Medicaid Eligibility in New Jersey: Income Limits & How to Apply
Medicaid Eligibility in New Jersey
New Jersey expanded its Medicaid program under the Affordable Care Act, opening NJ FamilyCare to adults aged 19-64 whose income falls at or below 138% of the federal poverty level. In 2026, that works out to roughly $21,597 for one person or $44,367 for a family of four.
Key threshold: If your income is below $21,597 (individual) or $44,367 (family of 4), you likely qualify for NJ FamilyCare with free or very low-cost coverage. No premiums, no deductibles.
The following residents are eligible for NJ FamilyCare:
- Adults aged 19-64 with income up to 138% FPL
- Children in families with income up to 200-300% FPL (varies by age)
- Pregnant women with income up to 185-200% FPL
- Seniors and people with disabilities who meet income and asset requirements
About NJ FamilyCare
NJ FamilyCare, New Jersey's Medicaid program, provides essential health coverage to a significant portion of the state's population. As of 2024, approximately 1.86 million people, or about 1 in 5 New Jersey residents, are enrolled in Medicaid. You may qualify for NJ FamilyCare if you are an adult aged 19-64 with income up to 138% of the Federal Poverty Level (FPL). For a single person, this is about $1,800 per month, and for a family of four, it's around $3,698 per month, based on 2025 guidelines. Children under 19 have higher income eligibility, up to 355% FPL, and pregnant individuals can qualify with incomes up to 205% FPL. Additionally, seniors, individuals who are blind, or those with disabilities may also be eligible, though specific income and asset limits apply to these groups. New Jersey has a lower uninsured rate of 6.8% compared to the national average of 8%, partly due to programs like NJ FamilyCare.
If your household income is near the NJ FamilyCare cutoff, you might transition between NJ FamilyCare and marketplace coverage on GetCovered.NJ.gov. For example, if your income is slightly above the Medicaid threshold, you could qualify for significant subsidies to help pay for a plan on the marketplace. With a benchmark Silver plan costing around $547 per month, subsidies can drastically reduce what you actually pay. Your eligibility for either program is based on your Modified Adjusted Gross Income (MAGI), which is often determined by your latest federal tax return. It's crucial to remember that income changes can shift your eligibility. New Jersey recently restarted its annual eligibility reviews for NJ FamilyCare members after a pause during the COVID-19 Public Health Emergency. If you were disenrolled during this "unwinding" period, often for procedural reasons like not returning paperwork, you have a special enrollment period of 120 days to apply for marketplace coverage with potential subsidies.
NJ FamilyCare offers comprehensive benefits with little to no cost-sharing for most enrollees. This typically includes doctor visits, preventive screenings, dental care, vision care, lab tests, prescription drugs, hospitalization, and mental health services. New Jersey also has unique programs and waivers, such as the Managed Long Term Services and Supports (MLTSS) program, which provides home and community-based services for individuals who need nursing facility-level care. The NJ WorkAbility program allows disabled working individuals to maintain health coverage through Medicaid even with slightly higher incomes, and as of April 1, 2023, it no longer has an asset test. For children with disabilities, the MLTSS program can qualify them based solely on their income, not their parents'.
Be aware that applying for NJ FamilyCare can involve processing times of 60-90 days, so it's important to apply early if you have a deadline, such as waiving a student health insurance plan. During eligibility reviews, especially with the recent "unwinding" from pandemic-era continuous enrollment, you will receive mail from the State of New Jersey or your County Board of Social Services. You must open this mail, follow instructions, and respond promptly to avoid losing coverage. Always keep your contact information updated with NJ FamilyCare by calling 1-800-701-0710. If you are denied or terminated, you can appeal the decision or reapply, especially if it was based on outdated income limits. A concrete action step you can take right now is to gather your most recent federal tax information and income details to prepare for your application or renewal.
New Jersey Medicaid Income Limits 2026
The following table shows the key income thresholds for New Jersey in 2026:
| Household Size | 100% FPL | 138% FPL (Medicaid Limit) | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,650 | $21,597 | $62,600 |
| 2 | $21,150 | $29,187 | $84,600 |
| 3 | $26,650 | $36,777 | $106,600 |
| 4 | $32,150 | $44,367 | $128,600 |
| 5 | $37,650 | $51,957 | $150,600 |
| 6 | $43,150 | $59,547 | $172,600 |
If your household income falls below the 138% FPL column, you qualify for NJ FamilyCare. If your income is between 138% and 400% FPL, you qualify for ACA marketplace subsidies to help pay for private insurance.
The benchmark Silver plan in New Jersey costs about $547/month before subsidies, which is in line with the national average. Subsidies can significantly reduce this cost for qualifying households.
Marketplace Insurance in New Jersey
New Jersey residents who do not qualify for Medicaid can purchase private health insurance through GetCovered.NJ.gov. The average benchmark (second-lowest cost Silver) plan in New Jersey costs approximately $547/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in New Jersey might pay after subsidies:
| Income Level | Annual Income | Expected Contribution | Estimated Monthly Premium |
|---|---|---|---|
| 150% FPL | $23,475 | 4.01% of income | ~$78/mo |
| 200% FPL | $31,300 | 6.52% of income | ~$170/mo |
| 250% FPL | $39,125 | 8.33% of income | ~$272/mo |
| 300% FPL | $46,950 | 9.83% of income | ~$385/mo |
| 400% FPL | $62,600 | 9.83% of income | ~$513/mo |
These are estimates for an individual. Actual premiums depend on your age, household size, tobacco use, and the specific plan you choose. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays.
New Jersey operates its own state-based marketplace, GetCovered.NJ.gov, which manages enrollment and plan selection independently from HealthCare.gov. This can mean different plan options and deadlines than the federal marketplace.
New Jersey's Medicaid program goes beyond the ACA's minimum requirements. NJ FamilyCare includes comprehensive benefits, and the state's investment in its own marketplace reflects a broader commitment to accessible healthcare coverage.
How to Apply for NJ FamilyCare
- Online application — Start at GetCovered.NJ.gov. Your Medicaid eligibility is checked automatically when you enter your income details.
- State Medicaid office — Apply directly through New Jersey's Medicaid agency at any time during the year. Unlike marketplace insurance, Medicaid has no enrollment deadline.
- Phone assistance — Call New Jersey's Medicaid helpline for guided help completing your application.
- In-person help — Visit your county human services office or a local navigator for face-to-face support.
To complete your application, you'll need income documentation (pay stubs, tax returns), a New Jersey address for residency verification, Social Security numbers for household members, and information about existing coverage.
Calculate Your Subsidy in New Jersey
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in New Jersey.
Check Your Eligibility →Frequently Asked Questions
What is the income limit for Medicaid in New Jersey?
In 2026, the Medicaid income limit in New Jersey is 138% of the federal poverty level: $21,597 per year for an individual, $29,187 for a household of 2, $36,777 for 3, and $44,367 for a family of 4.
Does New Jersey have Medicaid expansion?
Yes, New Jersey has expanded Medicaid under the ACA. Adults aged 19-64 earning up to 138% of the federal poverty level qualify for NJ FamilyCare.
Am I eligible for health insurance subsidies in New Jersey?
Yes. New Jersey residents with household income between 100% and 400% FPL ($15,650 to $62,600 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through GetCovered.NJ.gov.
What is the name of New Jersey's Medicaid program?
New Jersey's Medicaid program is known as NJ FamilyCare. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and adults up to 138% FPL.
What should I do if my NJ FamilyCare coverage is ending?
If your NJ FamilyCare coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through GetCovered.NJ.gov. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
Does working disqualify me from Medicaid in New Jersey?
Yes. Medicaid eligibility in New Jersey is based on your Modified Adjusted Gross Income (MAGI), not your employment status. If your household income is at or below 138% FPL ($21,597 for an individual), you qualify for NJ FamilyCare even if you work full-time. Many NJ FamilyCare enrollees are working adults.
NJ FamilyCare vs. marketplace insurance — which is better?
Medicaid (NJ FamilyCare) is free or near-free with no premiums or deductibles. Marketplace plans in New Jersey average $547/month before subsidies. If you qualify for Medicaid, it's the more affordable option. If your income puts you just above the cutoff, subsidized Silver plans with cost-sharing reductions are the next best thing.
Medicaid Eligibility in Nearby States
- Delaware Medicaid Eligibility — Expansion state
- New York Medicaid Eligibility — Expansion state
- Pennsylvania Medicaid Eligibility — Expansion state