An Overview of Medicaid Services Available in New Jersey

Healthcare is a necessity for everybody. However, as the cost of living rises in New Jersey, many residents of the Garden State worry about being able to afford essential healthcare services for themselves and their families. Luckily, New Jersey offers a variety of Medicaid services, making affordable medical care available to its citizens.

This guide will introduce you to Medicaid, New Jersey’s various Medicaid programs, and what factors are considered when applying.

What is Medicaid?

Medicaid is a joint federal & state program providing affordable healthcare to eligible individuals with limited income and resources. Medicaid saw a great deal of expansion in 2010, when the Affordable Care Act was implemented.

While states may opt out of participating in Medicaid, all 50 states administer Medicaid programs. States are subject to federal regulations, but are given a great degree of latitude to determine eligibility criteria and services offered.

What factors are considered when determining eligibility for Medicaid?

As we will explain in the next section, New Jersey offers a number of Medicaid programs. While each program has its own set of specific eligibility requirements, the main factors considered are age, health status, current insurance need, income, assets, and residence.

What Medicaid programs are available in New Jersey?

NJ FamilyCare, sometimes referred to as Affordable Care Act Medicaid, is New Jersey’s primary vehicle for administering affordable healthcare to its residents. In general, to qualify for NJ FamilyCare, you must be between the ages of 19 and 64 and not otherwise eligible for other Medicaid or Medicare programs. NJ FamilyCare covers a variety of services, including doctor visits, eyeglasses, hospitalizations, lab tests, prescriptions, dental care, and more.

New Jersey Care for the Aged, Blind, and Disabled, also known simply as “ABD,” is a special Medicaid program. As the name suggests, ABD provides services for individuals who are 65 or older and determined blind or disabled by the Social Security Administration or the state of New Jersey. Like NJ FamilyCare, ABD Medicaid covers doctors visits, hospitalization, mental health services, prescriptions, long term services and supports, and more.

If you are eligible for Social Security Income, you may automatically receive full ABD benefits. However, you can still receive only the Medicaid component if you do not receive Social Security Income.

New Jersey WorkAbility is another special Medicaid program. WorkAbility provides services for individuals who are between the ages of 16 and 64, who are working (either full time or part time), are disabled, and meet the relevant asset and income requirements. WorkAbility allows you to be eligible for Medicaid even when your SSDI would otherwise disqualify you from other programs.

Managed Long Term Services and Supports, or “MLTSS” for short, is a program providing long-term care for individuals who require assistance with three or more activities of daily living. Activities of daily living include mobility assistance, dressing, bathing, eating, and other forms of self-care. Individuals who receive MLTSS may require placement at a nursing home or assisted living facility or receive services at home.

Qualifying for MLTSS can be slightly more challenging than qualifying for other Medicaid programs. When you apply for MLTSS, you are subject to Medicaid’s five year lookback period and to estate recovery rules. When applying for MLTSS, we recommend working with a local attorney with an elder law practice like our own. An elder law attorney can help you qualify for MLTSS in a number of ways, including helping you set up a Qualified Income Trust. A Qualified Income Trust allows you to remain eligible for MLTSS despite exceeding its income limits.

Conclusion

In New Jersey, there are plenty of options for affordable healthcare depending on your circumstances. Whether you qualify for New Jersey FamilyCare, ABD, WorkAbility, or MLTSS, the Garden State has you covered.

At The Chamberlain Law Firm, our elder law attorneys are experts on the MLTSS process and are here to help you access affordable long-term care. Give us a call today at (201) 273-9763 to set up a consultation. For more information and tips about Medicaid, be sure to read our Insight Articles.

This article is for informational purposes only. It is not intended as legal advice. In the event you would like to speak with a lawyer about the specifics of your case, contact The Chamberlain Law Firm at (201) 273-9763 to schedule a consultation.