Page 69

N.J.A.C. 10:72-4.5 This file includes all Regulations adopted and published through the New Jersey Register, Vol. 57 No. 12, June 16, 2025 NJ - New Jersey Administrative Code > TITLE 10. HUMAN SERVICES > CHAPTER 72. NEW JERSEY CARE ... SPECIAL MEDICAID PROGRAMS MANUAL > SUBCHAPTER 4. FINANCIAL ELIGIBILITY § 10:72-4.5 Resource eligibility (a) Pregnant women and infants seeking Medicaid benefits under the provisions of this chapter are eligible without regard to the value of the household unit's resources. The county social service agency shall inquire about the household unit's resources only in order to establish income that may result from the household unit's resources. (b) Aged, blind or disabled persons (including specified low-income Medicare beneficiaries) must meet resource eligibility criteria as specified below in order to be eligible for benefits under this chapter. Eligibility for benefits does not exist in any month in which the countable resources of an aged, blind or disabled person exceeds the limits of $ 4,000 for an individual and $ 6,000 for a couple. 1. The resource provisions of the Medicaid Only Manual apply in the determination of countable resources for aged, blind, or disabled individuals except that, the provisions requiring the deeming of the resources of an alien's sponsor (N.J.A.C. 10:71-4.6(f)) do not apply in this chapter. 2. The spouse-to-spouse and parent-to-child deeming of resources found at N.J.A.C. 10:71-4.6 apply to eligibility under this chapter. In the deeming of resources from one parent to a child, the countable parental resources in excess of the Medicaid Only resource limit for an individual shall be deemed to the blind or disabled child. When the resources of two parents must be deemed to a child, the countable parental resources in excess of the Medicaid Only resource limit for a couple shall be deemed to the child. 3. For aged, blind or disabled persons, the policy concerning transfer of resources within 36 months of the date of application (see N.J.A.C. 10:71-4.7), applies equally to eligibility under this chapter for individuals seeking eligibility for institutional services through long-term care (LTC) facilities or Home- and Community-Based Waiver (HCBW) services. (c) Effective with the first month of coverage, resource eligibility limits for participants in the NJ WorkAbility program shall be as specified in N.J.A.C. 10:72-9.5. (d) No portion of a cash reward provided to any individual by the Division for providing information about fraud and/or abuse in any program administered in whole or in part by the Division shall be included in the computation of income for financial eligibility purposes. 1. In order for the cash reward to continue to be excluded, the funds shall be separately identifiable (that is, not commingled with other funds or assets), but held in a separate account. Any increase in the value of the excluded cash reward shall also be excluded. History HISTORY: Emergency Amendment, R.1988 d.96, effective February 2, 1988 (expired April 2, 1988).