New Jersey Medicaid for Seniors & Long-Term Care

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.

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.

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 set annually by DMAHS — $50/month as of 2026.

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 — check with DMAHS for participating PACE organizations near you.

New Jersey's asset limit for MLTSS — the program that covers nursing facility care and long-term HCBS — is $2,000 for an individual, the federal minimum. This is lower than the $4,000 asset limit that applies to NJ FamilyCare's separate Aged, Blind, Disabled (ABD) program, which covers community-based Medicaid for seniors and people with disabilities who do not need a nursing facility level of care. 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, up to $162,660 in 2026 (federal maximum), following federal minimums and maximums that CMS adjusts annually. 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.

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.

Medicare does not cover custodial nursing home care beyond 100 days following a qualifying hospital stay, and private long-term care insurance covers only those who purchased it — for most 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.