Prior to 2014, New Jersey had used the NJ FamilyCare label in a variety of ways. Sometimes it was used to refer to the health insurance coverage that was provided to some New Jersey parents and children under the Children’s Health Insurance Program (CHIP), rather than Medicaid. With the implementation of coverage changes under the Affordable Care Act (ACA), particularly the Medicaid Expansion, New Jersey decided to change the NJ FamilyCare label. As of January 2014, it refers to all Medicaid and CHIP programs administered by the State of New Jersey. All New Jersey Medicaid programs are included, whether they cover childless adults, parents, pregnant women, or children, and whether eligibility is based on income, disability, age, or other factors.
To be eligible for the NJ FamilyCare program, you must meet certain financial requirements. You must also be a resident of New Jersey and be a U.S. citizen or have a qualified immigration status.
Since the ACA changes were implemented in 2014, you may qualify for Medicaid based solely on your income. The income limits depend on whether you are an adult (up to 65th birthday and without Medicare), a child (up to 19th birthday), or a pregnant woman, as shown in the table below.
2020* INCOME ELIGIBILITY LEVELS FOR MEDICAID AND CHIP
Family size
|
Adults 138% |
|
Children to 147% (Medicaid) |
Children 147% to 355% (CHIP)
|
1 |
$ 17,609 |
$ 26,158 |
$ 18,758 |
$ 45,298
|
2 |
$ 23,792 |
$ 35,342 |
$ 25,343 |
$ 61,202
|
3 |
$ 29,974 |
$ 44,526 |
$ 31,929 |
$ 77,106
|
4 |
$ 36,156 |
$ 53,710 |
$ 38,514 |
$ 93,010
|
5 |
$ 42,339 |
$ 62,894 |
$ 45,100 |
$ 108,914
|
6 |
$ 48,521 |
$ 72,078 |
$ 51,686 |
$ 124,818
|
7 |
$ 54,704 |
$ 81,262 |
$ 58,271 |
$ 140,722
|
8 |
$ 60,886 |
$ 90,446 |
$ 64,857 |
$ 156,626
|
* Income is calculated based on the Modified Adjusted Gross Income (MAGI) method.
** Pregnant woman and unborn child count as family of 2.
There are also many Medicaid programs that provide coverage based on other reasons including disability and age. The financial eligibility rules for these other categories look at both income and resources. The income counting rules are different than the MAGI rules.
Here are some examples:
New Jersey has also opted to provide a "medically needy" program for certain categories of individuals who would otherwise be eligible for Medicaid except that they have income or assets that exceed the Medicaid limits. This option allows pregnant women, children under the age of 21, and persons who are aged, blind, or disabled to spend down their excess income on documented medical expenses to meet Medicaid eligibility limits.
Title XIX of the Social Security Act requires states to provide certain basic services to specific categories of persons under the state's Medicaid program. The following services are federally mandated:
States may also receive matching federal monies if they choose to provide other Medicaid-covered services. New Jersey provides these optional Medicaid-covered services to eligible individuals:
You can apply for NJ FamilyCare online at NJFamilyCare or print out an application from their website and mail it to their office; ; or by phone at 1 (800) 701-0710. You can also apply in person at your county welfare office.
Most NJ FamilyCare beneficiaries in New Jersey are required to join a participating HMO to receive most of their health care services. There are currently five NJ FamilyCare HMOs in New Jersey. For more information about these HMOs, visit NJ Medicaid & Managed Care (from the New Jersey Division of Medical Assistance and Health Services).
This information last reviewed: Mar 20, 2020