The Unwinding of Medicaid COVID Rules: What You Need to Know About NJ FamilyCare’s Upcoming Changes

Q: What is happening with NJ FamilyCare’s COVID-19 continuous coverage rules?
A: Since March 2020, NJ FamilyCare has followed special rules allowing most members to maintain their health coverage, even if they no longer qualified (e.g., due to higher income). Starting April 1, 2023, NJ FamilyCare will begin re-determining members’ eligibility, a process that will continue until June 1, 2024. If you are no longer eligible for NJ FamilyCare, your continuous coverage will continue until it is your time to recertify.

Q: When should I expect my recertification?
A: Recertifications will be conducted over the next 12 months, from April 1, 2023, to June 1, 2024. Your recertification can happen at any time within this period, so it’s essential to stay vigilant and monitor your mail for any notifications from NJ FamilyCare.

Q: How can I prepare for my recertification?
A: To ensure a smooth recertification process, make sure to update NJ FamilyCare with your current address if you move. Regularly check your mail for notifications and promptly respond to any requests for information.

Q: What happens if my recertification reveals that I am over the income limit for NJ FamilyCare?
A: If your recertification shows that your income is above the eligibility threshold, your NJ FamilyCare coverage will likely be terminated. Before the termination occurs, you will be notified and granted a Special Enrollment Period, allowing you to enroll in other health insurance coverage, such as an employer plan or individual health insurance plan. If you enroll in insurance before your termination date, you will not have a lapse in coverage.

Q: If I am no longer eligible for NJ FamilyCare, are there programs that can help me pay for private insurance?
A: New Jersey has a state-based exchange called Get Covered NJ which offers financial assistance to help cover the cost of private health insurance plans. If you are income-eligible and your employer does not offer affordable coverage, you may be eligible for help covering the cost of a private insurance plan. When you receive notice that your coverage is being terminated, you can contact the LRRC for help navigating the process of purchasing subsidized private health insurance through Get Covered NJ.

Q: What should I do if I’m unsure about my eligibility or the recertification process?
A: If you have questions or concerns about your eligibility or the recertification process, you can contact the LRRC, and a case worker will provide guidance and resources to help you navigate the upcoming changes. Schedule an appointment through the LRRC automated scheduling system by calling 732-523-1789. You can also contact NJ FamilyCare directly by calling 1-800-701-0710.

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