Important NJ Medicaid Update – Expanded Eligibility for New Jersey Home & Community Based Medicaid Benefits

One of the major downfalls of Medicaid coverage for long-term care is that the majority of funds are used for care in a nursing home setting. Thankfully, New Jersey has recently taken steps to attempt to rebalance Medicaid coverage for long-term care. The State of New Jersey has announced that it intends to expand the income eligibility requirements for seniors and those with disabilities living in a community setting.

To date, if a senior not living in a nursing home had monthly fixed income in excess of $2,163 per month, that senior was not eligible for home and community based Medicaid benefits. Thus, seniors and those with disabilities who had monthly income above $2,163 could not have New Jersey Medicaid pay for home care, adult medical day care, or assisted living care. There is no income cap applied to nursing home Medicaid coverage. This perceived inequity has forced many New Jersey seniors and those with disabilities into a nursing home setting because they could not afford to live at home or in an assisted living setting.

The State of New Jersey has publically announced that those previously over the $2,163 per month income cap will be permitted to deposit income above the cap into a trust known as a “Miller Trust.” It is currently expected that Miller Trusts are to be effective beginning December 1, 2014. This is great news for New Jersey’s seniors and those with disabilities who wish to remain in a community setting, outside a nursing home.

Those seniors who were previously ineligible for Medicaid home or assisted living care can now become eligible by use of a Miller Trust. The State of New Jersey has a Miller Trust website which includes a trust template to be used. The website address is http://www.state.nj.us/humanservices/dmahs/clients/mtrusts.html.

There are still several unanswered questions regarding the use of Miller Trusts. These questions include who will serve as trustee of the trust for an applicant who has no family? Is a guardian needed to establish the trust if the applicant is incapacitated and has no preexisting power of attorney, and in a spousal Medicaid case, what is the procedure for a healthy spouse to access income from the trust?

It is recommended for those applicants previously over the Medicaid income cap, especially living in an assisted living setting, that they consider the use of a Miller Trust as soon as possible in order to become Medicaid eligible. Please feel free to contact our office should you have any questions as to whether a Miller Trust is the right planning tool for you or a loved one.

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