Resources

Applying for Medicare and Social Security

Applying for Medicare and Social Security online: SSA.GOV – Note, this is the fastest way to apply for your benefits.

Open an account

Follow instructions to apply for Medicare Part A

Follow the instructions to apply for Medicare Parts & B

Follow the instructions to apply for Medicare Parts A & B and Social Security Income

Option 1 – Open an account on SSA.gov – (can you make this link work please) Please be sure to follow directions or you will be locked out for 24 hours and can try again tomorrow.

Option 2 – If you are turning 65 but continuing to work, you only need to join Part A – Use: https://www.ssa.gov/medicare/sign-up

Option 3 – If You are turning 65 and need to join Both Part A and Part B – Use: https://www.ssa.gov/medicare/sign-up

Option 4 – You have Part A and need to join Part B currently.  You will be given an SEP (Special Enrollment Period) from the last date of employment that will last 8 months.  To join Part B, you will use: https://www.ssa.gov/medicare/sign-up

In addition, you will need to complete two forms which you will upload if you choose to do this online.  Please follow all instructions.  The forms will be asked for at the end of your online application for Part B.

First Form: CMS 40B – You will complete this form with your Part A card.  It is your responsibility to get this done for yourself, and if you have a spouse in the same situation, they will also need to complete the form.  Here is a link to the form: https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms40b-e.pdf

Second Form: L564E – Your EMPLOYER (whomever now insures you and possible a spouse) You will need one form for you and if necessary, one form for your spouse.  Once again – Your EMPLOYER is responsible to complete this form. Here is the link: https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms-l564e.pdf

Once again, both the CMS 40B and the L564 E will need to be uploaded at the end of your online application on the SSA.gov website.

The balance (SSA locations) is fine – if you could add some more white space between addresses and make the letters a bit darker please.

Applying for Medicaid

In New Jersey, transitioning from a short-term rehab (skilled nursing) stay to long-term nursing home care via Medicaid requires meeting three strict criteria: medical necessity (PAS assessment), an income cap ($2,982/month), and low assets ($2,000).

Medical and Clinical Requirements

Nursing Facility Level of Care: The state must evaluate the patient and confirm they need hands-on help with at least three Activities of Daily Living (like bathing, dressing, eating, or transferring).

 

PAS Assessment: A Pre-Admission Screening (PAS) must be completed by state or county nurses while the person is still in the facility.

Financial Eligibility Rules

Income Limit: Individual monthly income cannot exceed $2,982. If income is higher, a Qualified Income Trust (Miller Trust) must be set up to funnel the excess funds toward care.

 

Asset Limit: Countable resources must be at or below $2,000 for a single applicant.

 

Look-Back Period: New Jersey checks asset transfers made up to 5 years prior to the application to ensure no assets were given away below market value.

Managing the Transition from Rehab

Medicare vs. Medicaid: Medicare short-term rehab coverage stops when daily skilled progress ends, even if the 100-day limit is not fully used.

 

Pending Status: If Medicare ends but Medicaid approval is still pending, the facility's social worker must coordinate with the New Jersey Department of Human Services and the local county board to handle the transition safely.

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