NJ Family Care
What is it?
What does it covers?
Who is eligible?
Immigrant Information
Questions & Answers
What it Costs
Choosing a Health Plan
Need help enrolling?
Application download
Online Application
County Enrollments
Using Your Benefits
Helpful links

Application download

You can download a copy of the English Application or Spanish Application as an Acrobat PDF and print it. Use legal sized paper if available. If you need more information about PDF's, click on the Get Acrobat Reader Button below -- it's free. If you have any question or need help filling out the application, you can call 1-800-701-0710 for assistance. After filling out the application, send it to:

NJ FamilyCare
P.O. Box 8367
Trenton, N.J. 08650-8367

If you have Acrobat Reader, download the application. English Application | Spanish Application




If you wish, you can also download:

English:  Application Instruction
 Rights and Responsibilities
 Privacy Brochure
 Privacy Officers

Spanish:  Application Instruction
 Rights and Responsibilities
 Privacy Brochure
 Privacy Officers


If you don't have Acrobat Reader, it's free just click the Get Acrobat Reader button.

Get Acrobat Reader

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