Understanding the Differences in the Many New Jersey Medicaid Programs

HNW Elder Law, Medicaid Eligibility and Asset Protection Planning

By Fredrick Niemann, Esq. As an elder law attorney, I regularly work in the State Medicaid programs that provide long term care benefits.  I categorize these programs primarily as institutional Medicaid and community waiver Medicaid under the MLTSS Program (Managed Long Term Support Services). Institutional Medicaid covers long term care in a nursing home.  New Jersey is a no “maximum income limit state with a medically needy program”.  What this means is that we have two (2) institutional Medicaid programs within the main institutional Medicaid program.  Confusing isn’t it? The first program is the “Medicaid Only” program which is for residents who have income below the maximum income limit (currently $2,205.00 gross income per month in 2017-2018).  For those with …

How Can An Annuity Protect Your Assets From New Jersey Medicaid Laws?

HNW Elder Law, Medicaid Eligibility and Asset Protection Planning

By Fredrick P. Niemann, Esq. a New Jersey Medicaid Attorney Annuities are really confusing.  But in today’s medical world, you may hear that annuities can be “Medicaid friendly.” What exactly is a “Medicaid friendly annuity”?  Simply stated, they are funds converted into an annuity that Medicaid treats as an exempt resource and only as income which allows for (sometimes) immediate Medicaid approval for nursing home, assisted living and home based care.  Under New Jersey law, a traditional commercial annuity does nothing to protect assets from the cost of long term care.  In fact, without careful planning, simply investing in an annuity will result in the unnecessary loss of assets and a denial of Medicaid benefits. Understanding why this is requires …

Federal Medicaid Law Prevents a Nursing Home from Billing You Directly

HNW Elder Care Law, Elder Law, Medicaid Eligibility and Asset Protection Planning

By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold, Monmouth County, NJ Elder Law & Medicaid Attorney I read an interesting case, which frankly brought up an issue I had not contemplated which is; must a medical service provider (i.e., a doctor, hospital x-Ray technician) bill a Medicare/Medicaid patient directly for services etc. rendered rather than Medicare or Medicaid directly?  I pretty much assumed that if you are eligible for Medicare or Medicaid and receiving services, there would be no reason for a nursing home or other medical provider to bill anyone but Medicare/Medicaid, otherwise, the provider would go unpaid.  Apparently, in this case, the patient was a plaintiff in a fairly substantial personal injury lawsuit and …

Program of All-inclusive Care for the Elderly (PACE)

HNW Elder Care Law, Elder Law, Medicaid Eligibility and Asset Protection Planning

By Fredrick P. Niemann, Esq. of Hanlon Niemann, a Freehold, NJ Elder Care Attorney What is PACE? PACE stands for Program of All-inclusive Care for the Elderly. It is an innovative Medicare program that provides individuals age 55 and older comprehensive medical and social services provided by a team of professionals in a community-based center and in their homes, helping program participants delay or avoid long-term nursing home care. The PACE center serves as the hub for medical care, rehabilitation, social activities and dining. Eligibility to participate in PACE To participate, an individual must be 55 years of age or older, require nursing home level of care but be able to live safely in the community at time of enrollment …

When Can Medicare Stop Paying for Skilled Care and Rehabilitation

HNW Elder Law, Medicaid Eligibility and Asset Protection Planning

By Fredrick P. Niemann, Esq. of Hanlon Niemann, a Freehold, NJ Medicaid Attorney Often times families and patients are told by representatives of a nursing home or outpatient Medicare provider that Medicare will not pay for continued rehab, therapy or care because the patient is not improving. But is this policy legal? The short answer is no! The Medicare Policy Manuals have been revised. These changes must be followed in NJ. The revisions have been published by the Centers for Medicare & Medicaid Services (CMS). The changes in policy pertain to care in Inpatient Rehabilitation Facilities (IRF), Skilled Nursing Facilities (SNF), Home Health care (HH), and Outpatient Therapies (OPT). Translated, it means nursing homes and outpatient visitations at home and/or …

This Just In From the State: 2015-2016 Community Spousal Maintenance, Shelter and Utility Allowance Adjustments (MMNA & CSRA Allowance)

HNW Elder Law, Medicaid Eligibility and Asset Protection Planning

Effective July 1, 2015 the new base income allowance for a community spouse will increase from $1,966.25 to $1,991.25. The new standard for determining the excess shelter allowance for the community spouse increases from $589.88 to $597.38. Therefore, in computing the community spouse allowance, the community spouse’s shelter costs in excess of $597.38 shall be added to the base allowance of $1,991.25. If the community spouse is paying directly for their utilities, the utility allowance is also added as a shelter expense. The utility amount has been increased effective October 1, 2014 from $454.00 per month to $491.00 per month. The community spouse’s own gross income is subtracted from the overall allowance to determine the amount that may be deducted …

Big Change to Medicaid

HNW Elder Law, Medicaid Eligibility and Asset Protection Planning

By Fredrick P. Niemann, Esq. of Hanlon Niemann, a Freehold, NJ Medicaid Attorney The Appellate Division of the Superior Court of New Jersey decided an interesting case. The case, Greta Reuter v. the Burlington County Board of Social Services, addresses the contents of any notice the state must give an applicant who is denied Medicaid benefits. If your application for Medicaid benefits is denied, the County Board of Social Services must provide you with a notice of the denial. The denial notice must inform you of the right to appeal this denial through a process called a “fair hearing appeal”. An applicant who is denied benefits has twenty days from the date the notice of denial is issued to file …

Must You Sell Your NJ Business to Qualify for Medicaid

HNW Applying for Medicaid Long Term Care Benefits, Elder Law, Medicaid Eligibility and Asset Protection Planning

By Fredrick P. Niemann, Esq. of Hanlon Niemann, a Freehold, NJ Medicaid Eligibility Law Firm When the State considers an applicant’s eligibility for Medicaid, it meticulously scrutinizes the applicant’s financial assets to ensure that all resources are valued below the $2,000.00 limit. In order to fully determine whether an applicant is Medicaid eligible, the State considers all assets, including real estate, bank accounts, and liquid resources. Issues exist all too often where families are torn between their need for Medicaid assistance and their ability to support themselves. Fortunately, federal regulations provide help in situations where individuals and their spouses are up against the wall. If your Medicaid application has been denied because of excess “liquid resources” as part of a …

Social Security – Should You Take it Early or Not?

HNW Elder Law, Medicaid Eligibility and Asset Protection Planning

By Fredrick P. Niemann, Esq., a Freehold, NJ Medicaid Attorney Much has been written recently about the pros and cons of taking Social Security early at age 62 vs. waiting till full retirement age (which gradually increases till it reaches age 67 for those born in 1959 and later). One article I read recently explains why it could be a huge mistake to take Social Security early. What I didn’t see in the discussion turns out to be a big blind spot. There is no mention of how long term care costs might impact the decision. Advocates of waiting till full retirement age point out that the payment, after adjusting for inflation, can be as much as 75% more than …

After Your Discharge From the Hospital: Choosing a Nursing Home that Accepts Medicaid for Your Long Term Care

HNW Elder Law, Medicaid Eligibility and Asset Protection Planning

By Fredrick P. Niemann, Esq. of Hanlon Niemann, a Freehold, NJ Medicaid Attorney Moving from one’s own home into a nursing home for long-term care is different for the resident and family members. In most cases, a person would rather not go to a nursing home at all. Think about it; who chooses to go to a nursing home? But sometimes people have little or no choice if they have suffered a medical setback, such as a stroke, kidney failure, heart attack, or have some other limitation, such as dementia, Alzheimer’s or Parkinson’s disease. Whatever the reason, choosing a nursing home is unsettling, especially if you need to rely on Medicaid to cover the cost of nursing home care. The …