Medicaid Redeterminations – Part 2

In last week’s post I began to discuss Medicaid redeterminations and how they have become more difficult than they once were. There are several reasons for this.    10 years ago New Jersey made changes to its Medicaid program that required certain applicants to utilize a qualified income trust.  I’ve written about the QIT a number of times in this blog but to summarize, it becomes necessary to use one when an applicant’s income exceeds the strict income cap or limit on income.  In 2024 the income cap is $2829 per month.

When that occurs, a Medicaid application will not be approved unless the QIT is used.  While there are specific rules that must be complied with, the State has imposed additional requirements and restrictions that were never intended.  In some cases the State has misapplied the rules.  For example, when the VA Aid and Attendance monthly benefit pushes the income over the income cap a QIT is not necessary, however, some counties are denying applications insisting on their use.

We have found that on a redetermination the State is closely examining – or really re-examining the QIT.  For example, many counties are requiring a full year’s worth of QIT bank statements and scrutinize them to determine if the correct amount of income is passing into and out of the account.  What makes things trickier is that this policy is not uniform.  It varies from county to county and application to application.

Innocent mistakes made in terms of deposits and withdrawals can result in months of lost benefits.  Some counties let these mistakes go and others do not.  Changes in income caused by cost of living adjustments, for example, may result in incorrect amounts being deposited to the QIT.  Some counties have taken a “no excuses” policy, resulting in lost benefits.

If families are not careful, other changes that occur after a Medicaid application approval can also be problematic when it comes time for a redetermination.  We’ll cover that next week.