New Jersey has expanded its Medicaid program to provide broader access to healthcare and long-term care services. These changes can affect eligibility, available benefits, and planning strategies for seniors and individuals with disabilities. Understanding the scope of the expansion is important for families considering Medicaid planning.
What does this mean? New Jersey has provided Medicaid services to individuals residing at home or in assisted living residences for about 15 years; however, only individuals with income no greater than a certain level, called the “income cap,” could qualify for Medicaid at home or in an assisted living residence. Currently, the monthly income cap is $2,094, meaning that if your gross income exceeds that amount by one penny you will not qualify for Medicaid at home or in an assisted living residence.
The Waiver permits the State to offer Medicaid services to individuals whose income exceeds the cap.
The Waiver also limits how the State will look at an applicant’s finances if the applicant’s income is below the income cap. If an individual’s income is below the amount of the income cap, the Medicaid Office will only ask the individual to sign a statement saying whether or not he has transferred assets in the last five years. If the applicant swears that he has not transferred assets in the last five years, then the Medicaid Office will not examine the applicant’s finances.
Of course lying that you have not transferred assets when you have may come back to haunt you, because the Medicaid Office does cross-checks with the Internal Revenue Service, so Medicaid may be calling you within a year or two when they discover that you had a number of assets within the five year period of time prior to applying for benefits and suddenly did not have those assets when you applied for benefits.
Medicaid expansions can create new opportunities but may also introduce new rules. Staying informed helps families take advantage of available benefits while avoiding unintended consequences.
Changes to Medicaid rules and programs can make a real difference for families trying to pay for long‑term care or support at home. Staying informed about expansions and eligibility options helps you make better choices about your planning — whether you’re applying now or preparing for the future.