Income Cap Changes for Medicaid

elderly people walking near trees

In order to qualify for Medicaid assistance, an individual’s gross monthly income must be less than the Medicaid income cap.  If a person’s gross monthly income is greater than the Medicaid income cap then he or she will not qualify for Medicaid, unless a Qualified Income Trust is established.  This is also known as a QIT.

The income cap is based upon an individual’s gross monthly income rather than net income.  Therefore, a deduction from an individual’s income, such as the Medicare Part B premium, is not considered in determining eligibility for Medicaid assistance.

The Medicaid income cap in 2021 was $2,382.00. The Medicaid income cap has increased in 2022 by almost 6%. The Medicaid income cap in 2022 is $2,523.00.

The New Jersey Medicaid regulations provide that a person’s gross monthly income is not allowed to exceed 300% of the maximum Supplemental Security Income (SSI) benefit for a single individual.  The SSI benefit for a single individual in 2022 is $841.00.  Therefore, the Medicaid income cap for 2022 is calculated as follows: $841.00 x 3 = $2,523.00.

If an individual’s gross monthly income is less than $2,523.00 then he or she will satisfy the income requirement for Medicaid.  If that person’s gross monthly income is greater than $2,523.00 then Medicaid eligibility will not be acquired unless a QIT is established.