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Think the State will Help You? Think Again

For as long as I can remember, I have explained to clients that although 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.

I have written previously in this blog about New Jersey’s assisted living Medicaid program and the difficulties in qualifying but New Jersey’s home based Medicaid program isn’t any better and actually is worse.  For years I have explained to families that at best, home based Medicaid will cover 40 or 50 hours a week of care.

Apparently the State won’t even cover that much.  In speaking with a number of home care agencies we are finding that the New Jersey 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 $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.

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.

It’s just another illustration of why you cannot naively think that if you spend all your money, the State will take care of you.  It won’t.    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 won’t be there.