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When It Comes to New Jersey Medicaid What You Don’t Know Can Hurt You

We were discussing how Medicaid in New Jersey, and around the country, is a constantly changing landscape.  Clients hire us for our experience in navigating through this maze and guiding their applications to success (ie. Medicaid approval).  An important point to remember is that the Medicaid caseworkers don’t know all the rules.  Very often they lack experience, having been moved over from another department, or simply being a new hire.  They misapply the rules.  A caseworker may tell me something that, in my experience as an elder law attorney, I know to be incorrect. But, if you are completely unfamiliar and inexperienced with Medicaid and it’s maddeningly confusing regulations how will you know that you are being given incorrect information.  The simple answer is, “you won’t”.  And that could cost you tens of thousands of dollars in extra nursing home fees as a result of New Jersey denying your Medicaid application.

A caseworker may say something that confirms our own belief as to how a rule should be applied.  However, that does not mean that that State employee cannot change his/her mind or be “overruled” by a supervisor.  It is therefore critical that when there are “sticky” issues with a Medicaid application, that an elder law attorney be consulted.  A New Jersey Medicaid employee’s statement should never be taken “as gospel”, even if favorable to our client.  There have been numerous instances when Medicaid has told us something that we know is simply wrong. We cannot just rely on that statement because, more likely than not, when the application is reviewed by a supervisor, the mistake will be corrected, and the original position reversed.  Our concern is that this reversal could cause a financial loss to our clients.

For more information, email us at and type in  “Consumer’s Guide to New Jersey Medicaid” and we’ll email you our Consumer’s Guide in pdf format.