Medicaid Planning Traps: Bad or Insufficient Paperwork

Applications for long-term care Medicaid in New Jersey take a long time to process. It is not unusual for the process to take six months to a year from the time the application is submitted until the time that the Board of Social Services makes a determination. The regulations say that the applications need to be processed in 45 days, but that simply does not happen. What does happen, though, is that the County Board uses that regulation to its advantage. It can sit on an application for months, make a request, and then from there if the application is not complete within forty-five days it will be denied for failure to provide information. It is good planning and it makes good sense to provide as much documentation as you can up front, so that there is less to request at the back end. The bottom line here is that if anything is missing and you are asked for anything that can’t be obtained quickly, your application may be denied. You will have to start all over again, and that often means months of lost payment and tens of thousands of dollars in liability.

The Board of Social Services will ask for a variety of basic information about the applicant to start an application, consisting of things like age, citizenship, identity and marital status. It may also be necessary for a married couple to provide proof of household expenses. Where things get complicated is in proving that the applicant has no more than the required income and assets to qualify for the program. A Medicaid applicant needs to provide bank statements for five years (or from account opening, if that’s more recent) for any statement that is or was open during the past five years. It’s a very broad request and realistically unless an application is submitted with all of those statements already, it will be very difficult to get the application all the way through.

If you have a question about the paperwork you need to file a Medicaid application, waiting to ask a Medicaid caseworker is a very dangerous strategy. It may be too late by then. An elder law attorney can tell you not only what paperwork you need to file, but they can also help you look at the paperwork you do have to find potential problems, and even address them before they become problems. Another pair of eyes can never hurt as this application process is not one you will want to repeat due to a mere oversight.