A person who has both NJ FamilyCare (Medicaid) and Medicare coverage is considered a "dual eligible," otherwise known as a "Qualified Medicare Beneficiary" (QMB). Many individuals with intellectual and developmental disabilities (IDD), who are dual eligibles qualified for Medicaid first and, at a later time, became eligible for Medicare as well. But, occasionally, some individuals may receive Medicare first, and qualify for Medicaid later.
The New Jersey Department of Human Services, Division of Aging Services, State Health Insurance Assistance Program (SHIP) has published the 2026 Medicare Part D Stand-Alone Prescription Drug Plans (PDPs) in NJ.
Enrollment in a Medicare Part D drug plan is mandatory for dual eligibles, unless the individual has creditable drug coverage from a private health insurance plan that is as good or better than Medicare Part D.
2026 Medicare Part D Stand-Alone Prescription Drug Plans (PDPs) available in New Jersey
Recent Webinars
11/6/25 Dual Eligibility - Understanding Medicare + Medicaid Enrollment & Coordination of Benefits
11/7/24 Update for 2025 on the Medicare Drug Benefit for People Who Have Both Medicare and Medicaid (the Dual Eligibles)
FAQs for Dual Eligibles
The Arc of New Jersey Health Care Advocacy program has distributed information in the form of Frequently Asked Questions (FAQs) fact sheets, to respond to the questions that families have been asking:
The Centers for Medicare & Medicaid Services (CMS) created a helpful fact sheet: