Medicaid was set up by the federal government; however it is administered by the states. Medicaid is a federal program for low-income people and in New Jersey there are specific rules that apply in order to be eligible. Medicaid provides health insurance to people who are over 65, the blind, disabled, pregnant, dependent children and caregivers. So, no, it’s not all about nursing homes or assisted living facilities!

Medicaid provides comprehensive coverage for inpatient and outpatient services. This coverage includes many services and costs associated with healthcare and caregivers. What is not covered is prescription drugs, eyeglasses, diagnostics and preventative care. Each state has its own set of coverage amounts and New Jersey specifically has its own regulations, rules, and coverages it provides to those who qualify. Medicaid can also be used to pay Medicare deductibles and Medicare premiums.

There are a few very basic requirements to be eligible for Medicaid in New Jersey:

1. Must be a resident of New Jersey
2. Must be a U.S. Citizen or qualified alien*
3. Meet financial standards for income and resources.
4. (Sometimes) there are specific medical criteria.

*Immigrants who arrived after August 22, 1996 are barred from Medicaid for 5 years.

New Jersey Medicaid has several specific (or “waiver”) programs for people who may not qualify for traditional eligibility, such as Home and Community-Based Programs and Global Options for seniors and people with disabilities. There is also a program to help immigrants who experience medical emergencies, meet the requirements for New Jersey Medicaid but not their immigration status. Many of the Medicaid applicants are considered on an individual basis for long-term care and other programs. This individual basis is where you might find a need for an elder law attorney. If you are looking for more information or need to determine if you qualify or have been denied for many of the programs offered by the New Jersey Medicaid program I would be happy to help. Feel free to call me to discuss how we can help you secure the coverage you need.