Applying for Medicaid

Medicaid is a State and Federal medical assistance program that pays medical bills for eligible, needy persons.

 

Programs for the elderly and disabled include:

• Community Medicaid for persons living in their own homes

• Nursing Home/Institutional Medicaid

• Assisted Living – under specific circumstances

 

Call the Somerset County Board of Social Services for an application 908-526-8800.

When applying for Medicaid, you must be very specific about which program you need. For Assisted Living or Nursing Home care, ask for the Nursing Home Unit or Adult Medicaid Unit or apply online at: njfc.force.com/abd/abdstart

 

Medicaid for Long Term Care (MLTSS)

Managed Long Term Services & Supports - A person must have high level of care needs which would qualify them for long term care in a skilled nursing facility. MLTSS provides home-based services to allow a person to remain at home or in an assisted living facility/nursing home.

 

The income limit for MLTSS services through Medicaid is $2,829/month for a single person. Liquid resources (defined as cash, stocks, bonds, etc.) for a single person may not exceed $2,000. There is a 5-year look back. If you are over the income limit, there are still ways to obtain homecare through MLTSS. To apply or learn more, contact the Aging & Disability Resource Connection, Somerset County 1-888-747-1122 or 908-704-6346 to request screening.

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Community Medicaid

Medicaid programs may be available to people living at home. Married couples must call the Board of Social Services (732-846-6499) to determine eligibility.

 

Individuals over 64 are required to apply for ABD (Aged, Blind & Disabled) Medicaid. Financial eligibility limits for ABD Medicaid are based on 100% of the federal poverty level; 2024 is $1,255 if single, and $1,704 for a couple. The resource limit is $2,000 if single, and $3,000 for a couple. The Board of Social Services recommends that contact be made 3 months prior to the time that the applicant’s liquid resources will be at the eligibility threshold.

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When You Apply for Medicaid

Medicaid “looks back” five years into your financial history to review all your assets. Persons who transfer countable resources at less than fair market value within 5 years prior to application for MLTSS Medicaid are presumed to have disposed of these resources to establish Medicaid eligibility. In those cases, depending on the amount and timing of transfer, there will be a waiting period before becoming eligible for Medicaid.

 

Your income and resources must be verified by the following means:

• General: Proof of age, marriage/divorce, death certificate of spouse, copy of will, Medicare card, social security card, health insurance card.

• Income verification: Copy of social security award letter, IRA, pension, etc.

• Resource verification: Deposits and withdrawals from financial accounts. Savings/checking accounts (past 5 years quarterly), investment accounts, life insurance policies, stocks, bonds, CDs, IRAs, annuity accounts, deed to burial plot, copy of irrevocable funeral contract.

• Needed when appropriate: Proof of citizenship, Power of Attorney, alien registration card. “Irrevocable” prepaid funeral arrangements are exempt from countable assets. Face value of life insurance cannot exceed $1500.