Although New Jersey Medicaid covers long term care in non-nursing home settings under what is now known as the Global Options program, it is very difficult to qualify and even if you can meet the requirements, more times than not these programs don’t cover everything you need.
New Jersey’s assisted living Medicaid program presents its’ own set of challenges and difficulties in qualifying, but New Jersey’s home based Medicaid program is unique and even more difficult to navigate and qualify for. For many years, at best, home based Medicaid would cover 40 or 50 hours of in home care. It now appears, however, that the State won’t even cover that much. In fact, a number of home care agencies have indicated that the New Jersey Medicaid Program is paying for not more than 12 to 15 hours per week of care. Think about that. In order to qualify for Medicaid, you have to spend down to less than $2000 in assets, have no more than $2163 per month in gross income – that’s before taxes – and you must medically need nursing home level care.
So, you have to spend all your money and satisfy the State of New Jersey that you need 24/7 care. If you do that, they’ll pay for 12 hours a week. Does that make any sense? How are you supposed to pay for the rest of your care? The State doesn’t have an answer for that. Move into a nursing home, I guess. Then they’ll pay for your care.
This is a prime illustration of why you should not naively think that if you spend all your money, the State will take care of you. That is not necessarily true, especially if you want to remain in your house. If you want to stay at home as long as possible you’ve got to put a plan in place and learn how to navigate the long term care system or work with someone, such as a knowledgeable elder care attorney, who can guide you through this maze of laws and benefits so you can stretch you dollars out. If you simply spend your money and then look for help it just might not be there.