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MEDICAID-101

NJ Medicaid Eligibility 101:

Medicaid is a State issued medical assistance program to help pay for healthcare related costs for individuals living at home, in assisted living/senior communities, and in nursing homes. There are specific criteria one has to meet to be eligible for Medicaid. The Department of Health and Senior Services determines that an applicant is medically eligible to enroll in the program, and the County Board of Social Services determines an applicant’s financialeligibility. Depending on where a resident is residing, in the community, or in a facility factors into what guidelines need to be followed in order to obtain Medicaid eligibility. To ensure someone is medically eligible there are certain forms which must be completed by a physician as well as the family of the applicant, and in some instances a nurse representative from the Department of Health will come out to do a clinical assessment of the applicant. To be financially eligible one has to be under a certain resource limit which varies depending on where the applicant is living. Also taken into consideration is if an applicant has a spouse, and if the spouse is living in the community or in a nursing facility. This can affect whether or not the applicant may keep some assets including a primary residence, and their monthly income, and can impact other asset regulations on a case by case basis.

For more information or for specific questions please contact a Senior Planning Services representative by calling 855.S.Planning (775-2664).






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