A New Jersey appeals court rules that a Medicaid recipient's wife is not entitled to an increase in her minimum monthly maintenance needs allowance (MMMNA) because she did not demonstrate that her financial duress was caused by exceptional circumstances. K.L. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., A.D., No. A-3288-10T1, March 9, 2012) (unpublished).
K.L. entered a nursing home and applied for Medicaid benefits. His wife, B.L., received $1,637.95 from K.L.'s monthly income as her MMMNA and the remainder of K.L.'s income went to the nursing home. K.L. filed an appeal, arguing that the MMMNA was insufficient to cover B.L.'s expenses.
The state determined that B.L. did not demonstrate exceptional circumstances resulting in financial duress. B.L. appealed, arguing she was entitled to an increase to help pay for repairs due to flood damage, pay premiums on four life insurance policies, and cover expenses such as cellphone and Internet access.
The New Jersey Superior Court, Appellate Division, affirms, holding that B.L. is not entitled to an increased MMMNA because she did not demonstrate that her financial distress was caused by exceptional circumstances. According to the court, although the flood damage is not an exceptional circumstance because it should be covered by homeowner's insurance, B.L.'s MMMNA may be adjusted if she is not fully reimbursed by insurance. The court also notes that the payment of life insurance policies is not an exceptional circumstance.
For the full text of this decision in PDF, go to: https://njlaw.rutgers.edu/collections/courts/appellate/a3288-10.opn.html.
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