Major Differences Between New York and New Jersey Medicaid

On August 9th, 2012, I and three other attorneys will be presenting a program to ICLE entitled: "A Comparison of New York and New Jersey Topics in Medicaid Planning & Interstate Guardianship".

It was surprising to me how different the Medicaid rules are in New York than they are in New Jersey. The program will be presenting approximately 20 areas of difference but the key areas that are dissimilar are as follows:

1. New York computes the community spouse resource in a different manner. In New Jersey, in order to receive the maximum CSRA, you must have twice that amount, or $227,280. In New York, the CSRA is applied to the first assets so that if you have between two spouses $113,640 plus two, the CSRA is $113,640 and the applicant has the appropriate amount with Medicaid being granted initially.

2. In New Jersey, Medicaid only covers home care under waiver programs, which limit the time that home care is available. In New York, home care is actually part of Medicaid coverage so that a person can remain home forever and not go into a nursing home.

3. Finally, although there are many other points, the exemptions for "transfers exclusively for another purpose" are treated differently. For example, in New Jersey, I once had a client who made a pattern of transfers for twenty years starting at age 70. The Medicaid authority said that since it was an elder person, they didn't care that there was a pattern and transfers for the five years prior to application were penalized. In New York, the word "exclusively" is treated differently. That is, if you can show a pattern of gifts, they will treat them exclusively for another purpose and Medicaid would be granted. The New York approach is very similar to the old Internal Revenue Service Rule regarding "transfers in contemplation of death." In that area of law, the federal government looks to the primary or dominant motive and a pattern of gifts was the key to exclusion.

In New Jersey, in order to show that a transfer was "exclusively for another purpose," you have to show an example such as the following: a thirty-five year old person gives $100,000 to his brother, has a stroke at age 36 and goes into a nursing home. It takes a unique example like this for a transfer to be treated "exclusively for another purpose". Therefore, it is important to realize that there are differences between jurisdictions regarding basic Medicaid rules.

At the program, we will be discussing other topics such as spousal refusal, payment of debts and expenses, disinheritance of the Medicaid applicant and the effect of inter vivos trusts. Although many other topics will be discussed, these are some of the other key examples of the difference between New Jersey and New York Medicaid.

Disclaimer: This article does not constitute legal advice and each person may have unique facts for which legal consultation may be necessary.

© July 2012, Post 204