On December 19th, 2014, the NJ Division of Medical Assistance and Health Services (DMAHS) issued Medicaid Communication No. 14-15 to the County Welfare (CWA) Directors, explaining the necessity for certain higher-income Medicaid applicants to divert their excess income into a Qualified Income Trust (QIT) before they can apply for MLTSS Medicaid services to pay for nursing home, assisted living or community care. I’ve blogged about this previously – check my October and November posts. According to the Med-Com at page 1, the purpose of the QIT is “to disregard an individual’s income above 300% of the Federal Benefit Rate (FBR). In order for [it] to be disregarded, it must be deposited into the QIT bank account.” Here is the pdf:
In 2015, if the monthly income is in excess of $2,199.00, it has to be diverted through a QIT.
Keep in mind that the Trust has to be set up before the date you want eligibility for. So you may need a few months to finish up the Medicaid “spend-down” and to set up this Trust at the bank. Many banks are still not familiar with this structure. Once the application is filed, and the CWA caseworker determines that there is eligibility, s/he will prepare a Medicaid Patient Responsibility (PR) form to be used by the Trustee as the guide for the monthly allocation of the income for the Medicaid recipient’s required expenses.The income has to be spent in this order each month: (1) Personal Needs Allowance or home maintenance allowance, (2) Spousal and family member maintenance allowance (calculated by the CWA based on the regulations), (3) unreimbursed state-approved medical expenses, (4) health insurance premiums, and (5) the mandatory cost share to the facility.
At ever step of the way there can be legal disputes that arise based on how the regulations apply to your particular case. Call us for advice and representation with Medicaid applications, MLTSS and QIT’s … 732-382-6070.