With the right help, it is
possible to
avoid typical
Medicaid application pitfalls.
With the right help, it is
possible to
avoid typical
Medicaid application pitfalls.

New Jersey Medicaid Filing Issues

Following is a sample list of Medicaid application issues, which should be addressed to avoid unnecessary delays and denials.  Your Medicaid attorney, like those at Begley Law Group, is trained to address all of these issues before they become problems.

Timeliness of Filing Your NJ Medicaid Application:

It is important that applicants do not apply for Medicaid prematurely.  Strategies for Medicaid planning often include triggering a penalty period for NJ Medicaid eligibility purposes.  While the time in which to wait to file an application may be more of less than five years, filing an application during a period of ineligibility could potentially cause a significant delay in the applicant’s eligibility approval status.  It is therefor important to check with a qualified professional as to the date after which the application may be filed.

Authorization to Apply:

In most cases, the applicant himself or herself is unable to visit the County social services office and offer detailed information on his/her financial status.  The law, therefore, specifically provides that a relative, welfare agency staff member staff member of the institution in which the applicant resides, or a professional may apply of the applicant’s behalf.  Because the Medicaid eligibility laws and policies are rapidly changing, subject to shifts in politics and lobbying by advocates for the elderly, applicants are well-advised to retain individuals with comprehensive knowledge of the Medicaid eligibility rules and all strategies that may be legally employed to expedite eligibility.

Physical Criteria for Medicaid Eligibility:

Qualifying for NJ Medicaid involves not only financial criteria, but also physical.  Therefore, an applicant must demonstrate through a physical exam that he or she is unable to perform the activities of daily living, including feeding, dressing, bathing, toileting and continence.  If it cannot be shown to Medicaid that the care is medically necessary, the Medicaid application will be denied.

Substantiating Data Needed for Approval of Medicaid Application:

Additional Documentation and Verification for Medicaid Eligibility:

The requirement that financial statements dating back five years prior to the filing of the application be submitted also varies from county to county.  Depending on the circumstances, some counties have been known to request as little as fourty-two (42) months of statements.

For questions about New Jersey Medicaid, call 1-800-356-1561 or your County Welfare Agency.

For help with your New Jersey Medicaid application, visit the experienced New Jersey Medicaid and Elder Law attorneys at Begley Law Group.
The Medicaid application itself is several pages, and the answers to each question must be substantiated by legal or financial documentation.  These supporting documents include: social security cards, Medicare cards, health insurance cards, birth certificates, marriage certificates, death certificates, life insurance policies, deeds, car registrations, household expense bills, funeral arrangement documents, pay or pension stubs, and financial statements typically dating back five years prior to the time the Medicaid application is filed.
 
Each Medicaid office in New Jersey has a computer program to verify social security numbers, employment history or other personal information.  Likewise, if any financial information is not disclosed to a county social service office, the office may deny the application based on information it periodically receives from the Internal Revenue Service.  Intentional failure to disclose relevant financial data is considered Medicaid fraud.  Even in cases where Medicaid eligibility has initially been granted, the county welfare office may revoke the approval upon receiving the IRS records.