MEDICAID QUALIFICATION
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Help With Medicaid Qualification

Skillful Assistance in Qualifying for Medicaid

Enrolling in Medicaid is a complicated, challenging process, but you can rely on Daniel Jurkovic, Certified Elder Law Attorney for experienced assistance at every stage. We have over 20 years of experience and we're up to date on all the latest changes. For compassionate, friendly assistance with Medicaid qualification, contact our office online or call us at 201-460-9888.

Defining Medicaid

Medicaid is a joint federal-state program that provides health insurance coverage to low-income children, seniors, and people with disabilities. The federal law is set forth at 42 U.S.C. 1396, et seq. While Congress and the federal Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA), prescribe the main rules under which Medicaid operates, each state runs its own program. As a result, the rules are somewhat different in every state, although the framework is the same throughout the country.

Medicaid covers care in most nursing homes and some assisted living facilities for qualified individuals, in addition to providing health insurance coverage for low-income children, seniors, and people with disabilities. Indeed, Medicaid has become the default nursing home insurance of the middle class where there is no other public program covering long-term care.
elder care

Determining Eligibility for Medicaid

Eligibility for long-term care Medicaid must be established in relation to each legal requirement in order to provide a valid basis for granting or denying medical assistance under New Jersey Medicaid. A single individual must be medically in need of skilled nursing care and have no more than $2,000 of total assets in their name. In determining the resource eligibility of a married applicant requiring long-term care, Medicaid will first establish the combined countable resources of the couple as of the first period of continuous institutionalization. This determination, called the “resource assessment.” The total countable resources includes all resources owned by either member of the couple individually or together. The community spouse’s share of these resources is one-half, subject to a ceiling of $120,900 (for 2017) and a floor of $24,180 (2017).
elder care

The Future of Medicaid

The Office of the Actuary for the Center for Medicare and Medicaid Services (CMS) reports that the expansion of Medicaid eligibility under the Affordable Care Act will broaden Medicaid’s role as part of the U.S. health care system. Several provisions of the ACA are designed to enhance home and community long-term care for seniors, which include the following:
  • Community First Choice Option (CFCO) provides community-based attendant services and supports to individuals who would otherwise be confined to a nursing home or other institution.
  • Medicaid’s spousal impoverishment protection provisions are extended to spouses of individuals who seek long-term care in the community.
If this seems confusing or overwhelming, we can help you understand it and how the rules affect you. Call 201-460-9888 to make an appointment with our experienced Elder Law attorney.
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