Medicaid Resources

Downloadable Fact Sheets


Medicaid Eligibility Problem Forms

The Arc of NJ's: Medicaid Eligibility Problem Form: (Revised January 2107) Family members and staff may use this form when a person with an intellectual and developmental disability is having difficulty obtaining Medicaid.  Click here for downloadable form

The Arc of NJ's: Medicaid HMO Problem Form Report:  Family members and staff may use this form if an individual is currently enrolled in a Medicaid HMO and is having difficulty obtaining a medical, dental, or behavioral health service that should be covered by the HMO.  This form can also be used with the HMO has reduced the approved number of hours of a service (e.g., person care assistant services or private duty nursing).  Click here for downloadable form
 


Disabled Adult Child (DAC) Medicaid Information

Section 1634 of the Social Security Act - Disabled Adult Child (DAC) flyer: This important flyer, developed by the NJ Department of Human Services, is applicable for persons with a disability who have Supplemental Security Income (SSI).  When the individual's mother or father retires, or if the parent becomes disabled or dies, this flyer describes the process by which the "disabled adult child" (DAC) can continue to receive Medicaid. However, if the process described in this flyer is not followed, the DAC would likely lose Medicaid benefits and, therefore, access to DDD services would also be jeopardized. 

View DAC flyer

 

Application for ​ABD ​​Medicaid as a Disabled Adult Child (DAC):  Tips when completing the ABD Medicaid Application: 

- ​When the application is completed, it should be brought to the Board of Social Services or mailed in.  Please ​keep​ a copy of the application.  If bring​ing​ it in, ask for a receipt that it was received.  If mailing, please do it return receipt.  

- The only income information that is required is the ​applying individuals income.  They don't need income information from anyone else in the household.​

Click here for downloadable application

 


SSI & Continued Medicaid Eligibility

Section 1619(b) of the Social Security Act - SSI and Continued Medicaid Eligibility: This important flyer, developed by the New Jersey Division of Developmental Disabilities, describes the process by which individuals who are employed and are eligible for Supplemental Security Income (SSI) may continue to be eligible for Medicaid coverage when their earnings are too high to continue to receive SSI. Downloadable flyer

 


Personal Preference Program (PPP)

Clarification on the PPP program and a parent/guardian being employed to provide the PPP services

Please see below for an update from DDD pertaining to the new fiscal intermediary, Public Partnerships.  In particular, there has been some confusion recently with regard to the Personal Preference Program (PPP) and the Public Partnerships procedures.  Questions were raised as to whether or not there will be any changes in the individual's parent or guardian being able to continue to provide services through the PPP process.  It should be noted that PPP services are approved through the NJ Division of Disability Services (DDS) and the individual's Medicaid HMO.  (​The approval for ​PPP services ​is​ completely​ different from the self-directed services that are available through DDD.)

The good news is that parents/guardians can continue to provide PPP services for their son/daughter, as they have done in the past.   

This is the relevant wording​ on the issue of parents providing their son/daughter's PPP services, copied​ from the Division Update below:

​"​Clarification on Hiring a Parent/Guardian as a Self-Directed Employee (SDE) Under the New Fiscal Intermediary"

DDD: Individuals participating in the DDD Self-Directed Employee option had not been able to employ a parent, guardian or spouse to provide DDD services under the old fiscal intermediary (Easter Seals) and will not be able to employ a parent, guardian or spouse to provide DDD services under Public Partnerships.

PPP: Individuals participating in the DDS Personal Preference Program (PPP) had been able to employ a parent or guardian to provide PPP services under the old fiscal intermediary, and will continue to be able to employ a parent or guardian to provide PPP services under Public Partnerships.

If you are interested in further information on the Personal Preference Program, see this link:  http://www.state.nj.us/humanservices/dds/services/ppp/


LogistiCare:

LogistiCare became NJ's medical transportation broker in July 2009 and is now responsible for arranging through its provider network: upper-mode non-emergent Mobility Assistance Vehicles (MAVs), Ambulance service and lower-mode, livery service for Medicaid recipients in all counties. Read More...

Medicaid-Covered Transportation More Than 20 Miles from Home

Medicaid Coverage for "Thick It"   


Affordable Care Act (Obamacare)

Health Insurance Through Affordable Care Act (Obamacare) 

Most people with I/DD have health insurance through Medicaid, Medicare, and/or a parent's private insurance.  However, anyone who is not able to access health insurance from those sources, can obtain it through the Affordable Care Act (ACA).  Below is a link for anyone that need help in applying for ACA insurance is available from organizations throughout New Jersey.  Once on the website,  enter your zip code and you will see the organizations that can assist in the process of applying for ACA health insurance.

HealthCare.gov - Find Local Help

A Guide to Assist NJ Residents' Selection of Health Insurance Plans: A Resource for Navigators and Community Assisters-  

Please note that this information is not applicable for people who are eligible for Medicaid (including persons who receive Medicaid expansion through the federal health care law).

The National Disability Navigator Resource Collaborative has released the first of several fact sheets entitled “Comparing Health Plans’ Benefits and Coverage Summaries.” This fact sheet is intended to inform navigators and other enrollment specialists about what people with disabilities need to look for in the Summary of Benefits and Coverage. Read More...