By Lauren Wanko
Correspondent
New Jersey residents in need of long-term care, including the elderly and people with long term disabilities who were once considered ineligible for Medicaid, could become new enrollees.
“Our goal is to ensure that people have the ability to age in place and have the ability to live in the community,” said Deputy Commissioner Lowell Arye.
The Medicaid income eligibility income cap is $2,163 a month. In the past, if residents’ income exceeded that cap, they couldn’t qualify for Medicaid coverage for in-home care or assisted living facilities in the communit, just nursing homes. But now a trust, called the qualified income trust, would change that.
“This qualified income trusts actually allow someone to put their money, put their income into this trust, and actually for income eligibility purposes for Medicaid and therefore become eligible for Medicaid and get those long-term services,” Arye said.
Once the money is placed in the trust, a person’s income is disregarded for Medicaid eligibility purposes by the county welfare agency. The trust can only be used for medical expenses, like over the counter drugs not covered by Medicaid, personal needs allowance, spousal and family needs allowances and there’s a shelter and utility allowance. Enrollees pay the income cap toward their care and Medicaid subsidizes the balance.
“The rule when someone dies, whatever is in that trust gets paid back to state of New Jersey up to the amount they paid on your account during your lifetime,” said Elder Law Attorney Steven Freidman.
Freidman says it’s already a challenge to navigate through the Medicaid application process.
“Like anything else there’s good and bad. The bad is right now folks who are over the income cap who are in nursing homes are eligible under a program called medically needy, that program is going away or has gone away as of yesterday. For those folks they’ll need to create qualified income trust in the future where right now, they wouldn’t have had to do that,” he said.
Friedman says this doesn’t apply to residents already on Medicaid, just new enrollees. Deputy Commissioner Arye says people can use an attorney, but they don’t have to. The Department of Human Services posted a trust form on their website.
“People can hire an attorney and can pay for the attorney, but they can’t pay for it out of the money that’s in the trust,” Friedman said.
Ayre says new enrollees may be eligible for legal services. Trusts can be set up at any bank and are irrevocable. While Arye is unsure of the amount of new enrollees, AARP expects thousands to become Medicaid eligible under the new program.
“We know not only is it common sense but surveys tell us that everyone wants to stay at home or in their communities as long as possible,” said AARP NJ Assoc. State Director Evelyn Liebman.
AARP calls the expansion a win-win, not only for New Jersey residents but for the state. Staffers say that’s because in-home care is significantly less than nursing home costs.
“On average it costs about $100,000 in Medicaid dollars for some to be in a nursing home. We believe costs of home and community based services can be a fraction of that,” said Liebman.
The Department of Human Services says there’s no specific timeline for the process. A person has to be determined clinically eligible and has to provide the necessary paperwork for Medicaid enrollment.