Statutes, codes, and regulations
New Jersey Administrative Code
Title 10 - HUMAN SERVICESChapter 72 - NEW JERSEY CARE ... SPECIAL MEDICAID PROGRAMS MANUAL
Subchapter 4 - FINANCIAL ELIGIBILITY
Section 10:72-4.5 - Resource eligibility

N.J. Admin. Code § 10:72-4.5

Download
PDF
Current through Register Vol. 56, No. 21, November 4, 2024
Section 10:72-4.5 - Resource eligibility
(a) Pregnant women and infants seeking Medicaid benefits under the provisions of this chapter are eligible without regard to the value of the household unit's resources. The county welfare agency shall inquire about the household unit's resources only in order to establish income that may result from the household unit's resources.
(b) Aged, blind or disabled persons (including specified low-income Medicare beneficiaries) must meet resource eligibility criteria as specified below in order to be eligible for benefits under this chapter. Eligibility for benefits does not exist in any month in which the countable resources of an aged, blind or disabled person exceeds the limits of $ 4,000 for an individual and $ 6,000 for a couple.
1. The resource provisions of the Medicaid Only Manual apply in the determination of countable resources for aged, blind, or disabled individuals except that, the provisions requiring the deeming of the resources of an alien's sponsor (10:71-4.6(f) ) do not apply in this chapter.
2. The spouse-to-spouse and parent-to-child deeming of resources found at 10:71-4.6 apply to eligibility under this chapter. In the deeming of resources from one parent to a child, the countable parental resources in excess of the Medicaid Only resource limit for an individual shall be deemed to the blind or disabled child. When the resources of two parents must be deemed to a child, the countable parental resources in excess of the Medicaid Only resource limit for a couple shall be deemed to the child.
3. For aged, blind or disabled persons, the policy concerning transfer of resources within 36 months of the date of application (see N.J.A.C. 10:71-4.7) , applies equally to eligibility under this chapter for individuals seeking eligibility for institutional services through long-term care (LTC) facilities or Home- and Community-Based Waiver (HCBW) services.
(c) Effective with the first month of coverage, resource eligibility limits for participants in the NJ WorkAbility program shall be as specified in 10:72-9.5.
(d) No portion of a cash reward provided to any individual by the Division for providing information about fraud and/or abuse in any program administered in whole or in part by the Division shall be included in the computation of income for financial eligibility purposes.
1. In order for the cash reward to continue to be excluded, the funds shall be separately identifiable (that is, not commingled with other funds or assets), but held in a separate account. Any increase in the value of the excluded cash reward shall also be excluded.

N.J. Admin. Code § 10:72-4.5

Emergency Amendment, R.1988 d.96, effective 2/2/1988 (expired April 2, 1988).
See: 20 N.J.R. 548(a).
Recodified from 10:72-4.4 and substantially amended.
Adopted Concurrent Proposal, R.1988 d.212, effective 5/16/1988.
See: 20 N.J.R. 548(a), 20 N.J.R. 1103(a).
Emergency Amendment, R.1991 d.223, effective 3/28/1991 (operative April 1, 1991; expires May 27, 1991).
See: 23 N.J.R. 1200(a).
Adopted Federally required coverage pursuant to Omnibus Budget Reconciliation Act of 1989.
Adopted Concurrent Proposal, R.1991 d.302, effective 5/24/1991.
See: 23 N.J.R. 1200(a), 23 N.J.R. 1945(a).
Provisions of emergency amendment R.1991 d.223 readopted without change.
Amended by R.1992 d.364, effective 9/21/1992.
See: 24 N.J.R. 2145(a), 24 N.J.R. 3343(a).
Transfer of resources provision at (b)3 changed from 24 to 30 months.
Amended by R.1993 d.369, effective 7/19/1993.
See: 25 N.J.R. 1042(b), 25 N.J.R. 3217(a).
Amended by R.1998 d.116, effective 1/30/1998 (operative February 1, 1998; to expire July 31, 1998).
See: 30 N.J.R. 713(a).
Adopted concurrent proposal, R.1998 d.426, effective 7/24/1998.
See: 30 N.J.R. 713(a), 30 N.J.R. 3034(a).
Readopted provisions of R.1998 d.116 without change.
Special amendment, R.2002 d.31, effective 12/26/2001 (to expire June 26, 2002).
See: 34 N.J.R. 600(a).
Added (c).
Amended by R.2002 d.124, effective 4/15/2002.
See: 33 N.J.R. 4188(a), 34 N.J.R. 1546(a).
Added (d).
Amended by R.2002 d.317, effective 9/16/2002.
See: 34 N.J.R. 600(a), 34 N.J.R. 1402(a), 34 N.J.R. 3270(a).
Amended by R.2008 d.30, effective 1/22/2008.
See: 39 N.J.R. 3704(a), 40 N.J.R. 723(a).
In the introductory paragraph of (b), deleted the comma following "blind"; and rewrote (b)3.