AWCA Resource Center
AWCA Resource Center

Medicaid

Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) in New Jersey is a critical component of the NJ FamilyCare system. It is designed to provide comprehensive, affordable health coverage to children in families who earn too much to qualify for traditional Medicaid but cannot afford private health insurance.

Eligibility

  • Age: Children under the age of 19
  • Residency: Residents of New Jersey
  • Immigration Status: As of 2026, under the ‘Cover All Kids’ act, all children in the following household Income Guidelines (2026) receive the same cost benefits regardless of their immigration status. 
  • CHIP applications are open year-round and there is no waiting period.

Income Guidelines (2026)

Household SizeFPL 147% or belowFPL 147% – 150%FPL 150% – 200%FPL 200% – 355%
PremiumNoneNoneNoneNone
CopayNoneNone$5 - 10$5 - $35
1 Person$1,955 or less$1,956 ~ $1,995$1,996 ~ $2,660$2,661 ~ $4,722
2 People$2,650 or less$2,651 ~ $2,705$2,706 ~ $3,606$3,607 ~ $6,401
3 People$3,347 or less$3,348 ~ $3,416$3,417 ~ $4,554$4,555 ~ $8,083
4 People$4,043 or less$4,044 ~ $4,125$4,126 ~ $5,500$5,501 ~ $9,763
Each Add'l+ $696+ $711+ $947+ $1,682

*Children with income at or below 147% of the FPL are classified under Medicaid rather than CHIP, and all medical costs are fully covered at no charge.

Comprehensive Benefits

  • Primary & Specialty Care: Routine checkups, immunizations, and visits to specialists.
  • Dental Care: Cleanings, fillings, X-rays, and essential orthodontic work.
  • Vision Care: Eye exams and prescription eyeglasses.
  • Hospitalization: Emergency room visits, inpatient hospital stays, and outpatient surgery.
  • Mental Health: Counseling, behavioral health therapies, and substance abuse treatment.
  • Prescriptions: Access to a wide network of pharmacies with low copays.

Key Changes in 2026

  • Continuous Eligibility: Children now benefit from multi-year continuous eligibility, meaning they do not lose coverage due to minor fluctuations in family income during the year.
  • Telehealth Expansion: Enhanced coverage for pediatric specialized telehealth services, including speech and occupational therapy.

Managed Care Enrollment (MCOs)

Families in New Jersey must choose an MCO to manage their child’s healthcare. If families do not choose one, an MCO and a Primary Care Provider (PCP) is automatically assigned.
  • Check if your preferred pediatrician is in the MCO’s network.
  • Review “Value-Added Services” such as free sports physicals or extra vision benefits.
* For details check the New Jersey MCO page.

How to Apply

  • Online: NJ FamilyCare website 
    • Contact: 1-800-701-0710 / TTY: 711
  • In-Person: visit local County Board of Social Services
    • Bergen County, NJ Board of Social Services
      • 218 Route 17 North, Rochelle Park, NJ 07662 
      • 201-368-4200
      • Hours: Weekdays 8:00 am thru 4:30 pm
*Enrollment is open year-round for NJ FamilyCare

Contact

  • AWCA can provide counseling free of charge (201-862-1665 / info@awcanj.org).

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    Medicaid