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Applying for Medicaid is a grueling task - maybe even a full time job

Article submitted by staff at Senior Planning Services of Howell, New Jersey. Senior Planning Services can be reached toll free at 855-775-2664. Senior Planning Services is licensed to provide services in New Jersey, New York, Connecticut and Pennsylvania.

Howell, New Jersey: For the uninitiated, getting onto Medicaid is a grueling task - maybe even a full time job. Medicaid requests significant amounts of paperwork providing proof of age, citizenship and marital status. In addition, Medicaid will ask for the last 5 years of bank statements and/or financial statements on every account held within a financial institution. That alone is enough work to put someone into frenzy, making it extremely difficult to care for a loved one who is transitioning into a skilled nursing facility.

Medicaid wants to see a full financial accounting of an individual’s finances and assets to determine eligibility. They will look to ascertain that no monies were gifted to family and friends during the five years prior to an individual getting onto Medicaid. Though the application may get approved, a period of ineligibility corresponding to the funds that were gifted will be imposed.

Senior Planning Services has gained a reputable name in the Medicaid industry for going the extra mile when necessary. You can count on Senior Planning to take care of everything, whether it is going into an elderly individual’s home and rummaging through old boxes or reaching out to Vital Statistics or Public Records to obtain documentation. Senior Planning will do everything in its power to make the application process a smooth ride. Our goal is to minimize stress and maximize peace of mind for the caregiver.

Here is a list of most common questions we get from individuals applying to Medicaid.

  1. Can the spouse in the community keep the home (Primary Residence) if the second spouse is going onto institutional Medicaid?
    Yes, although if both spouses’ names are on the deed, a deed change will need to be done. The name of the spouse going onto Medicaid will need to be taken off the deed.
  2. Can an individual getting onto institutional Medicaid (nursing Home Medicaid) keep their income and still be eligible?
    An individual that is on Medicaid in a nursing home must give all his income to the facility. However, he/she may keep a Personal Needs Allowance (PNA) of $35 per month.
  3. What assets are “Countable” according to Medicaid?
    Some assets that are countable include: checking accounts, savings accounts, CDs, stocks, bonds, mutual funds, revocable trusts, cash value, in a life Insurance policy and IRAs.
  4. What are some excludable resources according to Medicaid?
    Personal Possessions, Irrevocable Prepaid funeral and burial plot trust. Life insurance policy with current cash value less than $1,500.00. Life insurance policy that is strictly a death benefit with no current cash value. One vehicle/car. Community Spouse living in the home may keep the house., German Reparation Payments, Special needs trust set aside for a disabled child, Irrevocable trust funds setup prior to the look back period
    A house that is a primary residence of a community spouse, is exempt from the Medicaid spend-down. However, the Medicaid applicants name must be removed from the deed as part of the Medicaid application process.
  5. What is the resource limit I can keep and still qualify for NJ Medicaid?
    Medicaid allows a participant living in a nursing facility to keep between $2,000 and $4,000 in total liquid assets. If the individual’s income is below $2163 they are allowed to keep $2000 if its above $2163 they can keep $4000.
  6. Is there a citizenship requirement for Medicaid?
    Participants must be United States Citizens or “Qualified Aliens”.
  7. Can the community spouse keep the income of the spouse that is going onto Medicaid?
    There is a monthly maintenance needs allowance MMNA of $1,966.25 per month. In certain scenarios, a spouse may be able to keep more of the institutional spouse’s income if they have high shelter related costs. Medicaid will determine if the spouse needs the added income and how much. The spouse must provide documentation of rent bills, utility bills, outstanding medical bills, etc. for Medicaid to make this determination
  8. Can I put a way some money for my disabled child when I apply for Medicaid?
    Putting assets in a special needs trust for a disabled child is an excludable resource according to NJ Medicaid guidelines
  9. Why prepay mom’s funeral?
    Prepaying a funeral within the five year “Lookback” is an allowable spend-down according to NJ Medicaid guidelines. However, the Prepaid Funeral must be put in an Irrevocable Trust Fund in order not to impede Medicaid eligibility.
  10. Can one keep their life insurance policies when applying for Medicaid?
    a. Term Life policies do not carry a cash value and are exempt form the Medicaid spend-down
    b. Whole life policies that carry a cash value must be liquidated. However, there is one exception to this rule, if the Whole Life Insurance policy has a “Face Value” less than $1500, the cash value on the policy is exempt from the Medicaid spend-down
  11. Is there an income cap on adult Medicaid?
    For Institutionalized Medicaid there is no cap on income,
    For Global Options Medicaid (also referred to as Assisted Living Medicaid) there is an income cap of $2,163 (in 2014). Income that exceeds $2163.00 will deem the individual ineligible for the Global Options Program.
  12. How far back does Medicaid look at an applicants assets?
    Global Options and Institutionalized Medicaid requires an applicant to provide the last 60 months of their financial history. This includes five years of bank statements. Mutual funds, stocks, bonds and the like.
  13. Can a child keep a parents home if the parent is getting onto Medicaid?
    If an adult child lived with a parent for at least two years, and provided fulltime care that prevented the individual from being admitted to a skilled nursing facility. The adult child may keep the parents home without worrying about a Medicaid lien for reimbursement.
  14. What happens if Money has been gifted within the five year look back period?
    Medicaid will impose a penalty. A penalty is a period of time of ineligibility for Medicaid coverage.

For more information on Medicaid eligibility feel free to contact Senior Planning Services for a free no obligation consultation.

© 2014, All Rights Reserved by Senior Planning Services, Howell, New Jersey.

Posted September 2014 on