New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 49 - ADMINISTRATION MANUAL › Subchapter 2 - NEW JERSEY MEDICAID BENEFICIARIES › Section 10:49-2.2 - Persons eligible under the New Jersey Medicaid program

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The eligibility
				rules for persons eligible under the regular New Jersey Medicaid program are
				included in N.J.A.C. 10:69, 10:70, 10:71, 10:72, 10:78 and 10:79.
(b) The following groups may be eligible for
				medical and health services covered under the New Jersey Medicaid program
				requirements as outlined in the second chapter of each Provider Services
				Manual. The list is not all inclusive but is intended to provide an overview of
				some of the types of individuals who may be eligible for Medicaid benefits,
				when provided in accordance with the requirements of N.J.A.C. 10:69, 10:70,
				10:71, 10:72, 10:78 and 10:79, as appropriate.
1. Persons who are eligible to receive
				Supplemental Security Income (SSI) payments as determined by the Social
				Security Administration and those persons who meet the SSI standards but apply
				for the Medicaid Only program through the CWA. Those persons are the aged (65
				and over), the blind, and the disabled;
2. A person who qualifies under the
				Supplemental Security Income (SSI) program as the "ineligible spouse" of an SSI
				beneficiary determined by the Social Security Administration;
3. For a period of one year, a child born to
				a woman who is a Medicaid beneficiary, so long as the woman remains eligible
				for Medicaid, or would remain eligible if pregnant;
4. Persons for whom adoption assistance
				agreements are in effect pursuant to Section 473 of the Social Security Act (
				42 U.S.C. §
											673 ) or for whom foster or adoption
				assistance is paid under Title IV-E of the Act;
5. Persons ineligible for Supplemental
				Security Income (SSI) because of requirements that do not apply under
				Medicaid;
6. Persons receiving only
				mandatory State supplemental payments administered by the Social Security
				Administration;
7. Certain former
				beneficiaries of Supplemental Security Income (SSI) who would still be eligible
				for SSI except for entitlement to or increase in the amount of Social Security
				benefits;
8. Persons eligible for
				but not receiving TANF or an optional State benefit;
9. Children under the age of 21 years who
				meet the income and resource requirements for TANF but do not qualify as
				dependent children;
10. Persons who
				are in institutions for at least 30 consecutive days and who are eligible under
				a special income level (the Medicaid "cap") that is higher than the income
				level for a noninstitutionalized SSI or State supplement beneficiary;
11. Pregnant women and children up to the age
				of one whose income is below 185 percent of the Federal poverty level, and
				children up to the age of six whose income is below 133 percent of the Federal
				poverty level, codified as
				42 U.S.C. §
											1396a, or 1902(l) of the Social Security
				Act;
12. Aged, blind, and disabled
				persons whose income is below 100 percent of the Federal poverty level and
				whose assets are within 200 percent of the SSI asset limits;
13. For a period lasting through the end of
				the month following the 60th day following delivery, women who have applied for
				Medicaid benefits before the last day of pregnancy and who are eligible for
				Medicaid on the last day of pregnancy; and
14. Refugees who are eligible under the
				Refugee Resettlement program.