New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 69 - AFDC-RELATED MEDICAID
Subchapter 4 - MEDICAID SPECIAL
Section 10:69-4.2 - Determination of eligibility; Medicaid Special

Universal Citation: NJ Admin Code 10:69-4.2

Current through Register Vol. 56, No. 18, September 16, 2024

(a) All appropriate rules in this chapter regarding income shall apply in determining financial eligibility. Requirements related to employment or training or job search activities, school attendance of a child, the birth of additional children, and parent minors not residing with specified applicants/beneficiaries are not applicable in the determination of eligibility for Medicaid Special. Sanctions relating to the Child Support and Paternity program shall not be imposed on applicants for Medicaid Special.

(b) Earned income shall be calculated in accordance with AFDC-C and -F procedures found in this chapter.

1. Work First New Jersey/GA payments whether in the form of cash, check or assistance order or a combination of the above shall be countable as income for purposes of determining eligibility for Medicaid Special. If the individual is ineligible for Medicaid Special due to this income, he or she shall be evaluated for the Medically Needy Program as a child or if disability is alleged, for New Jersey Care ... Special Medicaid Programs.

(c) Obligations of LRRs who live in the same household as the applicant/beneficiary are accounted for in the eligibility determination process. No further evaluation or pursuit of contributions from such LRRs is required. Actual contributions from parents outside the household shall be considered in all eligibility determinations but pursuit of non-voluntary contributions from parents outside the household shall be made only by or on behalf of applicant/beneficiaries under the age of 18. Contributions from a spouse outside the household shall be sought in all cases.

(d) Medicaid Special is available only for U.S. citizens or eligible aliens (see N.J.A.C. 10:69-3.9 requirements related to alien status).

(e) Eligibility for Medicaid Special does not include eligibility for burial expenses, nor do the Medicaid extension benefits apply.

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