New Jersey State Medicaid Programs

The New Jersey Medicaid program provides health insurance to eligible low-income state residents. New Jersey Medicaid established several special programs designed to provide medical, dental, and prescriptions services to individuals who qualify. Eligibility is determined by residency, citizenship, and income guidelines.

New Jersey Medicaid Services

• The New Jersey Medicaid program has mandatory and optional services. Mandatory services provided for all New Jersey Medicaid recipients include inpatient and outpatient hospital treatment, laboratory and test x-rays, home health care, physician services, assistance with family planning, nursing care for individuals ages 21 and older, and early and periodic screening, diagnostic, and treatment services. Optional services are for individuals enrolled in specific programs. Optional services include dental care, optometry services, treatment in residential treatment centers, hospice care, and private nursing care.

Family Care

• The New Jersey Family Care/Medicaid program is available to eligible children under age 18 and parents that meet income requirements. Children under 18 years old must live in a household where the maximum total gross income is at or below 350 percent of the federal poverty level. Parents must earn incomes at or below 125 percent of the federal poverty level. All participants must not have insurance coverage. United States citizenship or legal immigrant status is required for individuals to receive Medicaid coverage.

Emergency Payment Program for Aliens

• The Emergency Payment Program for Aliens provides medical assistance for illegal immigrants that meet all other Medicaid eligibility requirements. Immigrants are subject to a five-year ban on Medicaid eligibility if they came to the United States on or after Aug. 22, 1996. However, qualified aliens may receive emergency coverage if they are subject to the five-year ban and meet all other requirements. Immigrants receiving emergency care must inform the hospital that they wish to apply for the Emergency Payment program. The hospital may take the application or refer the individual to a county welfare office to complete and submit an application.

Aged, Blind, and Disabled

• New Jersey offers a special Medicaid program for eligible aged, blind, and disabled individuals who are not eligible for regular New Jersey Benefits because of high income or resources. For individuals who are not blind or disabled, the minimum age limit to participate is 65. The Social Security Administration or the Division of Medical Assistance and Health Services must declare individuals blind or disabled if they are under 65 years old. Services offered include acute care general hospitals, nursing facilities, facilities to assist the developmentally disabled, and psychiatric hospitals for individuals under 21 and over 65 years old.

New Jersey Workability

• The New Jersey Workability program is designed to provide Medicaid assistance to eligible disabled individuals who are working and earning an income that makes them ineligible for regular Medicaid benefits. Age requirements for eligibility are between 16 and 64. Individuals must work full-time, part-time, or self-employed and show proof of income. The Social Security Administration or the Disability Review Team at the Division of Medical Assistance & Health Services must determine that individuals have a permanent disability. The maximum total gross income is $54,948 for an individual and $73,644 for couples.