Effective February 1, 2024
On April 17, 2024, the New Jersey Division of Medical Assistance and Health Services (“DMAHS”) issued Medicaid Communication No. 24-05, in which it announced the second phase of the NJ WorkAbility eligibility expansion. Medicaid Communication No. 24-05 outlined the following changes, which are effective February 1, 2024:
- Income shall not be considered in determining eligibility.
- A sliding-scale premium will be required for the members with countable income (earned and unearned) over 250% of the Federal Poverty Level (FPL). [According to the DMAHS website, “People with no unearned income may have to pay a premium if their gross earned income is more than $76,332 per year (2024). For people who have unearned income (for example, in addition to wages they also receive alimony), the maximum earned income threshold to determine any premium payment will vary”].
- Applicants must agree to the determined premium prior to enrollment, and failure to pay the premium may result in termination of eligibility.
The NJ WorkAbility program allows eligible individuals with disabilities who are working to receive Medicaid coverage, even though they would otherwise be disqualified due to their income, resources, or age. The program promotes employment and independence for those with disabilities, by removing the barrier of losing Medicaid coverage when they work.
According to the DMAHS website, in order to qualify for NJ WorkAbility, current and prospective Medicaid members must:
- Be at least 16 years old;
- Be a New Jersey resident;
- Be employed, either full or part time; and be able to show proof of employment; and,
- Be determined as disabled by the Social Security Administration OR the Medical Review Team at the Division of Medical Assistance & Health Services, prior to age 65
A copy of Medicaid communication No. 24-05 is attached here.