Current through Register Vol. 56, No. 18, September 16, 2024
(a) In order to
be eligible for the NJ FamilyCare program, an individual shall be a citizen of
the United States, an alien lawfully admitted for permanent residence, or an
alien who can be classified as an eligible alien in accordance with this
chapter.
1. The term "citizen of the United
States" includes persons born in Puerto Rico, Guam, the Virgin Islands, Swain's
Island, American Samoa, and the Northern Mariana Islands.
(b) The following aliens, regardless of the
date of entry into the United States, if they otherwise meet the eligibility
criteria, are entitled to NJ FamilyCare benefits:
1. An alien lawfully admitted for permanent
residence;
2. A refugee admitted
pursuant to section 207 of the Immigration and Nationality Act;
3. An asylee admitted pursuant to section 208
of the Immigration and Nationality Act;
4. An alien whose deportation has been
withheld pursuant to section 243(h) of the Immigration and Nationality
Act;
5. An alien who has been
granted parole for at least one year by the United States Citizenship and
Immigration Services (USCIS) pursuant to section 212(d)(5) of the Immigration
and Nationality Act;
6. An alien
who has been granted conditional entry pursuant to section 203(a)(7) of the
immigration law in effect prior to April 1, 1980;
7. An alien who is granted status as a Cuban
or Haitian entrant as defined by section 501(e) of the Refugee Education
Assistance Act of 1980;
8. An
American Indian born in Canada to whom the provisions of section 289 of the
Immigration and Nationality Act apply;
9. A member of an Indian tribe as defined in
section 4(e) of the Indian Self Determination and Education Assistance
Act;
10. An alien who is admitted
to the United States as an Amerasian immigrant pursuant to section 584 of the
Foreign Operations, Export Financing, and Related Programs Appropriations Act
of 1988;
11. An alien who is
honorably discharged or who is on active duty in the United States Armed Forces
and his or her spouse and the unmarried dependent children of the alien or
spouse; and
12. Certain qualified
aliens who are victims of domestic violence and when there is a substantial
connection between the battery or cruelty suffered by an alien and his or her
need for NJ FamilyCare benefits, subject to certain conditions described below:
i. The alien has been battered or subjected
to extreme cruelty in the United States by a spouse or a parent.
ii. The alien has been battered or subjected
to extreme cruelty in the United States by a member of the spouse's or parent's
family residing in the same household of the alien and the spouse or parent
acquiesced to such battery or cruelty.
iii. The alien's child has been battered or
subjected to extreme cruelty in the United States by the spouse or the parent
of the alien (without the active participation of the alien in the battery or
cruelty).
iv. The alien's child has
been battered or subjected to extreme cruelty in the United States by a member
of the spouse's or parent's family residing in the same household as the alien
and the spouse or parent acquiesced to and the alien did not actively take part
in such battery or cruelty.
v. In
addition to the conditions described in (b)12i through iv above, if the
individual responsible for the battery or cruelty continues to reside in the
same household as the individual who was subjected to such battery or cruelty,
then the alien shall be ineligible for full NJ FamilyCare benefits.
vi. The eligibility determination agency
shall apply the definitions "battery" and "extreme cruelty" and the standards
for determining whether a substantial connection exists between the battery or
cruelty and the need for NJ FamilyCare as issued by the Attorney General of the
United States under his or her sole and unreviewable discretion, in accordance
with 8 U.S.C. §
1641.
(c) Persons claiming to be eligible aliens
shall provide the eligibility determination agency with documentation of alien
status.
1. If an applicant presents an
expired USCIS document or is unable to present any document demonstrating his
or her immigration status, the eligibility determination agency shall refer the
applicant to the local office of USCIS to obtain evidence of status. If,
however, the applicant provides an alien registration number, but no
documentation, the eligibility determination agency shall file USCIS Form G-845
along with the alien registration number with the local office of USCIS to
verify status.
2. The following
sets forth acceptable documentation for eligible aliens:
i. Lawful Permanent Resident--USCIS Form
I-551, or for recent arrivals, a temporary I-551 stamp in a foreign passport or
on Form I-94.
ii. Refugee--USCIS
Form I-94 annotated with stamp showing entry as refugee under section 207 of
the Immigration and Nationality Act and date of entry into the United States;
USCIS Form I-688B annotated "274a.12(a)(3)," I-766 annotated "A3," or I-571.
Refugees usually adjust to Lawful Permanent Resident status after 12 months in
the United States, but for purposes of determining NJ FamilyCare eligibility
they are considered refugees. Refugees whose status has been adjusted will
have, USCIS Form I-551 annotated "RE-6," "RE-7," "RE-8," or "RE-9."
iii. Asylees--USCIS Form I-94 annotated with
a stamp showing grant of asylum under section 208 of the Immigration and
Nationality Act, a grant letter from the Asylum Office of either the
Immigration and Naturalization Service or the USCIS, Forms 688B annotated
"274a.12(a)(5)," or I-766 annotated "A5."
iv. Deportation Withheld--Order of an
Immigration Judge showing deportation withheld under section 243(h) of the
Immigration and Nationality Act and the date of the grant, or USCIS Form I-688B
annotated "274a.12(a)(10)" or I-766 annotated "A10."
v. Parole for at Least a Year--USCIS Form
I-94 annotated with stamp showing grant of parole under section 212(d)(5) of
the Immigration and Nationality Act and a date showing granting of parole for
at least a year.
vi. Conditional
Entry under Law in Effect before April 1, 1980--USCIS Form I-94 with stamp
showing admission under section 203(a)(7) of the Immigration and Nationality
Act, refugee-conditional entry, or USCIS Forms I-688B annotated "274a.12(a)(3)"
or I-766 annotated "A3."
vii. Cuban
Haitian Entrant--USCIS Form I-94 stamped "Cuban/Haitian Entrant under section
212(d)(5) of the INA."
viii. An
American Indian born in Canada--USCIS Form I-551 with code S13 or an unexpired
temporary I-551 stamp (with code S13) in a Canadian passport or on Form
I-94.
ix. A member of certain
Federally recognized Indian tribes--a membership card or other tribal document
showing membership in tribe is acceptable documentation.
x. Amerasian Immigrant--USCIS Form I-551 with
the code AM1, AM2, or AM3 or passport stamped with an unexpired temporary I-551
showing a code AN6, AM7, or AM8.
3. For aliens who entered the United States
on or after August 22, 1996, the date of entry into the United States shall be
determined as follows:
i. On USCIS Form I-94,
the date of admission should be found on the refugee stamp. If missing, the
eligibility determination agency should contact the local office of the USCIS
by filing Form G-845, attaching a copy of the document;
ii. If the alien presents USCIS Form I-688B
(Employment Authorization Document), I-766, or I-571 (Refugee Travel Document),
the eligibility determination agency shall ask the alien to present Form I-94.
If that form is not available, the eligibility determination agency shall
contact the USCIS via the submission of Form G-845, attaching a copy of the
documentation presented;
iii. If
the alien presents a grant letter or court order, the date of entry shall be
derived from the date of the letter or court order. If missing, the eligibility
determination agency shall contact the USCIS by submitting a Form G-845,
attaching a copy of the document presented.
4. For aliens who present themselves as on
active duty or honorably discharged from the United States Armed Forces, the
following shall serve as documentation:
i. For
discharge status, an original, or notarized copy of the veteran's discharge
papers issued by the branch of service in which the applicant was a
member;
ii. For active duty
military status, an original, or notarized copy, of the applicant's current
orders showing the individual is on full-time duty with the U.S. Army, Navy,
Air Force, Marine Corps, or Coast Guard (full-time National Guard duty does not
qualify), or a military identification card (DD Form 2 (active));
iii. A self-declaration under penalty of
perjury may be accepted pending receipt of acceptable documentation.
(d) As a condition of
eligibility, all applicants for NJ FamilyCare shall sign a declaration under
penalty of perjury that they are citizens of the United States or aliens in a
satisfactory immigration status. In the case of a child or incompetent
applicant, another individual on the applicant's behalf shall complete the same
written declaration under penalty of perjury.
(e) On and after April 1, 2010, applicants or
beneficiaries who are adult restricted aliens shall be ineligible for
enrollment in, or benefits from, the NJ FamilyCare Program and any other
program under this chapter, except as allowed pursuant to (e)2 below; this
termination of enrollment and benefits under the program does not apply to
individuals who are pregnant women or children under the age of 19.
1. The term "restricted alien," within this
chapter, means an alien lawfully admitted for permanent residence, who has
lived in the United States for less than five full years after such lawful
admittance.
2. Enrolled restricted
aliens who, between October 1, 2009 and March 25, 2010, received a medical
service that was actually covered by NJ FamilyCare shall be ineligible for
enrollment in, or benefits from, the NJ FamilyCare Program and any other
program under this chapter, effective July 1, 2010, rather than April 1, 2010.
Additionally, as of July 1, 2010, the Division of Medical Assistance and Health
Services may additionally extend medical service coverage to any such
restricted alien still enrolled who is being treated for a life threatening
illness or receiving on-going life sustaining treatment; however, any such
decisions regarding extending coverage, the duration of any such coverage, the
extent of services covered and the reimbursement methodology used for service
coverage shall all be vested in the on-going sole discretion of the Division,
based upon the Division's assessment of the necessity of such coverage, use of
resources and/or available options.