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Medical Assistance Programs in New Jersey

In New Jersey thousands of residents are unable to cover the cost of basic medical care. For these low-income families, obtaining access to health care is critical to assisting New Jersey in breaking the cycle of poverty within the state. Many medical assistance programs are offered to the medically needy and those who cannot obtain health care through the state run health exchange. Some programs are focused on the specific health care needs of children, while others offer medical assistance to women or those who are suffering from chronic or debilitating illnesses. Most programs require a New Jersey resident to fall within income guidelines established by the federal and state government. Additional information, such as household size, citizenship and ability to work may be factored in. As government programs, many of the following medical assistance services work alongside several others, to make sure that the coverage offered is comprehensive and complete. The following offers a brief summation of the benefits and services offered to those who need medical assistance in New Jersey.

Medicaid in New Jersey

As one of the largest programs in New Jersey, Medicaid offers a wide range of services for many low-income individuals and vulnerable populations. Low-income New Jersey residents, low-income families with children, certain low-income women and residents with existing medical conditions are all eligible to apply for care under the Medicaid program. Medicaid provides comprehensive coverage for many medical services including doctor’s visits, medication, hospital stays and nursing home care. The New Jersey FamilyCare program is offered specifically to children who fall at or below the 350 percent of the federal poverty guideline. Parents can qualify if their income is at or below the 133 percent level. Those who apply for this program must not be eligible for any other types of health care coverage. There are specific enrollment periods (usually October through November 15). During this time participants can choose a health plan with the effective date staring in January. However, these plans can be changed at any time if there is good cause. Legal immigrants who are adults must have had their legal status for five years to be eligible for this program. However, legal immigrant children under the age of 18, or pregnant women, do not have this time requirement.

Foster care children who have “aged out” of the Medicaid system can still obtain coverage, if they are still under the age of 21 and do not qualify for other programs. Additionally, children under the age of 21 who are not qualified to receive regular Medicaid in New Jersey because of income requirements can apply to be part of the Medically Needy program.

New Jersey Workability

This program has been designed for New Jersey residents who are disabled and working. The New Jersey Workability health coverage is issued to the working disabled whose earnings might otherwise make them ineligible to receive Medicaid. There are earned income limits with this program, but money received from disability benefits and railroad retirement benefits are not included in the overall income.

WorkFirst New Jersey

This program is called Temporary Assistance for Needy Families (TANF) in most states. In NJ, the program is referred to as WorkFirst New Jersey. This program offers cash assistance, including medical support, for individuals and families who are struggling to make ends meet and often cannot afford to continue their medical coverage. Unlike other TANF programs, this program in NJ is also available to individuals without children. Services are limited to five years.

Catastrophic Illness in Children Relief Fund

Families with children who have incurred significant medical debt can apply for relief through this NJ program. The program can cover ongoing expenses which can include outpatient care, medical equipment, modifications to the home, medical transportation or acute /specialized care.

Division of Developmental Disabilities

This program offers services to New Jersey residents who have intellectual disabilities, autism, spina bifida, cerebral palsy and traumatic brain injuries. Many of the services include counseling, 24-hour care, respite care for caregivers and offers skill development for different supportive agencies.

New Jersey Health Care Exchange Subsidies

As part of the affordable care act, New Jersey offers subsidies to families and individuals who make below the income limits established by the program at the federal level. New Jersey residents complete the information requested through the exchange and those who qualify will be able to receive health care coverage at a greatly reduced rate.

New Jersey Medicare Programs

New Jersey Medicare Programs are in compliance and are similar to other Medicare programs in other states. Residents in New Jersey who have worked at least ten years within the U.S. and made payments into Medicare will receive Part A for free. The other parts of Medicare include Part B, C, and D. These other parts are optional, but Part B offers what most consider to be traditional health care coverage. Part C offers NJ residents a combination of Part A and B with expanded coverage that often includes dental, vision and hearing services. New Jersey residents are automatically enrolled for the Part A upon their 65th birthday, but additional coverage must be arranged by the enrollee through private participating insurance companies.

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