New Jersey Medicaid's Global Options (GO) for Long-Term Care Waiver

Page Reviewed / Updated - Mar. 2014

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers" which are also called Home and Community Based Services (HCBS Waivers) or Waiver Funded Services.

Waiver Description

This Medicaid waiver offers home care and assisted living services to persons clinically qualified for nursing home care. Participants, while eligible for nursing home care, must choose to remain living at home or in the community and receive care services in those locations.  GO provides for a broad range of services intended to help families care for a loved one or to increase the program participant's self-reliance.  This includes attendant (personal) care at home, in adult day care or in assisted living as well as minor home modifications.

 Under GO, certain family members can be hired and paid for their caregiving services. 

The GO waiver offers a consumer or participant direction option that enables participants to self-direct some of their care. This means they can hire the individuals or agencies they desired to provide them with care services. Among those who can be hired as paid caregivers are family members such as the adult children of aging parents. All care providers must be approved by the state.  In Medicaid parlance, these are called Participant-Employed Providers or PEPs.  The hourly rate which they are paid for their services is also determined by the state.

The GO waiver was created in 2009 as a consolidation of 3 other New Jersey Medicaid Waivers.

  • Assisted Living/Adult Family Care (AL/AFC)
  • Caregiver Assistance Program (CAP)
  • Community Care Program for the Elderly and Disabled (CCPED)

 

 Did You Know?  NJ seniors can receive free assessments for bathroom safety modifications such as the addition of a walk-in tub in place of a shower.  Learn more.


Eligibility Guidelines

To qualify for the GO Waiver, there are age, functional and financial requirements. Applicants must be a minimum of 65 years old and a New Jersey resident. They must be clinically eligible for nursing home care and financially qualified for Medicaid.

2014 NJ Medicaid Income Limits
The income limit depends on the individual's cost of care. For most persons, the limit is set at $2,163 / month. However, for certain individuals with usually high medical expenses, there is a Medically Needy program that allows persons with higher incomes to qualify provided their excessive income is spent towards paying for their care.

2014 NJ Medicaid Asset Limits
Individual applicants are permitted to have up to $2,000 in countable assets, Medically Needy applicants up to $4,000. Married couples, with one spouse applying for Medicaid and the other spouse not applying, are permitted to allocate up to $117,240 in countable resources to the non-applicant spouse. This is called New Jersey's Community Spouse Resource Allowance.

Countable resources do not include all a family's assets. For example, their home is not considered provided it is valued at less than $814,000 and it is lived in by the applicant or their spouse. Primary vehicles, burial plots, funeral trusts and certain annuities may also be considered as non-countable assets. Persons whose believe their assets exceed Medicaid's limits should not automatically assume they cannot qualify. There are Medicaid planning experts who help families to structure their resources appropriately so they can become eligible. For example, an applicant can pre-pay for a funeral using an irrevocable funeral trust and lower their assets by up to $15,000. Learn more about IF Trusts or find assistance applying for NJ Medicaid.

 

Benefits and Services

Waiver participants are eligible for any of the following. Specific services are determined at the individual level during an assessment and periodically thereafter.   Some of these services can be self-directed, meaning the participant can choose their service provider.  

  • Adult Day Health Service
  • Assisted Living/Adult Family Care
  • Attendant Care
  • Care Management
  • Caregiver/Recipient Training
  • Chore Service
  • Community Transition Services
  • Environmental Accessibility Modification
  • Home-Based Supportive Care
  • Home-Delivered Meals
  • Personal Care Attendant
  • Personal Emergency Response System (PERS)
  • Respite Care
  • Social Adult Day Care
  • Special Medical Equipment
  • Transitional Care Management
  • Transportation

 

How to Apply / Learn More

Interested individuals should apply for Medicaid and the GO Waiver with their County Board of Social Services, their local NJ Area Agency on Aging or by calling toll free 877-222-3737.  It was undetermined at the time of writing if a waiting list for services existed, but it is not uncommon for waivers to have "Services Registries". 

More information about this program is available on the Division of Aging Services webpage.