Medicaid basics

Adult Medicaid has a wide variety of programs that you may be eligible for. At MedicaidXPress we mainly focus on the LTC (Long Term Care) Medicaid, meaning Medicaid for Assisted Living, Nursing Home, or Community-based Home Care.

According to the internet the average cost for LTC in the state of New Jersey is approximately $65,000/year. This isn’t even close to prices I see my client’s paying at local facilities. If you know that you may need Medicaid for LTC, or your loved one may need Medicaid for LTC in the next 5 years it would be beneficial to contact a professional. Medicaid has a lot of rules about how monies are spent in the 5 years prior to needing Medicaid for LTC, also known as the look back period.

Crisis Planning


In most cases needing LTC Medicaid is an emergency, this is where I excel. Something may have happened unexpectedly and now your loved one can not come home and needs a higher level of nursing care, whether that means a nurse coming to the home to help with ADL’s, Assisted Living, or Nursing Home. In these instances, time is of the essence. There are medical and financial deadlines that are important to meet in order to qualify for LTC Medicaid. If you are unaware of these deadlines or even if you are aware but cannot meet the requirements on your own there is no eligibility for Medicaid. This is a fine balance of dates and numbers that can cause a lot of stress on families financially, mentally, and emotionally.

Income Eligibility


Medicaid for LTC has a basic threshold for monthly income of $2313/month. However, if you are over this income level the state of New Jersey created a program for you to still be eligible called Qualified Income Trust.

Resource Eligibility


This can be complicated to say the least, but for a single person the resource requirement is $2000 in order to be eligible for LTC Medicaid. For a couple who both need Medicaid the resource limit is $3000 to apply. For a couple with a community spouse a resource assessment must be completed and the amount could vary depending on how much in assets the couple has and the time in which institutionalization has occurred.


Medical Eligibility


This is a requirement before LTC Medicaid can be granted. The timeliness of this requirement can be crucial to your eligibility for LTC Medicaid. Contact your local office on ageing to start the process of completing the medical eligibility requirement. What you are trying to obtain is called a PAS or Pre-Admission Screening. An approval must be granted in order to qualify for LTC Medicaid benefits, the PAS is currently good for 12 months. LEARN MORE HERE


What MedicaidXPress Can Do For You


We can take the worry away, hold your hand, and take over the application process for you. An initial consult is required to determine when Medicaid will be needed, then we will work from there. No guesswork, confusion, or hours on the phone trying to get help for your local Medicaid office. With my background in Medicaid I can confidently handle any crisis situation and help relief the stress of applying for Medicaid.