New Jersey Application for Presumptive Eligibility for Medicaid

State:
Multi-State
Control #:
US-0538BG
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PDF
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Description

Use this form to find out quickly if you qualify for presumptive eligibility for Medicaid. Presumptive eligibility offers you and your family immediate access to health care while you apply for regular Medicaid or other health coverage.
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  • Preview Application for Presumptive Eligibility for Medicaid
  • Preview Application for Presumptive Eligibility for Medicaid
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FAQ

Adults age 19-64 with income up to 138% FPL ($1,677/month for a single person and $2,268/month for a couple).

New Jersey Health Plan Savings are available to eligible households with annual incomes up to 600% of the federal poverty level. In 2024, an individual with an income of up to $87,480 and a family of four who makes up to $180,000 can receive state subsidies to lower the costs of health coverage.

Parents of Dependent Children: Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

Who is eligible for New Jersey FamilyCare (NJFC)? Household Size*Maximum Income Level (Per Year)4$105,0005$122,9906$140,9807$158,9704 more rows

Department of Human Services | Medical Emergency Payment Program (MEPP) MEPP covers emergency services, including labor and delivery, for New Jersey residents age 19 and older who do not qualify for NJ FamilyCare because they do not meet the U.S. Citizenship or immigration requirement.

The Presumptive Eligibility (PE) for Pregnant Women Program was created to allow Medi-Cal Providers to grant immediate, temporary Medi-Cal coverage for ambulatory prenatal care and prescription drugs related to pregnancy to low-income patients, pending their Medi-Cal or health insurance affordability program ...

For an adult to qualify for NJ FamilyCare, the total family income must be at or below 138% of the Federal Poverty Level. For a single person, that is $1,677 a month; for a family of 4, that is $3,450 a month (2023 guidelines).

Presumptive eligibility allows children to get access to Medicaid or CHIP services without having to wait for their application to be fully processed.

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New Jersey Application for Presumptive Eligibility for Medicaid