Medicaid FAQ Sheets

Table of Contents 

• What Is Medicaid?
• What Healthcare Does Medicaid Cover?
• How Much Does Medicaid Cost?
• How to Qualify for Medicaid in New Jersey
• How to Apply for Medicaid in New Jersey
• How to Make Changes to Your Application
• How to Check Your Application Status
• What Happens After You Apply for Medicaid?
• How to Appeal a Denial of Benefits
• What Happens to My Medicaid If I Move?
• Need More Help?
• View or Download Our Free Guide

What Is Medicaid?

Medicaid is a federal U.S. health insurance program that provides health coverage to millions of Americans. The program primarily covers low-income adults, children, pregnant women, elderly adults and people with disabilities.

Federal guidelines for the Medicaid program are established by the Centers for Medicare and Medicaid Services (CMS). Learn more about Medicaid at a national level on the CMS website here.

The New Jersey Medicaid program is administered by the New Jersey Department of Human Services. Learn more about Medicaid in New Jersey on the Department of Human Services website here.

What Healthcare Does Medicaid Cover in New Jersey?

Through Medicaid, people gain access to health care services that may not be affordable without it. Additionally, some programs and benefits include special protections—such as provider networks and payment methods—that help ensure services are accessible. Medicaid also provides preventive care and other services to help people stay healthy and avoid costlier care.

Medicaid covers medical and health care services such as:

• Doctors visits
• Vision and dental care
• Family planning services
• Preventive health education
• Hearing services
• Home healthcare
• Hospice and hospital care (inpatient and outpatient)
• Maternity services
• Mental healthcare
• Nurse midwife services
• Nursing home services
• Prescription drugs
• Transportation services

Medicaid does not cover the following types of medical services:

• Cosmetic procedures or surgeries
• Unnecessary hospital expenses, like TV rentals or meals for guests
• Experimental treatments, supplies, equipment or drugs
• Any services not covered under the State Plan for Medical Assistance

Learn more about medical and health care services that are covered by Medicaid in New Jersey on the Department of Human Services page here.

How Much Does Medicaid Cost?

Medicaid recipients in New Jersey may need to pay a monthly premium, which is a monthly fee for enrollment in the program. Premium amounts are based on the recipient’s annual income.

Recipients may sometimes need to pay a small out-of-pocket cost for treatments, which are known as copayments. Copayment amounts depend on the recipient’s age, household income and what the state pays for the specific service.

Each Medicaid participant through the New Jersey Department of Human Services has their own individual health care plan. Some participants may be required to pay fees, and some recipients may not be required to pay fees, i.e., are exempt.

How to Qualify for Medicaid in New Jersey

To qualify for Medicaid in New Jersey, you must meet all of the following:

• Be a resident of New Jersey
• Be a U.S. citizen or have a qualifying immigration status
• Meet the Medicaid program’s income limits
• Be either a person who is at least 65 years of age, disabled, pregnant, or has dependent children

Income limits vary depending on household size, medical status and other factors and are subject to change annually. Find the current Medicaid income limits based on household size in New Jersey here.

Find further information on New Jersey Medicaid eligibility here.

How to Apply for Medicaid in New Jersey

To apply for Medicaid in New Jersey, complete the following two steps:

1. Choose how you are going to apply, whether online, by mail, or in person.

To apply for Medicaid online, click here to access NJ Family Care.

To apply for Medicaid by mail, call (800) 701-0710 to request an application be mailed to you or click here to access the application form. Fill it out, and mail it with the necessary documents to the address shown on the application.

To apply for Medicaid in person, click here to find your nearest County Board of Social Services.

2. Submit your application.

If you have questions about the application process or require assistance, call New Jersey Medicaid at (800) 701-0710.

Or, contact your nearest local County Board of Social Services. Find contact information for local county offices in New Jersey here or refer to the list below.

How to Make Changes to Your Medicaid Application

New Jersey Medicaid recipients must report changes that can influence their eligibility status. You can report the change in the following ways:

• By phone at (800) 701-0710
• In person at a local New Jersey County Board of Social Services. Find contact information for local offices in New Jersey here.

How to Check Your Application Status

You can check the status of your Medicaid application in person or by phone:

• Click here to find your nearest County Board of Social Services
• Call the toll-free customer service number at (800) 701-0710

What Happens After You Apply for Medicaid?

The New Jersey Department of Human Services will review your application to verify if you are eligible for Medicaid. In some cases, the state may ask for additional information before approving your application. New Jersey will mail applicants a letter detailing if their Medicaid application was approved or denied.

How to Appeal an Application Denial

Medicaid applications will be denied if applicants do not meet the eligibility requirements. Also, beneficiaries can have their benefits terminated or reduced if their eligibility status changes while they are enrolled.

Learn more about New Jersey Medicaid eligibility requirements here.

If your Medicaid application is denied or the amount of your benefits is reduced, you have the right to file an appeal. Your determination letter will include step-by-step instructions for submitting an appeal and the date that you must submit your request by.

The New Jersey Department of Human Services will review your claim and may ask for additional information or evidence of your eligibility. Learn more about the appeal process here.

What Happens to My Medicaid If I Move?

New Jersey Medicaid recipients must report changes that can influence their eligibility status, including relocating to a new address.

If you move to a new residence within New Jersey, you can update your address by contacting the New Jersey Department of Human Services in the following ways:

• Click here to find your nearest County Board of Social Services
• Call the toll-free customer service number at (800) 701-0710

Note: Medicaid benefits do not transfer. If you move to a new state, you must reapply for Medicaid in your new location. If you have further questions about moving with Medicaid, visit the national Medicaid Contact Us here.

Need More Help?

For help with a Medicaid application, or for any further questions about the Medicaid program, contact the New Jersey Department of Human Services at (800) 701-0710.

You can also visit or call a local County Board of Social Services for further assistance. Find your nearest County Boards of Social Services location and contact information here.

View or Download Our Free Guide

While we are not affiliated with the government in any way, our private company engaged writers to research the Medicaid program and compiled a guide and these answers to frequently asked questions. Our goal is to help you get the benefits that you need by providing useful information on the process.

Our free Medicaid Guide is filled with helpful information about how to apply, program eligibility and how to get in touch with local offices. You can view or download our free guide here.

Last Updated: September 22, 2022