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Page 2 of 2 § 10:71-1.2 Choice of program by applicant Essex Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 05476-17, 2017 N.J. AGEN LEXIS 363, Initial Decision (June 2, 2017). County Board of Social Services (CBSS) acted properly when it determined that an applicant was not eligible for institutional Medicaid for the months of December 2013 and January and February 2014 due to the fact that she possessed resources that exceeded $ 2,000. The applicant argued that $ 10,524 cash value of a life insurance policy was not a resource within the meaning of the relevant regulations because it was used to reimburse her son for funds he expended to purchase a cemetery plot for the applicant and to fund an irrevocable funeral trust. However, such resources were countable because they exceeded the limits on such life insurance policies and burial funds. In sum, because the applicant had countable resources in excess of $ 2,000 and had received the maximum allowed credit of $ 1,500 for burial expenses, the CBSS had acted properly in determining that the applicant was ineligible in the cited months. L.H. v. Hudson Cty. Bd. of Social Servs., OAL DKT. NO. HMA 05597- 14, 2015 N.J. AGEN LEXIS 167, Initial Decision (March 24, 2015). Agency determination denying the application of a disabled adult for enrollment in the Community Care Waiver/Medicaid Only (CCW) on the ground that her resources exceeded the ceiling imposed by N.J.A.C. 10:71- 1.2(a) and N.J.A.C. 10:71-4.1 was reversed. The disabled adult owned life insurance policies, one of which had a cash surrender value of $ 2,065, and her ownership thereof meant that her resources exceeded the eligibility standard of $ 2,000. However, resources which are not accessible to an individual through no fault of his or her own are excluded per N.J.A.C. 10:71-4.4(b)6. Thus, though the cash value was "available" to the disabled adult in the sense that she had the right to liquidate the policy, the circumstances presented by these facts, which included that the adult has Down's Syndrome and had been declared incompetent by reason thereof, the adult lacked the capacity to deal with the insurance, and its value should not have been considered when evaluating the adult's resources. Once the value thereof was excluded, the adult was eligible for Medicaid as of the proposed date of September 1, 2013. P.M. v. DMAHS, OAL DKT. NO. HMA18597-13, AGENCY REF. NO. 9020032129-01, 2014 N.J. AGEN LEXIS 291, Initial Decision (May 12, 2014). NEW JERSEY ADMINISTRATIVE CODE Copyright © 2025 by the New Jersey Office of Administrative Law End of Document