Understanding Medicaid Income Limits in NJ
Medicaid is designed to ensure that families and individuals can access affordable medical care, regardless of their circumstances. To ensure that the system is fair and that help goes to those who need it the most, there are income limits for eligibility. One thing to understand is that Medicaid is not the same as Medicare.
People who are seeking help through something like NJ’s FamilyCare scheme will be assessed based on MAGI, which stands for Modified Adjusted Gross Income. This system will look at the income, and the size of the household, according to the latest federal tax return for the household. This can be verified electronically relatively easily, which makes it an efficient way of determining eligibility. This system makes calculating income quite easy.
Children aged 18 or younger will be eligible in hopes with incomes up to 355% FPL, which means $7,189 per month for a family of four. Parents, and relatives that take care of dependents are eligible with an income of up to 138 percent FPL – or $2,795 per month for a family of four. For this eligibility, there must be tax dependent children in the household. Any adults not born in the USA must hold legal status as a permanent resident, and must have had that status for at period of five years or more in order to be eligible.
The income limits are stricter for adults without children – set at $1,367 for a single person, or $1,842 for a couple. A pregnant woman will enjoy eligibility up to 205% FPL, which means an income of $4,152 per month in a family of four.
There are different thresholds for people who are blind, recognized as being permanently disabled, or over the age of 65.
There are staggered income thresholds depending on the number of children in a family. Some low income households will not have to pay any premium at all for their cover. As income increases, there is a per-family premium (not a per person premium). The lowest income households do not have to pay a co-pay. There is a co-pay for households in the higher income brackets, and the co-pay starts before the premium kicks in.
The full table of income can be found on the NJ FamilyCare website, and it is updated when the thresholds are re-assessed. The size of a family is determined by the total number of parents or caretakers, and also includes children under the age of 18.
Looking to learn about Medicare? Click here to learn about the various plans and who qualifies. You can also learn about the supplemental insurance that’s available if you are a senior aged 65 and over and require additional coverage.