Nursing home care is very expensive in New Jersey and people often turn to Medicaid Long-Term Services and Supports (MLTSS) to pay for that care. The rules for the program are complicated, but with our proper guidance, eligibility can be obtained. I’ve written earlier posts about aspects of the application process. The application requires a 5 year lookback — 5 years of financial records — statements, cancelled checks, etc. — and gifts that were made to someone other than a spouse will generally cause a denial of benefits called a “transfer penalty.” (There are some exceptions.)
The total of gifts is divided by a formula number called the daily divisor. Last year, that number was $440.10. For every $13,423 of gifts made, MLTSS wouldn’t pay for care for a month. This divisor is going DOWN on April 1st even though costs are going up! The State just published its Notice that for applications filed on or after April 1st 2025 the divisor will be just $402.74 which means that for every $12,284 of gifts, MLTSS won’t pay for care for a month. The decrease in the formula might affect a spend-down/gift Plan you are working on.
25-04_Decrease_in_the_Penalty_Divisor-Effective_April-1-2025
Here’s a quick reference about the current rules for MLTSS. MEDICAID FUNDAMENTALS 2025
We have been assisting people with Medicaid eligibility for thirty years. If you need to apply for MLTSS to pay for nursing care, meet with us to discuss options that could protect your family’s assets ……………………… 732-382-6070