New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 90 - WORK FIRST NEW JERSEY PROGRAM
Subchapter 5 - SUPPORTIVE SERVICES
Section 10:90-5.9 - Medicaid extension (employment-related)
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Extended Medicaid benefits are available to families who lose eligibility for Medicaid due to employment-related criteria based on the income standards and methodologies in effect for the Aid to Families with Dependent Children (AFDC) program as of July 16, 1996. Thus, extended Medicaid benefits will begin with the loss of WFNJ cash assistance only when that loss was coincident with the loss of Medicaid eligibility under the July 16, 1996 AFDC income standards and methodologies in accordance with N.J.A.C. 10:69.
(b) When a family with dependent children loses eligibility for Medicaid based on the income standards and methodologies in effect for the AFDC program as of July 16, 1996, for the reasons given below, Medicaid eligibility continues for a period of 24 months beginning with the month in which the family was no longer eligible under those standards and methodologies. The 24-month extension period shall begin, even though the family may continue to receive WFNJ cash assistance.
(c) A family with dependent children, whose case closes for reasons other than employment, that gains employment within the 24 months after case closing, may be eligible to receive extended Medicaid benefits for the balance of the 24 month Medicaid extension period which would have begun at case closing.
(d) Persons who secure employment through the Early Employment Initiative (EEI) program (see N.J.A.C. 10:90-17) may be eligible for 24 months of extended Medicaid benefits.
(e) New members added to a family in receipt of extended Medicaid are not included in the extended coverage, with the exception of a child born to or legally adopted by the family during the extension period.
(f) The following individuals shall not be included, or continue to be included, in the eligible WFNJ/TANF assistance unit for Medicaid extension:
(g) When the last remaining child eligible for Medicaid extension is no longer eligible for an extension, eligibility for the other members ceases.
(h) Medicaid shall be the payer of last resort in those instances in which a recipient or his or her dependent child(ren) have third party (employer-provided or from a noncustodial parent) health care coverage.