NJ FamilyCare/Medicaid programs provide coverage for pregnant women who are residents of New Jersey and either U.S. Citizens or immigrants whose papers allow them to reside permanently in the US. Family income must be at or below 200% of the Federal Poverty Level (FPL) - for example $46,100 annual income for a family of four. This coverage extends to women during the pregnancy and for 60 days following delivery or the date on which the pregnancy ends.
A child born to an eligible Medicaid mother is eligible for NJ FamilyCare/Medicaid for one year regardless of changes in the family's income. Call your local County Welfare Agency to see if eligibility can be extended beyond these time periods.
Most pregnant women apply for this coverage at their provider's office, such as a clinic or doctor's office. The pregnant woman must then follow up with their local County Welfare Agency, where eligibility can be determined.
2012 Income eligibility guidelines at 200% of the Federal Poverty Level for Pregnant Women:
|
Family Size* |
Monthly Income |
| 2 |
$2,522 |
| 3 |
$3,182 |
| 4 |
$3,842 |
| 5 |
$4,502 |
| 6 |
$5,162 |
*A pregnant woman is considered a family of two, or more,
if a multiple pregnancy.
For more information, consult the Maternal Health Coverage Fact Sheet.
Pregnant women who do not meet citizenship or legal permanent resident requirements
Pregnant women who meet all the other criteria for New Jersey Medicaid except that:
- they have no documentation from U.S. Citizenship and Immigration Services
- they are non-immigrant (tourist, student, or child of a worker or visitor on business)
- may be eligible to receive treatment necessary for an emergency medical condition, including labor and delivery. They are not eligible for any other New Jersey Medicaid benefits. Consult the Medical Emergency Payment Program for Aliens Fact Sheet.
- may be eligible for the NJ Supplemental Prenatal Care program, which provides for prenatal care in clinics or hospitals when state funds are available.
Medically Needy section of NJ FamilyCare/Medicaid for pregnant women
Pregnant women who meet all the criteria for New Jersey Medicaid except that their income or resources are too high may qualify for the program through a spend down provision that allows documented medical expenses to be used to reduce monthly income to meet eligibility requirements.
Pregnant women eligible for this program are entitled to most Medicaid services. Consult the Medically Needy Fact Sheet, and note the additional services for pregnant women.
