Medicaid is a joint federal and state benefit program designed to ease the burden of paying for medical expenses for those who cannot afford them. This program is especially important for covering the cost of 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 dangers, 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 $150,000 per year can wipe out a lifetime of savings in a matter of a few years, and families are usually not equipped to bear those costs on behalf of their loved ones. Medicaid eligibility is dependent on four main factors: clinical eligibility, income, assets and transfers. 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 Brogan 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 can give a client as much clarity as possible, and therefore process applications more quickly. Our team cuts through the regulations, gives clear advice, and prepares and defends Medicaid applications anywhere in New Jersey and Pennsylvania. The firm also has experience advocating for different interpretations of regulations, and appealing unfavorable decisions in both states, whether the firm files the application itself or if others need the firm’s assistance.