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An Overview of Medical and Financial Eligibility for Medicaid – A Single Person


The phrase long-term care Medicaid includes Medicaid benefits in a variety of living environments. These would include, for example, assisted living communities, nursing homes and continuing care retirement communities (except the independent living part of the continuing care retirement community).  Long-term care Medicaid is the benefit that pays for care in those communities and is a benefit that can ultimately be worth hundreds of thousands of dollars over the lifetime an individual who qualifies for it.

In order to qualify for long-term care Medicaid in the State of New Jersey an individual has to first be medically eligible. In order to be medically eligible you must require assistance with your activities of daily living or have a cognitive issue like Alzheimer’s disease or dementia. Activities of daily living include bathing, dressing, toileting, continence, feeding yourself and medication management.   Medicaid will examine an individual applying for Medicaid benefits to determine whether they are medically eligible. If they are medically eligible then they still must meet the financial eligibility requirements.

To qualify for Medicaid financially an individual cannot have more than $2,000 in assets. There are some exceptions that allow you to retain more than $2,000 and those exceptions include an irrevocable prepaid funeral, life insurance up to a certain amount and a few other possible exceptions but as a rule of thumb people can have $2,000 in assets along with the prepaid funeral and a certain amount of life insurance.

If you meet the medical and financial eligibility requirements for benefits at the time you apply you will likely be found eligible for benefits.  However, there are many traps and pitfalls when applying for Medicaid so you should educate yourself is much as possible about the rules, requirements and processes if your loved one needs long term care Medicaid.  It is alway helpful to work with an elder law attorney familiar with the Medicaid application process.

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