How to get Medicaid or low-cost care in New Jersey

How the NJ FamilyCare program works

Medicaid is a government program that helps people with low incomes pay for health care. In New Jersey, the version for adults and children is called NJ FamilyCare. A state office called the Division of Medical Assistance and Health Services runs it. NJ FamilyCare also includes CHIP, the Children's Health Insurance Program, which covers children.

The state expanded Medicaid on January 1, 2014. Because of that, it says adults ages 19 to 64 with income up to 138 percent of the federal poverty level can apply. This level is a yearly dollar amount that the government uses to measure poverty. It changes with the size of your household.

Monthly premiums ended on July 1, 2021, so the program no longer charges them. Children under 19 can also apply no matter what their immigration status is. Other groups are covered in our guide on who qualifies for Medicaid.

How to apply for NJ FamilyCare

Applying online is what the state strongly encourages. If you need help with the form, call 1-800-701-0710. A Health Benefits Coordinator will answer your call. The phone line is open Monday and Thursday from 8am to 8pm, and on Tuesday, Wednesday and Friday from 8am to 5pm.

The call line has a translation service, so you can ask for help in your own language. Applying in person at your county welfare agency is another choice. The state says this is a good idea if your income is low now. You may also qualify for food help there.

On the program's website, a Need Help Enrolling page lets you pick your county. It lists local agencies that offer face-to-face help. The papers to gather are listed in our guide on how to apply for Medicaid.

Charity Care can wipe out a hospital bill

A program called Hospital Care Payment Assistance, which most people call Charity Care, helps with hospital bills. Charity Care is not a type of insurance plan. It lowers or removes the price of medically necessary care at any acute care hospital in the state. That covers both inpatient and outpatient services, at those hospitals.

You must live in New Jersey and have no coverage, or coverage that pays only part of the bill. You also must not qualify for Medicaid, which the hospital checks first. How much you pay depends on your income compared with the federal poverty level. If you are at 200 percent or below, you pay none of the bill. From 201 to 225 percent, you pay 20 percent. The share then rises in steps to 80 percent at 276 to 300 percent.

There are limits on assets too, which are things you own, such as savings. The limit is $7,500 for one person and $15,000 for a family. Extra assets can be spent on your hospital bill or other approved medical costs.

Apply at the hospital's business office or admissions office. The hospital has 10 business days to decide once it has a complete application. You have up to one year after your date of service to apply. Because the hospital must first screen you for Medicaid, finish that step quickly. Questions go to the state Charity Care unit at 1-866-588-5696.

Private doctor fees and anesthesia fees are not covered, and neither are outpatient prescriptions. Any of them can arrive as a separate bill. Our guide on hospital financial assistance shows how to ask for help with those.

What changes for NJ FamilyCare on January 1, 2027

Under a 2025 federal law, the rules for keeping Medicaid change. Starting January 1, 2027, the state says some adults ages 19 to 64 must work, volunteer or go to school to qualify or stay covered. These members must also renew every six months, not every twelve.

This rule applies to adults on a plan type called ABP, short for Alternative Benefit Plan. To find your plan type, look at the front of your health plan card or call the number on the back. Children and people in the aged, blind and disabled group are not covered by the rule.

Exemptions are reasons you do not need to meet the rule. The state lists several of them on its site. Being pregnant or within one year after a pregnancy is one. Caring for a person with a disability is another. So is being a parent or caregiver of a child 13 or younger, using the federal wording. An Activity Requirements Checker on the state's site tells you in about 10 minutes whether the rule applies to you.

By fall 2026, NJ FamilyCare planned to contact affected people. Update your contact information now so those letters reach you. Our guide on the Medicaid work rules explains the federal side.

If your income is too high for NJ FamilyCare

GetCoveredNJ is the state's own marketplace for private plans. You can compare plans there and see if you qualify for help with the monthly cost. The yearly sign-up period runs from November 1 to January 31. New Jersey also requires most residents to have health coverage. If you go without it, you may owe a fee called a Shared Responsibility Payment on your state tax return. Some people do not owe it because they qualify for an exemption.

Outside that window, a major life event such as losing job-based coverage can open a special sign-up period. That window runs from February 1 to October 31, the state says. Your choices after a job loss are covered in our guide on what to do after losing insurance.

Community health centers and doctor lookups

Community health centers get federal money, and their prices depend on your income. The free Find a Health Center tool from the Health Resources and Services Administration searches by zip code. The New Jersey Primary Care Association supports these centers across the state.

Doctors can be searched by name in the New Jersey Health Care Profile, a tool the State Board of Medical Examiners points to. Check it before you book with a new doctor.

Flat-fee doctors and emergencies in New Jersey

Some New Jersey doctors offer direct primary care. You pay a monthly fee, and the office does not bill insurance for visits. Our directory lists cash-pay doctors you can search. Ask for the fee and what it covers in writing.

In an emergency such as chest pain or trouble breathing, call 911 or go to the nearest emergency room. A hospital with an emergency room must examine you whether or not you have coverage, under federal law. Charity Care may help with the bill afterward.