by Herbert D. Hinkle, Esq.
This is the second of a three-part series of articles, which briefly discusses the different programs under which New Jersey provides Medicaid services.
Split Application Medicaid is for disabled children who are not income-eligible for Medicaid through SSI or otherwise because of their parents’ income; and who have a non-disabled sibling. Parents must apply for both children under the Medically Needy Program. Under the “split application” analysis, the parents’ income is deemed to the child without a disability and the child with the disability is now considered on his/her own, so the child with the disability will now meet the income eligibility requirements. The disabled child must also meet the SSI disability requirements and the resource limit of $6,000.
Institutional Medicaid provides Medicaid payment for institutional stays (such as, nursing home care) for those who meet both financial criteria ($1,737/month in income & up to $2,000 in resources) and medical necessity requirements.
New Jersey Work Ability Program is for individuals between 16 and 65 years of age, who have been determined to be permanently disabled by SSA or the Division of Medical Assistance & Health Services, and are employed. Income limits for individuals may be up to 250% of the Federal Poverty Level (that is, 250% of $9,080) and resources up to $20,000.
Work First New Jersey/General Assistance provides cash and medical assistance to single individuals who have a monthly income of less than $140 per month ($210/month for those unable to work); and to couples without minor dependent children with less than $193 gross income per month ($289/month for those medically certified as unable to work). Inpatient and outpatient hospital services are not covered under this program.