In its latest move to promote alternatives to nursing homes, the Christie administration in New Jersey will enact a new funding measure that will allow more elderly and disabled people to apply for Medicaid assistance to pay for care at home or in non-institutional settings. This newest amendment to the New Jersey's Medicaid program will allow those who earn too much to qualify for full assistance — but who can't afford the cost of the care they need — to receive help through the creation of a trust account at a bank.
The Bergen Record recently published an article, titled "N.J. to allow Medicaid to cover in-home elder care," reminding us that any income above the Medicaid eligibility limit of $2,163 a month that a senior or disabled individual receives can be placed into an irrevocable trust accounts. Withdrawals are then permitted for qualified living expenses and some of their care that they can afford. After that, Medicaid pays the rest, whether it's in a nursing home or in their own home.
This change comes about in response to advocates who believed the state’s old Medicaid rules made seniors move to nursing homes prematurely because the state gave them no help with home health aides, adult day care programs, or assisted living residences.
"With these trusts, the individual who wants to live at home and age in place will have the capability of being able to live at home or remain in their communities while getting the long-term services and support they need," a state official said in original article.
New Jersey has earmarked three-quarters of the $125 million in its long-term-care budget for these new Medicaid enrollees.
Medicaid officials in New Jersey think that the changes may bring about additional Medicaid enrollees, but will save money long-term by postponing the nursing home. Medicaid funds these stays for roughly $205 a day. Still, some advocates and elder care attorneys worry that these trust arrangements could be too confusing and complex for the elderly and their caregivers, creating a potential "nightmare” for people trying to do this on their own.
Qualifying for Medicaid is already a time-consuming and laborious task. Seniors have to organize their bank and financial records for the past five years to show that they didn’t give any money to adult children or others to avoid spending inheritances on long-term care. The senior’s trustee is tasked with ensuring that all pension checks are deposited, the qualified living expenses are paid, and remaining funds are then paid to the care facility or back to Medicaid. These all have to happen within the same month to stay eligible.