Children age 18 and younger may be eligible for NJ FamilyCare/Medicaid if their family's total income before taxes is at or below 350% of the Federal Poverty Level. For example, in a family of four, that would be $6,723 per month.
Parents may also be eligible if earned income is at or below 133% of the Federal Poverty Level ($2,555 monthly for a family of four).
Applicants must be uninsured (although there are exceptions) and must be either citizens or legal immigrants who have documents that allow them to remain in the United States permanently. Parents/guardians must be legal permanent residents for at least 5 years in order to be eligible (This does not apply to children or pregnant women). There are exceptions to the 5 year rule for qualified aliens, such as refugees, asylees, etc.
To determine if you or your children meet the general and financial eligibility requirements for NJ FamilyCare/Medicaid or to get additional information, you can
How to apply:
Parents whose income exceeds the eligiblity limits for the NJ FamilyCare can purchase health insurance for their children at reasonable rates through the NJ FamilyCare ADVANTAGE program administered by Horizon NJ Health, if they qualify. The cost is $144 per month for one child; $288 per month for two children; and $432 per month for three or more children. To learn more, click here or call 1-800-637-2997
Other Programs for Children Under the age of 21
Children who have "aged out" of the programs described above, or who have other special circumstances, may be eligible for one of the programs described below.
1. Medicaid Special
||Children under the age of 21 who do not qualify for other NJ FamilyCare/Medicaid programs may be eligible for the Medicaid Special Program. Family income for all family members residing in the same household is used to determine financial eligibility. For instance, children 19 or 20 years of age, who have "aged out" of NJ FamilyCare/Medicaid may be eligible if their family has earned income at or below 133% of the Federal Poverty Level (e.g. $2,555 monthly for a family of 4).|
2. Medically Needy
||This special program provides limited health coverage to children under the age of 21 who do not qualify for regular New Jersey Medicaid because their family income or financial resources are too high. It includes a "spend down" provision that allows documented medical expenses to be used to reduce monthly income to meet eligibility limits. Click here to learn more about the Medically Needy Program. A check list is available for what you may need in order to apply.|
Children who qualify for this Medically Needy section of the New Jersey Medicaid are entitled to most Medicaid services except for inpatient hospital care.