Federally-facilitated, the Medicaid-Marketplace offers health coverage to millions of New Jersey residents, including pregnant women, parents, children, individuals with disabilities, and seniors. With the permission from the state Medicaid agency, Marketplace has the authority to determine the eligibility for both Medicaid and CHIP.
Note: sometimes, Medicaid is referred by state names, but regardless of this they are governed by the Federal Medicaid requirements and law.
All Medicaid programs must follow federal guidelines, but they somewhat vary from one state to state. To befit from this program, you need to be a US citizen, permanent resident, legal alien, US national, or have low income. Above all, you must me a resident of the state of New Jersey for you to be eligible for this program.
Division of Medical Assistance and Health Services Home (DMAHS)
The DMAHS offers Medicaid s state and federally-funded NJ Family programs for particular groups of adults and children from low and moderate-income backgrounds. Through these programs, about 1.7 million of New Jersey residents are served every year. Notably, NJ FamilyCare offers health coverage to pregnant women, children, Childress couples, the aged, single adults, disabled, caretakers, and individuals eligible for long-term care services. The comprehensive NJ FamilyCare program offers a range of services, which include hospital services, doctor visits, vision care, tests, mental health care, nursing home care, prescriptions, and many other healthcare services, depending on the eligibility category of an individual.
Medicaid and CHIP Applications
The adoption of the Affordable Care Act brought a streamlined enrollment process through which people can access affordable insurance plans for which they qualify. The law gave the Secretary of Health and Human Services (SHHS) the power to develop a model for an application, which will be used in applying for coverage using Marketplace, CHIP, and Medicaid. Each state has an option to adopt the SHHS s model of application for affordable insurance programs, or they can instead adopt an alternative application that meets the requirements by the Federal.
Targeted Enrollment Strategies
As a response to the CMS Guidance given on May 17, 2013, most states have adopted one or many targeted enrollment strategies meant to facilitate enrollment and maintain coverage for eligibility. More information about those states that have adopted one or many targeted enrollment strategies can be found on the Targeted Enrollment Strategies page.
Medicaid and CHIP State Plan Amendments
The state CHIP and Medicaid plans define how each state has decided on how to design its program within many requirements for federal funding. Typically, states amend their Chip AND Medicaid state plans so as to inform CMS of financing and programmatic changes and to get legal authority for those changes. The establishment of the Affordable Care Act entailed many new opportunities for the states to supplement and improve their programs. As a result, the recent times have witnessed a great deal of activities for State Plan Amendment, particularly in the areas of eligibility, financing and benefits design, and new approaches to offering health homes, long-term supports and services, as well as enrollment strategies such as hospital presumptive eligibility.
Demonstrations and Waivers
The primary forms of demonstrations and waivers used by states to test new or existing Pay and Deliver for Health Care Services in CHIP and Medicaid include section 1115 demonstrations, section 1915 9(c) community and home-based services waivers, and section 1915 (b) managed care waivers.
Every state has a choice of the approach to delivering system design under the CHIP and Medicaid programs.
MAGI Conversion Plans
States are provided by the CMS with the template to complete their MAGI Conversion Plans, which are designed to reflect the MAGI-based standards of eligibility for CHIP and Medicaid.