New Jersey Medicaid Asset Organizer

Put everything in one place. See where you stand. Hand your attorney a clean packet.

Who is applying?

Only what the estimate actually needs.

We do not ask for a Social Security number. The estimate does not need one, and collecting it would only create risk. The application itself will need the card — track that on the Documents step.

Questions the application asks

This single checkbox is what routes an application to MLTSS. There is no separate long-term care application in New Jersey — answering "yes" to this question on the standard form is what triggers it. You do not need to live in a nursing home to qualify.

A prior application matters more than it looks: on a reapplication the look-back runs from the first application date, so the window can be longer than five years.

Living arrangement

The form lets you check more than one — someone can own a home and be living in a facility at the same time, and both matter.

Anyone else living in the household

The form asks for name, date of birth, and relationship for each.

Marital status

Military service

VA Aid & Attendance is a separate benefit from Medicaid and has its own rules. Worth raising with your attorney if either box is checked.

Monthly income

Gross monthly amounts, before deductions. New Jersey's 2026 cap is $2,982/month for a single applicant.

Total monthly income: $0.00

Household expenses

These matter for one reason, and it is a big one: they decide how much of the applicant's income the spouse at home is allowed to keep instead of paying it to the facility.

Shelter costs for the spouse at home

New Jersey allows exactly these and nothing else (N.J.A.C. 10:71-5.7(c)1), for the principal residence only. Monthly figures.

Utilities

New Jersey uses a fixed standard allowance and actual utility bills may never be substituted — so do not enter your bills, just pick the situation. Exactly one applies.

Dependent family members living with the spouse at home

Children under 21; children 21+ claimed as tax dependents; parents or siblings of either spouse claimed as tax dependents. Each gets its own allowance of ($2,705 − their gross income) ÷ 3. They must live with the spouse at home.

Health insurance premiums the applicant pays

Deducted from the applicant's income before the facility is paid (N.J.A.C. 10:71-5.7(i)). Monthly figures.

If the State pays it, it is not deductible — the deduction is only for expenses "not subject to payment by a third party." If you are unsure, leave it unchecked and ask the county.

Spouse at home may keep: $0.00

Assets

Add every account and every asset. For a bank with several accounts, add the bank once per account — name the bank each time, then the account.

Countable: $0.00 · Exempt: $0.00

The 60-month look-back

New Jersey examines every gift, transfer, and below-market sale in the five years before the application. Money given to family counts — this is what surprises people most.

Be complete here even if it looks bad. An undisclosed transfer found by the county is far worse than a disclosed one your attorney can plan around. Some transfers are exempt.
Total disclosed: $0.00

Bank statement coverage

New Jersey wants one statement per quarter — 20 per account over five years — for every account owned or co-owned, open or closed. It can ask for all 60 months if the quarterly statements show a lot of activity. This grid shows exactly which ones are still missing, so you are chasing a short list.

No app can fetch five years of statements for you — including this one. Every bank-connection service on the market tops out at about 24 months, and none of them can reach an account that has been closed. Your bank, however, usually keeps about seven years of statements available to download yourself. That is the path that actually works, and this page tracks it.
Quarters covered: 0 of 0

Document checklist

What the county will ask for. Check what you have and note where it is.

Located: 0 of 0

Where things stand

The Excel packet contains every entry, the classification of each asset, the arithmetic, and the disclaimer — formatted so an attorney can work from it directly.