Medicaid is designed to ease the burden of paying for long-term care in skilled nursing facilities. In New Jersey, Medicaid can also cover some home care under a program called Managed Long-Term Services and Supports, and it can also cover assisted living care as well. The program is not without its risks, though: it can be very complicated to navigate and care is enormously costly if the application is approved with a penalty period, or denied altogether. Without proper planning and assistance, facility costs in excess of $100,000 per year can wipe out a lifetime of savings in a matter of a few years, and families are not equipped to bear those costs on behalf of their loved ones. Medicaid eligibility is dependent on three main factors, those being clinical eligibility, financial (income and asset) eligibility, and other factors that may delay an application, such as gifts made by the applicant within the five-year lookback period before the application is filed. While the asset eligibility is the most well-known requirement among families, clinical eligibility is often overlooked, and gifts can derail an application if they are not handled with great care.
The State has implemented regulations to govern these eligibility requirements for each program but their interpretation often varies by county and even by caseworker. Archer Law Office has experience filing a large number of applications annually in many New Jersey counties, so we know what the caseworker is going to ask for even before they do. We can spot and anticipate issues before we file an application, so we give a client as much as clarity as possible, and process applications more quickly. The firm cuts through the regulations, gives clear advice, and prepares and defends Medicaid applications anywhere in NJ and PA. The firm also has experience advocating for different interpretations of regulations, and appealing unfavorable decisions in both states, when the firm files the application itself and also when others need the firm’s assistance.
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