What if Your Income is Greater than the Income Cap?

New Jersey has two nursing home Medicaid programs, one for those with $2094 a month of gross income and one for people with greater than $2094 per month.  New Jersey’s Medically Needy program is available to people whose income exceeds that number up to what is known as the Medicaid reimbursement rate.  This is the rate that New Jersey reimburses the nursing home for its Medicaid residents.  Each nursing home negotiates that rate directly with Medicaid but generally the rate is somewhere between $5000 and $6000 a month.

But, if your income is greater than the Medicaid reimbursement rate, you may not be eligible for either Medicaid program.  Although most seniors with income from Social Security and pension fall within the $2000 to $4000 per month range, teachers and other government workers with large pensions may have income of $6000 to $8000 per month.  Unless New Jersey changes its Medicaid program, they will never qualify.