Income Eligibility and Cost
Medicaid Eligibility changes effective October 1, 2013
New federal rules change Medicaid eligibility by streamlining the populations we cover under NJ FamilyCare.
NJ FamilyCare will now cover: children, pregnant women, parents/caretaker relatives, and single adults/childless couples.
There are no changes in eligibility for anyone applying for the Aged, Blind or Disabled program or those in Long Term Care.
- Children 18 and under will continue to be eligible with higher incomes up to 350% FPL ($82,425 for a family of four).
Parents still need to renew the coverage each year.
- Parents/Caretaker Relatives with income up to 133% FPL ($31,322 for a family of four) must have tax dependent children in their household in order
to be eligible under this category. This is a new Medicaid Expansion eligibility group. Dependent children in the household must be insured also.
- Adults without dependent children among ages 19-64 with incomes up to 133% FPL ($15,282 single/ $20,629 couple) are considered to be another new
Medicaid Eligibility Expansion Group.
- Pregnant Women up to 200% FPL (31,020 family of two). There are no changes.
New Income and Household Size Calculations
Beginning October 1, 2013, financial eligibility for individuals seeking eligibility for NJ FamilyCare will based on their Modified Adjusted Gross Income or
MAGI. This means the income and household size will be determined by their latest federal tax return which when filed, can be electronically verified.
This new Tax Based Household size provides a simplified income calculation. Before, income was counted for parents/guardians and children up to
age 21 that were living in the household and in some cases counted earned and unearned income separately.
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