In New Jersey, the Medicaid program which provides an institutional level of care is called “Managed Long Term Services and Supports”.- This program pays for nursing home care or up to 12 hours per day of care in the home.
- In order to be eligible for Managed Long Term Services and Supports (“MLTSS”) the applicant must be “Aged, Blind or Disabled” and must qualify medically and financially.
How to qualify for Medicaid long term care benefits
To qualify medically, an individual must be aged, blind, or disabled, and require physical assistance with two (2) or more activities of daily living, or have a cognitive impairment. To qualify financially, an individual must have less than $2,000 in available resources, and must not have transferred resources to another within sixty months prior to applying for Medicaid.
Because Medicaid is a joint program between the federal government and the states, an individual must qualify under federal law, federal regulation, state law, and state regulation. It is funded by the federal government, and administered by the states, including New Jersey. The federal government requires that New Jersey enacts state legislation mirroring the portions of the Federal Medicaid Act the state is adopting.
New Jersey’s state legislation is found in the New Jersey Medical Assistance and Health Services Act, N.J.S.A. 30:4D-1 to -19.50:
An individual applying for Medicaid must meet both the resource and income eligibility standards before she may qualify for the Medicaid program. New Jersey looks at all sources of income and all resources the Medicaid applicant has within the five (5) years leading up to the date of the application. “All income, whether in cash or in-kind, shall be considered in the determination of eligibility, unless such income is specifically exempt. An individual’s resources may not exceed $2,000. New Jersey delegates review of Medicaid applications to each of the 21 county boards of social services. N.J.S.A. 30:4D-3i(8)(f)(i)-(iii).
To discuss applying for Medicaid in NJ, 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