New Jersey Medicaid Expansion Information Released

Federal and state officials are beginning to provide information so the uninsured can begin to apply for health coverage beginning October 1. Information is available at the Health Insurance Marketplace.

The following is a reprint of information recently posted to a New Jersey Family Care
web page.

Medicaid Eligibility Changes Effective October 1, 2013

The Affordable Care Act changes the Medicaid eligibility rules 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.

ACA Standardizes 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. Prior to ACA, the 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.

Health Insurance Marketplace: Open Enrollment Begins October 1, 2013

Starting in less than two months health care consumers will be able to apply for health coverage through a new system created by the Affordable Care Act (ACA). You may know it by another name, Obamacare. Under the new law you can apply for or buy health insurance through a health insurance exchange. These “marketplaces” are they are sometimes called have been created for individuals and families who do not receive coverage through their employer or do not qualify for Medicaid.

Enrollment in health plans in the Health Insurance Marketplace starts October 1, 2013. Coverage starts as soon as January 1, 2014.

If you are a consumer ready to learn about and buy health insurance through the Marketplace, visit , the official consumer site for the Marketplace.

If you are a professional learning about the Marketplace or helping people apply, get the latest resources at the Marketplace at

You can learn more by visiting Health Insurance Marketplace’s Facebook
page. Be sure to “Like” them.

Additional information on the ramifications of the Affordable Care Act will be presented in the weeks ahead.