N.J. Admin. Code § 10:71-3.8

Current through Register Vol. 56, No. 23, December 2, 2024

Section 10:71-3.8 - Medicaid eligibility for individuals who enter New Jersey in order to secure medical care

(a) Federal and State statute and regulations expressly bar a duration-of-residence requirement as a condition of eligibility. The New Jersey Medical Assistance and Health Services Act authorizes a grant of medical assistance to a qualified applicant who is a resident of the State which " ... means a person living, other than temporarily, within the State."

(b) When an individual enters this State in order to receive medical care, and applies for Medicaid to meet all or a portion of the costs of such care, the fact that the immediate purpose of the move was to secure medical care does not, in and of itself, have the effect of making this person ineligible for the medical assistance program. It is the responsibility of the county welfare board to evaluate all such cases and to make an eligibility determination, considering carefully all the following criteria:

1. Whether the move is a temporary one, being solely for the purpose of receiving medical care for a limited time;

2. Whether the move is part of a carefully conceived social service plan which would serve to meet other requirements of the individual in addition to purely physical needs, for example, a person moves to a nursing home in order to be closer to relatives who are interested in the person's welfare;

3. Whether there is a clear expression of intent on the part of the individual to remain permanently in this State;

4. Whether there is objective evidence that the individual has, in fact, abandoned or not abandoned residence in the State from which he/she came;

5. Whether the State in which the individual previously resided recognizes him/her as having continuing eligibility under the Medicaid program (or other program providing payment for medical care) of that jurisdiction.

(c) If, after full consideration of these factors, the CBOSS is satisfied that the individual has become a resident of this State, then eligibility for medical assistance is established if the person is otherwise eligible.

N.J. Admin. Code § 10:71-3.8

Amended by R.1995 d.651, effective 12/18/1995.
See: 27 New Jersey Register 3543(a), 27 New Jersey Register 5046(a).
Amended by R.2000 d.415, effective 10/16/2000.
See: 32 New Jersey Register 2565(a), 32 New Jersey Register 3844(a).
In (c), substituted "CBOSS" for "CWA".