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New Jersey Medicaid Guidelines

New Jersey Medicaid is a joint state and federal health care program designed to provide insurance to low-income and medically needy residents. To receive coverage, certain requirements must be met. Medicaid covers a wide range of services and treatments, including hospital care, doctor visits, prescriptions, nursing home and hospice needs. To apply for Medicaid, visit the New Jersey Department of Human Services.

  1. Citizenship and Residency

    • To receive Medicaid in New Jersey, you must be a resident. You must also be a U.S. citizen or legal alien. If you a legal immigrant who arrived after August 22, 1996, you must reside in the country for at least five years before applying for coverage. The restriction does not apply to pregnant women or those in need of emergency care. Proper documentation to confirm citizenship is required for all household members. A certified certificate, government issued identification card, Social Security card or immigration documents will suffice.

    Eligibility Categories

    • Medicaid is only open to certain eligibility groups. Children, families with dependent children, pregnant women, elderly and disabled or blind can apply for Medicaid in New Jersey. Those who are disabled or legally blind must have verification from the Social Security Administration.

    Income Limits

    • Medicaid is open to low income applicants. The income guidelines are based on eligibility group and household size. For example, pregnant women are allowed an income of up to 200 percent of the Federal Poverty Level (FPL). A pregnant women is counted as two individuals. In 2011, a family of three cannot exceed $3,052 per month. For children under 21, the family cannot have an income exceeding 133 percent of the FPL. The limit for a family of four is $2,444 a month. Elderly, blind and disabled on SSI must receive less than $705.25 monthly for an individual and $1,036.36 for a couple. Those not on SSI cannot exceed $903 for a single person or $1,215 for two household members. Nursing home limitations are higher. In 2011, the income limit is $2,022 per month for long-term care.

    Resources

    • There are no asset restrictions for children or pregnant women. Medicaid applicants receiving SSI benefits are allowed no more than $2,000 for individuals and $3,000 for couples. A person applying for nursing home coverage is also limited to $2,000. Resource limits are higher if there is a healthy spouse. Elderly, disabled or blind individuals not receiving SSI can have $4,000. Couples are allowed $6,000.

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