How to Get New Jersey Medicaid Benefits?

We have scoured the internet to provide you with all you need to know about the New Jersey Medicaid benefits.

Medicaid is a joint federal-state initiative that covers health insurance for low-income people who qualify, including children, pregnant women, the elderly, and people with disabilities. It is simple to apply for Medicaid in person, over the phone, or online.

This post will teach you all you need to learn about Medicaid in New Jersey.

What is the New Jersey Medicaid Program?

Medicaid is a service for people and families with income and resources within specific parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.

Who is eligible for the New Jersey Medical Program?

New Jersey  Medicaid offers particularly limited Medicare beneficiaries to;

• Expectant mothers
• People who are blind or disabled or who have a spouse who is blind or disabled; 
• People whom someone adopts;
• People whom someone adopted; 
• People who are blind or disabled or have a spouse who is disabled.

The Annual Household Income Limits (before taxes)

*For households with more than eight people, add $6,277 per additional person.

How do I contact Medicaid in New Jersey?

Phone

1-800-701-0710

Mailing Address

NJ Department of Human Services Division of Medical Assistance and Health Services PO Box 712. Trenton, NJ 08625-0712.

What are the Medicaid plans in New Jersey?

PACE program

The state will add long-term services and supports, mental health programs, and host-based and network services to its managed care programs from 2013 to 2014. Many of these populations will be moving from fee-for-service to managed care. 

Delivery System and Reform Incentive Payment (DSRIP)

Due to unanticipated delays in completing the DSRIP Going to Plan Protocol and DSRIP Funding & Mechanics protocols, CMS approved an amendment request to modify the Delivery System and Reform Incentive Payment (DSRIP) program so that the Hospital Relief Subsidy Fund (HRSF).

The NJ Family Care program

Under the NJ Family Care program, New Jersey now has agreements with four managed care plans, including three for-profit national plans and one not-for-profit regional plan (Horizon NJ).

How do I apply for New Jersey Medicaid?

Call: 1-800-701-0710 to enroll. 

Apply in person: NJ Department of Human Services Division of Medical Assistance and Health 

Online:  Visit New Jersey Medicaid website.

Mail: To Services PO Box 712. Trenton, NJ 08625-0712.

What is covered by New Jersey Medicaid?

The following services are covered by New Jersey Medicaid:

Can I have both New Jersey Medicaid and Medicare?

A Dual Eligible Special Needs Plan is available to New Jersey citizens who are “dual eligibles,” who have both Medicare and Medicaid (D-SNP, pronounced “dee-snip”). 

A D-SNP is a distinct type of Medicare-managed care plan that unifies all Medicaid and Medicare-managed care benefits under one health plan.

New Jersey Waiver

Following are the waivers of New Jersey:

• Home and community-based services waiver for the developmentally disabled
• Traumatic brain injury (TBI) waiver

Copayments?

They do not have to pay a copayment; when a member is: 

• under 21 years old; 
• pregnant; 
• Held by the state
• Placed under government supervision
• Native American participants who qualify for Contract Health funding
• Services or Tribal Union of Indian Health Services
• Residing in one of the facilities listed below and funding a portion of their care:
• The hospital (inpatient)·
• A facility for skilled nursing
• A nursing home

What is not covered by New Jersey Medicaid?

NJ Medicaid is not mandated to offer coverage for in-home caregiving services or private nursing. Bandages, adult diapers, and other disposable items are frequently excluded from insurance coverage, as well as cosmetic surgery and other elective procedures.

What is the highest income limit for New Jersey Medicaid?

The NJ Medicaid Programs are for those whose gross monthly income is at or below 100% of the Federal Poverty Level, which in 2022 will be $1,133 for a single person and $4,000 for a couple; $1,526 for a single person and $6,000 for a couple.

What if a person’s income is too high to qualify for regular Medicaid benefits?

If your income is too high, you may still be eligible for New Jersey Medicaid, thanks to the asset spend down option. Paying down your surplus assets on non-countable ones will allow you to qualify.

Will you still have New Jersey  Medicaid once you are over 18?

You may be eligible for Medicaid if you are 19 years or older or your family has a low income.

What documents do I need to apply for Medicaid?

• The following papers must be included with the application.
• The Social Security Number;
• Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
• Evidence of all income sources, both legal and illegal 
• Proof of origins 
• Proof of residency 
• Including the Medicare card, any insurance cards
• Pregnancy (doctors’ certification of the pregnancy and, if applicable, the expected delivery date);
• When non-parents apply for Medicaid on their behalf, they must provide proof of their financial position.
• dicaid on their behalf, they must provide proof of their financial position.

What is the best Medicaid in New Jersey?

Among all the participating Medicaid plans in the state, Horizon NJ Health, a Horizon Blue Cross Blue Shield of New Jersey, has the best Medicaid managed care rating.

Where do I find the letter showing the reason(s) for denial or discontinuance from New Jersey Medicaid?

By signing into your account at Portal, you can see the progress of your New Jersey Medicaid application.