New Jersey Medicaid for seniors and long-term care
Last verified: June 2026
Long-term care Medicaid rules are complex
Estate recovery applies after age 55
New Jersey's integrated approach: MLTSS
New Jersey uses a Managed Long-Term Services and Supports (MLTSS) model, launched in 2014. Under MLTSS, your NJ FamilyCare managed care organization coordinates not just medical care but also nursing facility services and home and community-based supports through one integrated plan. This is different from many states where long-term care is managed separately from physical health coverage.
MLTSS serves dual-eligible enrollees (people on both Medicare and Medicaid) as well as Medicaid-only enrollees who meet the nursing facility level of care. The goal is to keep people in the community as long as possible rather than defaulting to institutional care.
Global Options waiver: home and community-based services
The Global Options for Long-Term Care waiver (a Section 1915(c) Medicaid waiver) provides home and community-based services to NJ FamilyCare enrollees who would otherwise require nursing facility placement. Waiver services go beyond what standard Medicaid covers at home.
- Personal care assistance for daily activities
- Adult medical day care programs
- Respite care for family caregivers
- Assistive technology and home modifications
- Emergency response systems
- Home-delivered meals
- Care management and coordination services
Enrollment in Global Options is subject to available slots — there is no statutory entitlement as with standard Medicaid. Contact your NJ FamilyCare MCO or DMAHS to inquire about current waiver availability in your county.
Nursing facility coverage
NJ FamilyCare covers nursing facility care for enrollees who meet the clinical level of care criteria and financial eligibility requirements. An assessment determines whether the individual requires nursing facility-level care. Once financially and clinically eligible, Medicaid pays the facility after the enrollee contributes their income (minus a personal needs allowance).
The personal needs allowance for NJ FamilyCare nursing facility residents is set annually by DMAHS — confirm the current amount when applying, as it updates periodically.
PACE: an alternative for those 55 and older
Program of All-Inclusive Care for the Elderly (PACE) is available in select New Jersey counties for individuals age 55 or older who meet nursing facility level of care criteria but prefer to remain in the community. PACE provides all medical and social services through a day health center, coordinating everything from primary care to specialty visits to transportation.
Not all counties have PACE programs. Availability depends on your specific location within NJ — check with DMAHS or nj.gov/humanservices/dmahs for participating PACE organizations near you.
Asset limits and spousal protections
New Jersey's asset limit for nursing facility Medicaid is $4,000 for an individual. This is higher than the federal minimum of $2,000 used by many states, but still relatively low. The primary home is excluded from the asset count if a spouse, minor child, or disabled child lives there — or if the applicant intends to return home.
When one spouse enters a nursing facility while the other remains in the community, federal spousal impoverishment rules protect the community spouse. The Community Spouse Resource Allowance (CSRA) lets the at-home spouse keep a portion of the couple's assets. The exact CSRA amount follows federal minimums and maximums, which CMS adjusts annually — consult DMAHS or an elder law attorney for current figures.
The community spouse also retains a Minimum Monthly Maintenance Needs Allowance (MMMNA) from income — protecting them from financial hardship while the institutionalized spouse's income goes toward nursing facility costs.
Estate recovery: what families need to know
DMAHS files estate claims against the assets of deceased NJ FamilyCare recipients who received long-term care services at age 55 or older. The claim can include nursing facility costs, MLTSS services, and related hospital and prescription costs paid during the long-term care period. The primary home is protected during the lifetime of a surviving spouse or minor or disabled child, but that protection expires when those conditions no longer apply.
Families can request a hardship waiver from DMAHS if estate recovery would cause undue hardship. Planning ahead — ideally years before needing long-term care — gives families more options to protect assets within the rules. An elder law attorney who specializes in New Jersey Medicaid can advise on legitimate planning strategies.
Medicaid as the primary payer for long-term care
Medicare does not cover custodial nursing home care beyond 100 days following a qualifying hospital stay. Private long-term care insurance covers only those who purchased it. For the majority of Americans who need extended nursing home care, Medicaid ends up as the payer — after they have spent down their own assets to the program's limit.
Nationally, Medicaid pays for roughly two-thirds of all nursing home residents, per CMS data. New Jersey's share of that population is administered through NJ FamilyCare (New Jersey Medicaid). The rules that determine eligibility — income, assets, lookback periods, and exempt property — differ from the MAGI-based rules used for standard Medicaid.
Long-term care Medicaid also includes home and community-based services (HCBS), which allow people to receive care at home or in assisted living rather than a nursing facility. These programs operate through Section 1915(c) waivers and have waiting lists in most states.
Nursing facility coverage
NJ FamilyCare (New Jersey Medicaid) covers skilled nursing facility care for seniors who meet clinical and financial criteria. Clinical eligibility requires a documented need for skilled nursing care — typically assessed through a standardized instrument. Financial eligibility means income and countable assets fall within the program's limits.
Once approved, Medicaid pays the nursing home directly. The resident contributes most of their monthly income toward the cost of care — typically all income minus a personal needs allowance (which varies by state but is often $30–$50 per month). Medicaid covers the gap.
If income exceeds the institutional Medicaid limit, New Jersey may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible. Not all states allow this; verify whether New Jersey uses this approach with NJ FamilyCare (New Jersey Medicaid).
Home and community-based services (HCBS)
HCBS waivers let states cover long-term care services outside nursing facilities — in a person's home, adult day program, or assisted living. Section 1915(c) of the Social Security Act authorizes these waivers. Each state designs its own waiver programs, so what's available through NJ FamilyCare (New Jersey Medicaid) differs from what's available in neighboring states.
Common HCBS services include personal care assistance, home health aide visits, adult day health care, respite care for family caregivers, and modifications to make a home accessible. Some states cap the number of waiver slots, creating waiting lists that can run for months or years.
Contact NJ FamilyCare (New Jersey Medicaid) to ask which HCBS waiver programs are currently open for enrollment and whether there is a waiting list.
Asset limits for long-term care Medicaid
Unlike MAGI-based Medicaid, long-term care Medicaid has an asset test. Countable assets — bank accounts, investments, second vehicles, vacation property — must fall below the state's limit. The specific threshold varies by state and is updated periodically; it is not a figure this page can reliably publish.
Exempt assets are not counted. The primary home is exempt while the applicant lives there or intends to return, as well as when a spouse, minor child, or disabled adult child lives there. One vehicle is typically exempt. Personal belongings and a prepaid funeral arrangement are also generally exempt.
Medicaid has a 60-month (5-year) lookback period for asset transfers. Transfers of assets for less than fair market value within those 60 months can result in a penalty period during which Medicaid will not pay for care. Consult NJ FamilyCare (New Jersey Medicaid) or a Medicaid planning attorney before transferring assets.
Spousal protections
When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse (the one still at home) is entitled to keep a minimum amount of assets — called the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income.
The CSRA allows the community spouse to keep between a federal minimum and maximum, with the exact amount varying by state and updated annually. New Jersey's current CSRA is set by NJ FamilyCare (New Jersey Medicaid) and published on their website.
The community spouse's own income is not counted toward the institutionalized spouse's Medicaid eligibility. If the community spouse has insufficient income, a portion of the institutionalized spouse's income may be allocated to them — the minimum monthly maintenance needs allowance (MMMNA).
Estate recovery applies to long-term care recipients age 55 and older
What long-term care Medicaid typically covers
- Skilled nursing facility care — room, board, nursing services, and most medical care in the facility
- Physical, occupational, and speech therapy provided in a nursing home
- Personal care assistance with daily activities (bathing, dressing, eating) through HCBS waivers
- Home health aide visits for those receiving care at home
- Adult day health care programs
- Respite care to give family caregivers temporary relief
- Durable medical equipment prescribed by a physician
- Transportation to and from medical appointments