To be eligible for New Jersey Medicaid, a person must
- Be a resident of New Jersey
- Be a U.S. Citizen or qualified alien most immigrants who arrived after August 22, 1996 are barred from Medicaid for five years, but could be eligible for NJ Family Care.
- NJ Family Care is a federal and state funded health insurance program created to help New Jersey’s uninsured children and certain low-income parents and guardians to have affordable health
- NJ Family Care also includes certain programs for pregnant women. Go to www.njfamilycare.org for more
- Meet specific standards for financial income and resources
Please visit http://www.state.nj.us/humanservices/ddd/services/medicaideligibility.html
Supplemental Security Income (SSI)
SSI makes monthly payments to people with low income and limited resources who are 65 or older, or blind or disabled. Your child, younger than age 18, can qualify if he or she meets Social Security’s definition of disability for children and if his or her income and resources fall within the eligibility limits.
When the Social Security Administration decides if a person can get SSI, it considers his/her income and resources. It also considers the income and resources of family members living in the child’s household. These rules apply if the child lives at home. They also apply if he or she is away at school but returns home from time to a dependent or has guardianship.
If the child’s income and resources, or the income and resources of family members living in the child’s household, are more than the amount allowed, the Social Security Administration will deny the child’s application for SSI payments.
It is highly recommended that individuals apply for SSI as soon as possible after his/her 18th birthday. Individuals receiving SSI will automatically receive Medicaid – required for DDD eligibility. Establishing SSI eligibility at 18 can help an individual maintain Medicaid eligibility as a “1634 DAC” (Disabled Adult Child) even if the individual later receives Social Security Disability (SSD) through a parent who has retired, become disabled, or died.
For more information, please visit http://www.ssa.gov/pubs/10026.html#ssi-benefits
Catastrophic Illness in Children Relief Fund Commission
The Catastrophic Illness in Children Relief Fund (CICRF) is a financial resource to help New Jersey families, regardless of income, cope with medical expenses for their children that are not fully covered by insurance, state or federal programs, or any other source, such as fundraising. The Fund provides a financial safety net to families struggling with a child’s previously incurred medical expenses. The definition of a catastrophic illness in this program is economic and is measured in terms of the financial impact of health care expenses on the family, rather than on the diagnosis or severity of the illness.
Eligibility criteria include:
- Uncovered medical expenses in any prior, consecutive, 12 month period, dating back to 1988
- Eligible expenses must exceed 10% of the first $100,000 of a family’s annual income, plus 15% of any income over $100,000.
- The child must have been 21 years or younger when the medical expenses were
- The child’s family or legal guardian have been residents of New Jersey for at least 3 months prior to the date of Temporary residents of any type are not eligible to apply.
The Fund pays traditional medical expenses such as physician, hospital and pharmacy services. The Fund also assists with non-traditional expenses such as home modifications, modified vans and funeral expenses not usually covered by insurance. All expenses are subject to established caps and program regulations.
You can contact the Catastrophic Illness in Children Relief Fund Program at 1-800-335-FUND (3863) or visit their web site at http://www.njcatastrophicfund.org
Support can be found through New Jersey’s departmental resources – https://fasdnj.org/state-agencies-providing-services/
New Jersey’s Child Evaluation Centers support individuals and families contending with challenges associated with developmental disabilities like FASD – https://fasdnj.org/child-evaluation-centers/
The Perinatal Consortia of NJ are a valuable resource to individuals and families in all part of our state – https://www.state.nj.us/health/fhs/maternalchild/consortia.shtml
Self Help Recovery Groups have a long history of assisting many people in of support – https://ncaddnj.nationbuilder.com/recoveryandselfhelp
If a person is not eligible for Medicaid or does not have other forms of health coverage please consider the following:
- Federally Qualified Health Centers (FQHCs) (https://nj.gov/health/fhs/primarycare/fqhc/) – New Jersey’s Federally Qualified Health Centers (FQHCs) deliver high quality health care to all people regardless of their ability to pay. You don’t need health insurance to receive care at a health center. They serve the uninsured as well as patients with Medicaid, NJ FamilyCare, Medicare and private insurance. If you are uninsured, fees are charged based on your income level using a sliding fee scale. No one is every turned away for lack of funds.