Medicaid

Medicaid – (856) 225-8800

Medicaid is the Federal/State Health Assistance program that provides payment for pharmacy, doctor, hospital, optometry and dental care to eligible needy persons. Medicaid benefits may be provided to eligible persons through Health Maintenance Organization (HMOs). Medicaid also pays for nursing home care for eligible individuals.  These programs have different eligibility criteria and covered services.

Medicaid Only – Provides medical assistance to income/resource eligible aged, blind or disabled individuals or couples, based on living arrangements in the community, or to an individual in need of a Title XIX facility for 30 consecutive days.

Medicaid Assistance Program – Provides Medicaid benefits to Work First NJ recipients who meet the eligibility requirements of the former AFDC program (Aid to Families with Dependent Children).

Community Care Program for the Elderly and Disabled – This programs provides home health services to qualified elderly and disabled individuals, as an alternative to nursing homes.

Home and Community Based Services Programs for Blind or Disabled Children and Adults (Model Waiver) – This program is similar to the Community Care Program for the Elderly and Disabled in that it is designed to offer an array of home health services to help maintain qualified individuals in their own homes, rather than in an institutional setting. Eligible individuals however, must be disabled and can be children.

The New Jersey Medicaid Traumatic Brain Injury Program (TBI)– The Traumatic Brain Injury Program is a Federal Waiver program which offers home and community-based services to persons disabled by a traumatic brain injury. Eligible applicants must be 18 to 65 years of age and meet certain medical requirements regarding brain injuries.

Medically Needy Program – This program offers Medicaid coverage with limitations to individuals 65 years or older, persons blind or disabled, children under 21 or pregnant women who have income or assets too high to qualify for other Medicaid programs.

New Jersey Care…Special Medicaid Program
HealthStart – Medical assistance presumptive eligibility program that offers prenatal care to eligible pregnant women prior to application for Medicaid benefits and while application is being processed. The qualified HealthStart provider completes the application for Presumptive Eligibility.

NJ FamilyCare – can help meet the health care needs of families with children, single adults and married couples without children who do not have health insurance coverage. Eligibility is based on income and the number of people in the family.

Caregiver Assistance Program – supplements the assistance a qualified individual receives from his/her natural support network of family, friends, neighbors, community agencies and volunteer groups. This program is designed to provide supports and services that enable the individual at risk of placement in a nursing facility to remain in his/her community home.

Qualified Medicare Beneficiary (QMB) Program – Provides eligible recipients with payment of the Medicare Part B medical insurance premium and deductibles.

Medical Emergency Payment Program for Aliens – may provide payment for emergency services to persons who are not eligible for Medicaid or FamilyCare because citizenship/alien requirements for these programs have not been met. Eligible applicants must be 65 years of age or older, blind, or permanently disabled, pregnant, under age 21 or a caretaker relative of children under 18 years of age and meet income guidelines.

Work Ability – Provides MEDICAID coverage to disabled persons between 16 and 64 who are employed and earn under $47,340 a year.