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Who
is covered?
Who is eligible for NJ FamilyCare?
Children 18 and younger may apply for the program, as well as certain low-income parents.
The income eligibility level for children's coverage is 350% of the
federal poverty level. For example, children in a family of four
with a monthly income of up to $6,432 could be eligible for coverage.
For parents, the income eligibility level is 200% of the federal
poverty level, or $3,675 for a family of four.
Eligibility is based on family size and monthly income. Family size includes
children under 21, adoptive and natural parents and their spouses. If
a child is living in a household with a grandparent, guardian, or caretaker,
that person is not included in the family size, and their income is not
taken into consideration when calculating eligibility for NJ FamilyCare,
unless the guardian is also requesting coverage.
Only monthly income, not assets, is considered for eligibility.
To view income eligibility limits for various family sizes, go to
Income Eligibility and Cost. The blue line shows the maximum income (annual and
monthly) that families of various sizes can have in order to be eligible
to apply for parent coverage. The bottom line of the chart shows the maximum income
for coverage for children.
What if my family makes too much money to qualify for NJ FamilyCare?
Parents at higher income levels can purchase health insurance for their
children at reasonable rates through the NJ FamilyCare ADVANTAGE program
administered by Horizon NJ Health if they qualify. The cost is $143 per
month for one child; $286 per month for two children; and $429 per month
for three or more children. To learn more, please visit
http://www.horizonnjhealth.com/members/advantage.html
or call 1-800-637-2997.
Other
insurance?
Applicants will be eligible for NJ FamilyCare only if they have been
uninsured for a period of three months or more. However, there are exceptions
to this rule, such as if you lost your insurance because your place of work
went out of business or you were laid off. Depending on income, other
exceptions may apply for families privately paying for health insurance
or for COBRA benefits. Call 1-800-701-0710 and speak with a Health Benefits
Coordinator to find out if any exceptions apply to you.
Premiums,
co-payments?
For many families, NJ FamilyCare will be free. Other families will pay
a monthly premium based on their income and small co-payments for some
services.To view premiums, go to What
It Costs.
How
do I apply?
It is easy! Download an application from this website, or apply online, or
call toll-free
1-800-701-0710 to
request an application or to receive more information. If you are not
sure you or your children could be eligible, please call us.
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