There are many Medicaid or New Jersey Family Care programs in NJ and each has different eligibility criteria. Here is a brief overview. Keep in mind, the rules are complicated, so if you believe you may be eligible, contact Central Jersey Legal Services (CJLS) for assistance. CJLS is a law firm that provides representation and advice to people who cannot afford an attorney. If you need legal help please contact our Middlesex County office at 732-249-7600 to be screened for eligibility.
Affordable Care Act Medicaid (ACA): In order to be eligible you must be between 19 and 64 and not Medicare eligible. Individuals who have been receiving Social Security Disability for 24 months are eligible for Medicare and cannot get ACA Medicaid. But for ACA Medicaid, there is no asset cap for this program so money in the bank does not affect your eligibility. There is an income limit that is 138% of the Federal Poverty Level (FPL) based on household size. For a single person in 2025 the limit is $1,800 per month.
Aged, Blind, Disabled (ABD): To qualify an individual must be 65 or older or be disabled. Individuals who are aged, blind, or disabled often have Medicare as a primary insurance, but these individuals can be “dual eligible” and also receive Medicaid. To qualify an individual must have monthly gross income at or below 100% FPL, which for a single person in 2025 is $1,305 and $1,763 for a married couple. Some income is disregarded, including the first $20 of unearned income and an additional $65 of earned income, plus half of the remainder. ABD also counts the value of housing and support as unearned income when the person is living with someone for free or another person is paying for their food or shelter. The asset limit is $4,000 for a single person and $6,000 per couple.
Workability: This program is for disabled individuals 16 and over who are working. Like with ABD, those on Workability may be dual eligible with Medicare. While there is no income cap individuals with countable income above 250% FPL must agree to pay a premium to receive benefits. Importantly, Social Security Disability benefits received by an individual on their own account are not included in the eligibility criteria and are considered disregarded income. In addition, a spouse’s income is not counted. There is no asset cap for this program so the amount of money you have in the bank does not affect your eligibility.
Managed Long Term Services and Supports (MLTSS): This program is for individuals who require a nursing home level of care, whether at home or in a facility. The income limit for 2025 is $2,901.00. However, if the applicant is over the income limit, they can place income in a Qualified Income Trust to qualify. The asset limit for a single person in NJ is $2,000.00. Some resources, such as the home you live in and a car are exempt. There are additional complicated rules for both income and assets when there is a spouse. The most complicated part of MLTSS eligibility is the lookback period and transfer penalty. When an individual applies for Medicaid, they must provide 5 years of financial records. If there has been an improper transfer of assets during the 5-year lookback period, a penalty period of ineligibility will be imposed.
SSI Medicaid: Supplemental Security Income (SSI) Medicaid does not require an application. If you are eligible for SSI, you are automatically eligible for Medicaid with no further action needed on your part. Individuals who collect SSI do not have enough work credits to be eligible for Social Security Disability Insurance (SSDI) on their own work history. In addition to requiring a disability determination, SSI has income and resource limits. Your income must be under the SSI benefit rate, $998.25 per month in 2025, and your assets must be below $2,000.
Medicare Savings Programs: You can apply for Medicare Savings Programs by completing the NJ Save online or paper application. These programs help Medicare recipients pay for Part A and B premiums, as well as deductibles, coinsurance, and copayments for services and items Medicare covers. For 2025 the income limits vary from $1,305 to $1,761for an individual and $1,763 to $2,380 for a married couple. Asset limits can be as high as $9,660 (individual) and $14,470 (couple). The NJ Save application also includes other savings programs for prescriptions and utilities so it pays to complete the application.
The purpose of this article is to present a general overview of Medicaid programs. It is not intended to be used as legal advice. Each client’s case is unique and merits individual substantive and procedural legal advice from an attorney.
