-month look-back period (5 years). N.J.A.C. 10:71-4.10(a)(2).  Transfers made within the look-back period “are presumed to be improperly motivated to obtain Medicaid eligibility.”  Read the regulations.  However, an applicant retains the right to rebut this presumption.  N.J.A.C. 10:71-4.10(i).  This means you have the right of challenge the state’s claim that you transferred resources just to become Medicaid eligible.  If the presumption is not rebutted, the state imposes a transfer penalty, calculating the period of ineligibility following a transfer of an available resource. N.J.A.C. 10:71-4.10(b)(4) and 10:71-4.10(c).

If there is reason to believe an applicant transferred assets for no value (i.e., a gift) the County can request verification of the applicant’s resource statements through one or more third parties going back 5 years.  N.J.A.C. 10:71-4.1(d)(3).

To discuss your NJ Medicaid matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com.  Please ask us about our video conferencing or telephone consultations if you are unable to come to our office.

By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold Township, Monmouth County, NJ Medicaid Attorney

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