MLTSS Tag

Previously we reported on concerns about whether the $1200 per person payments or the $600 unemployment enhancements that would be arriving via the CARES ACT would be counted as income or a resource which would affect the means-tested benefits being received under New Jersey’s Medicaid (NJ FamilyCare) programs. We’re happy to report that the Director of DMAHS has released a...

How often have I heard clients tell me they were told to cash out a life insurance policy as part of a “Medicaid spend-down,” because it was “an asset.” The fact is, whether a given policy needs to be liquidated depends on who owns the policy, what its cash surrender value is, and who is applying for Medicaid benefits. There’s no “one rule for all...

Several months ago I reported on  problems that were cropping up for people with irrevocable funeral trusts who apply for NJ Medicaid/MLTSS to pay for their nursing care, home care or assisted living. The issue is that once the funds are paid and the contract is signed, the contract is irrevocable and the funds cannot be returned to the purchaser at that time. Based on this irrevocability, the...

The NJ Division of Medical Assistance and Health Services (DMAHS) has just released Medicaid Communication #20-01 which provides the new numbers that are relevant to applications for Medicaid Long Term Services and Supports (MLTSS) benefits.   20-01_Medicaid_Only_Standards         MLTSS pays for nursing home care (skilled nursing facilities), Assisted Living Facilities and part-time home care...

One of the threshold eligibility requirements for Medicaid has to do with legal status. N.J.S.A. 30:4D-3(q)(1)(a).  If a person is an alien (non-citizen) with the status of a Legal Permanent Resident (LPR) (“green card holder”) who was present in the United States prior to August 22, 1996, s/he is eligible to apply for Medicaid (and receive “full Medicaid benefits” if...

Here is a recent case that is interesting because of its detailed description of the prolonged delay in the processing of an application for MLTSS Medicaid benefits, which was followed by the agency’s failure to really look at the information submitted and an abrupt denial of benefits that could have caused horrendous consequences. The Appellate Division reversed, in a decision that is...

The Medicaid program that pays for long-term services and supports (MLTSS) for nursing home care, assisted living and home care services is available for applicants whose income is less than the cost of care, as long as their resources (assets) don’t exceed the prescribed limits. We still hear from clients that they’ve been told that “you can never apply for Medicaid because...

When a married person applies for MLTSS Medicaid benefits, the applicant must provide 5 years of records pertaining to all financial activity of the applicant and their spouse. The applicant also must supply proof of the spouse’s current income and assets. Sometimes, the spouse just refuses to cooperate with the process, creating a dilemna for the Medicaid applicant. In some...

NAELA has been at the forefront of keeping the Spousal Impoverishment Protections in the Medicaid Home Care Program (HCBS) that were included in the Affordable Care Act.  So far, with great effort, it’s working. It’s important for disabled people who are under 65 and who meet the nursing facility level of care to recognize that these protections are out there. The “level of...

If you or any of your colleagues, friends, or family members are in support of improving the system for Medicaid eligibility determinations, you should call the Governor’s Office  of new jersey’s Governor Murphy at 609.292.6000 and request that the Governor sign A4569/S499 into law. pass on this information to people you know who are interested in this issue. According to BillTrack50, in...