You must apply for Medicaid in New Jersey through your county board of social services. You have the right to an interpreter if you speak a language other than English, and you have the right to bring someone with you to help you with the application or represent you during the application process. If you are bedridden, you may request that a Medicaid caseworker come to your home to take your application.

Some New Jersey hospitals and federally qualified health centers have “outstation” workers who will process a shorter form of the Medicaid application for pregnant women and children. If you are not eligible for Medicaid because of your immigration status, please read Emergency Medical Assistance for Immigrants for information about Medicaid coverage for medical emergencies, including labor and delivery.

What proof do I have to show when I apply?

You must show proof of identity, residency, household income and, for some Medicaid programs, proof of disability and amount of resources. (Note: the home you reside in is not counted as a resource for Medicaid eligibility.) You also must show proof of citizenship status and provide your Social Security number. Household members who are not applying for Medicaid, including parents of children, do not have to furnish their Social Security numbers.

How long does it take?

Medicaid must process your application within a reasonable amount of time and give you a written explanation if there is a delay. You also have a right to a copy of your completed application if you ask for it. If you are determined eligible for Medicaid and you have unpaid medical bills from the three-month period immediately before the month of your Medicaid application, the state will pay for those services if you were eligible for Medicaid at the time of the service. This is called “retroactive eligibility,” and you must apply for this coverage within six months of the date of your Medicaid application.

What if Medicaid decides that I’m not eligible?

Medicaid must give you a written denial that describes the legal basis for Medicaid’s decision. This document must also inform you of your right to appeal this decision by requesting a fair hearing within 20 days of the date of the written denial. If you ask for a fair hearing, you have the right to see your case file, review the Medicaid manual that Medicaid used to make their decision, submit evidence, and bring witnesses to the fair hearing. You also have the right to hire legal counsel or to ask for free legal help from your local Legal Services office if you are eligible for their assistance. You also have the right to appeal the judge’s decision if you do not agree with it.

New Jersey

County Boards of Social Services

This article originally appeared in the April 2003 issue of Looking Out for Your Legal Rights®.

Last legal review 3/10/05.