Needing long-term care does not always mean moving into a nursing home. New Jersey Medicaid can help eligible people receive long-term care services while living at home. The state’s Managed Long Term Services and Supports (MLTSS) program helps provide care in the home and community.
What home-care services can Medicaid cover?
Depending on a person’s needs, MLTSS may cover several services that can make it easier to remain at home. These services can help with daily activities, meals and other needs:
- Personal care assistance
- Home-delivered meals
- Respite care
- Certain home modifications
- Personal emergency response systems
The services available depend on Medicaid financial eligibility and the person’s clinical eligibility and assessed care needs.
Can Medicaid pay a family member to provide care?
New Jersey’s Personal Preference Program (PPP) gives certain eligible Medicaid members more control over their personal care services. Participants may be able to choose their own caregivers, including certain relatives, friends or neighbors, as long as program requirements are met.
For families, this means a trusted person – rather than an outside agency worker – may be able to provide care and receive compensation for doing so.
How does Medicaid evaluate income, assets and transfers?
Medicaid has strict financial eligibility rules. Income, assets and other financial circumstances can affect eligibility for long-term care benefits.
Families should also be careful when transferring assets. New Jersey Medicaid looks at financial transactions from the previous 60 months (five years) when determining eligibility for MLTSS and looks for transfers made below fair market value.
Transfers during that period, including gifts to family members, can result in a penalty period that delays Medicaid eligibility. A decision that seems helpful now could create significant problems when care is needed.
When should families start planning for Medicaid home care?
Long-term care needs can arise quickly. Waiting until care becomes urgent may leave fewer options for arranging care and protecting assets.
Medicaid planning early can help families determine whether Medicaid-funded home care may be available and what steps may be needed to qualify.
