The NJ Division of Medical Assistance and Health Services (DMAHS) has released Medicaid Communication #22-01 which provides the new numbers that are relevant to applications for Medicaid Long Term Services and Supports (MLTSS) benefits. 22-01_Income_and_Resource_Standards_for_Medicaid_Only (1) MLTSS pays for nursing home care (skilled nursing facilities), Assisted Living Facilities and part-time home care for eligible individuals. Eligibility is based on income, resources, and clinical condition, and if eligibility is established, a determination is made about whether to delay the start of benefits due to transfers/gifts that were made during the 5-year look-back.
For a married couple, available non-excluded resources owned by the applicant cannot exceed $2,000. In 2022, at the time of application, the available non-excluded resources owned by the community spouse cannot exceed $137,400 or half the amount that the couple owned when the applicant became institutionalized, whichever is less. This is called the CSRA or Community Spouse Resource Allowance, or the “spousal share.” The CSRA need not be less than $27,480.
After approval, the applicant can retain some of his/her monthly income as a Personal Needs Allowance (“PNA”). The new 2022 amounts for the PNA are as follows: Skilled Nursing Facility – $50; Assisted Living – $124.70; Home Care $2,523.
Applicants whose gross monthly income exceeds a certain limit (sometimes called the “income cap), are required to establish a Qualified Income Trust (QIT) for their excess income. There are no formal regulations and the program requirements are very tricky. The income threshold that requires a “QIT ” in 2022 is $2,523.
In 2022, applicants in Assisted Living Facilities must have monthly income of at least $866.35, which is the room and board fee.
The Minimum Monthly Maintenance Allowance (MMMNA) for low-income spouses of applicants in 2022 is $2,177.50 up to $3,435.
As readers of this blog are aware, the MLTSS program contains numerous legal traps for seniors and individuals with disabilities, but careful planning can preserve the assets and protect the applicant and their family while achieving eligibility and avoiding the tremendous risk of unpaid nursing home bills
Call for individualized legal advice and assistance with Medicaid applications and asset protection planning …………. 732-382-6070