New Jersey
What Is New Jersey Medicaid Long-Term Care?
Medicaid is a healthcare program for individuals with limited financial means. While assistance is provided for people of all ages, this section focuses on long-term care Medicaid eligibility for New Jersey residents aged 65 and older. Medicaid in New Jersey covers nursing home care, adult foster care homes, comprehensive personal care homes, assisted living facilities, and provides non-medical services to help seniors live at home.
What Are the Types of Medicaid Long-Term Care Programs in New Jersey?
There are three categories of Medicaid long-term care programs in New Jersey:
1. Institutional / Nursing Home Medicaid
This is an entitlement program, meaning anyone who meets the eligibility requirements will receive assistance. Benefits are provided only in nursing homes.
2. Home and Community Based Services (HCBS)
New Jersey no longer offers HCBS Medicaid Waivers. Previously, the state offered limited slots for participants, and waiting lists existed. Currently, long-term care services are provided through a managed care system, with no waiting list or enrollment caps. These services are offered in home settings, adult day care, adult family care homes, comprehensive personal care homes, and assisted living residences.
3. Regular Medicaid / Aged Blind and Disabled
This is also an entitlement program. Those who meet eligibility requirements will receive services. Benefits may include personal care assistance or adult day care.
How Do I Qualify for New Jersey Medicaid Long-Term Care?
Eligibility for Medicaid long-term care varies depending on income, assets, and the level of care required. The criteria change annually and can differ based on marital status.
What Are the Income and Asset Limits for 2025?
The following table outlines eligibility based on income and assets for New Jersey’s long-term care Medicaid programs for 2025.
| Type of Medicaid | Single | Married (both applying) | Married (one applying) |
|---|---|---|---|
| Institutional / Nursing Home Medicaid | $2,901/month | $5,802/month | $2,901/month for applicant, $2,000 for applicant & $157,920 for non-applicant |
| Home and Community Based Services | $2,901/month | $5,802/month | $2,901/month for applicant, $2,000 for applicant & $157,920 for non-applicant |
| Regular Medicaid / Aged Blind and Disabled | $1,305/month | $1,763/month | $1,763/month |
What Are the Income Definitions and Exceptions?
Countable vs. Non-Countable Income
Most income sources, such as wages, pension payments, Social Security benefits, and IRA withdrawals, are counted towards Medicaid’s income limits. Some income sources, like VA Aid & Attendance Allowance and Holocaust restitution payments, are excluded.
How Is Income Treated for Married Couples?
If only one spouse applies for Nursing Home Medicaid or HCBS, only the applicant’s income is counted. The non-applicant spouse may receive a Minimum Monthly Maintenance Needs Allowance (MMMNA) to avoid poverty. In 2025, the MMMNA in New Jersey is $2,643.75 per month, with potential additional allowances for housing and utility costs.
What Are the Asset Requirements and Exemptions?
Countable vs. Non-Countable Assets
Countable assets include savings, stocks, bonds, and real estate not used as the primary residence. Exempt assets include personal belongings, household items, and a car.
How Are Assets Treated for Married Couples?
All assets of a married couple are considered jointly owned. The non-applicant spouse may keep half of the couple’s assets, up to $157,920. If the non-applicant’s share is below $31,584, they may keep up to $31,584.
What Is the Medicaid Look-Back Rule?
New Jersey applies a 5-year Medicaid Look-Back Period, during which Medicaid examines any assets gifted or sold below market value to ensure the applicant didn’t intentionally reduce their assets to meet eligibility. Violations can lead to periods of Medicaid ineligibility.
What Are the Home Exemption Rules for Medicaid in New Jersey?
For home exemption, the Medicaid applicant or their spouse must live in the home. If there’s no spouse, the home equity interest limit for 2025 is $1,097,000. The home can be exempt for up to six months if the applicant or spouse intends to return.
What Are the Medical and Functional Requirements for Medicaid?
Applicants for Medicaid long-term care must demonstrate a need for nursing home care or community-based services. Additional criteria may be required, such as the need for home modifications to remain in the home safely.
How Can I Qualify for Medicaid if I Exceed the Financial Limits?
What Is the Medically Needy Pathway?
New Jersey’s Medically Needy Program allows individuals with income over the Medicaid limit to become eligible by “spending down” their income on medical bills. The income limit for 2025 is $367/month for individuals and $434/month for couples.
What Are Qualified Income Trusts (QIT)?
QITs, or Miller Trusts, allow individuals who exceed the Medicaid income limit to become eligible by depositing excess income into an irreversible trust. This trust can only be used for specific purposes, such as paying for medical expenses, and the state of New Jersey must be the beneficiary upon the recipient’s death.
How Can I Spend Down My Assets?
Individuals with assets above the Medicaid limit can reduce their countable assets by spending on exempt assets, such as home modifications, funeral expenses, or paying off debt. Proper documentation is required to ensure compliance with Medicaid’s Look-Back Rule.
What Are the Specific Medicaid Programs Available in New Jersey?
New Jersey offers several programs to help seniors with long-term care needs, including:
1. Managed Long Term Services & Supports (MLTSS) Program
Provides nursing home care and a variety of services in the community, including personal care, home modifications, and respite care.
2. Personal Preference Program (PPP)
Offers participants a budget to manage their own long-term care needs, including the ability to hire family members as caregivers.
3. Program of All-Inclusive Care for the Elderly (PACE)
Combines Medicaid and Medicare benefits, including additional services like dental and eye care.
4. Money Follows the Person (I Choose Home)
Helps individuals transition from institutionalized care back to their homes or the community.
How Do I Apply for Medicaid in New Jersey?
Seniors can apply for Medicaid online at NJFamilyCare, by completing a printed application, or by calling 1-800-701-0710. For assistance, applicants can contact their county welfare agency or local Area Agency on Aging.
