Description
Under PPP, family members can be hired as paid personal care providers.
Recognizing the needs and preferences of many of the state’s seniors, New Jersey’s Medicaid program offers the Personal Preference Program (PPP). The PPP provides financial assistance to elderly and / or disabled, Medicaid-qualified residents to help them live independently and manage their activities of daily living.
Based on the “Cash and Counseling” model, the program distributes to participants a budget that would otherwise be spent on services for them. Participants have the power to select their own care providers. Program participants can hire friends and family members, so relatives, including spouses, can be paid to be caregivers if they are at least 18 years old.
Program participants who are cognitively challenged or unable to direct their own care can still participate in the program, given they elect a representative to assist in making decisions on their behalf. The representative may be a friend or relative, but cannot also be the hired caregiver. A fiscal intermediary agency handles the financial responsibilities, such as processing payroll and deducting taxes.
This program and the category of programs are referred to by many different names. The Personal Preference Program might also be referred to as Personal Care Assistance (PCA) services. Cash and Counseling programs, in general, are also known as consumer-directed, self-directed and participant-directed.
Did You Know? Cash and Counseling programs are a win-win for consumers and state governments. Participants report higher satisfaction and the state experiences cost savings.
Eligibility Guidelines
General Requirements
Program candidates must have a need for assistance with their activities of daily living, such as bathing, toileting, and eating as determined by a healthcare professional. However, their needs cannot be so severe that full-time nursing home level care is required.
Financial Requirements
The following limits are accurate for seniors applying for the Personal Preference Program through N.J. Medicaid’s Managed Long-Term Services and Supports Program:
Income Limits
In 2024, seniors can have up to $2,829 in monthly income. Married couples with both spouses applying are allowed $5,658 a month.
Asset Limits
Individual applicants can have countable assets valued at $2,000. Married couples with both spouses applying are allowed $3,000. However, certain assets are exempt and not counted. An applicant’s vehicle and home — as long as the equity value is under $1,071,000 — are not counted toward the limit.
Couples With One Spouse Applying
Persons in this situation have considerably more flexibility when seeking Medicaid. When only one spouse of a married couple is applying, the non-applicant spouse can keep 50% of the couple’s joint assets, up to $154,140 (as of 2024). If the couple’s assets are under $30,828, the non-applicant spouse can keep all of the assets, up to this amount. (This is commonly called a community spouse resource allowance and is in addition to the $2,000 in assets the applicant spouse can retain).
Furthermore, in some cases, the applicant spouse can transfer as much as $3,853.50 a month to his or her non-applicant spouse. This is known as a monthly maintenance needs allowance. It is intended to prevent impoverishment of the non-applicant spouse, and also lowers an applicant’s countable income. If the non-applicant spouse already has monthly income equal to or above this figure, a transfer of income is not permitted.
Over the Financial Limits?
Individuals or couples who exceed these limits may still be able to receive benefits. Qualified income trusts and Medicaid-compliant annuities are complicated tools, but can help. Professional financial planners can help to re-structure income and property so that needy families can comply with the eligibility rules. Learn more about how they could help your family.
WarningMedicaid has a 60-month look-back period in which all transfers within this time frame are scrutinized. Assets are not allowed to be gifted in order to meet financial requirements, otherwise the individual will be penalized with a period of Medicaid ineligibility.
Benefits and Services
One of the best things about the Personal Preference Program is that participants have a great deal of flexibility on how to spend the funds given to them for their care. We divide the types of expenditures into three categories that are considered eligible.
1) Personal Assistance Services – a hired individual that assists the program participant to manage his or her activities of daily living, and instrumental activities of daily living such as bathing, grooming, meal preparation, eating, mobility, housekeeping, shopping and laundry.
2) Assistive Technology – appliances, devices, and controls that increase the individual’s ability to live independently, such as remote controls, specially designed cooking equipment, and motion-sensitive lighting.
3) Home Modifications – changes to one’s home to accommodate for physical challenges, such as stair glides, handicap ramps, walk-in tubs, grip bars for the bathroom, and doorway alterations to accommodate for wheelchairs.
How to Apply / Learn More
This program is managed by the Division of Medical Assistance and Health Services (DMAHS), which is within the N.J. Department of Human Services. A downloadable PDF about PPP is available here, and additional information can be found on the DMAHS’ website. Questions can be directed to DMAHS at 609-631-2481.
To apply for the Personal Preference Program, one must first be accepted into Medicaid in New Jersey. To apply for N.J. Medicaid, one can start here.
