AWCA Resource Center
AWCA Resource Center

Medicaid

ACA Medicaid (Medicaid Expansion)

The Affordable Care Act (ACA) is a federal law that allows each state government to expand Medicaid eligibility to low-income adults with incomes up to 138% of the Federal Poverty Level (FPL).

Officially named as NJ FamilyCare in New Jersey, this Medicaid program allows low-income adults, including those without dependent children, to receive comprehensive health insurance benefits through NJ FamilyCare with no monthly premiums.

*OBBBA (One Big Beautiful Bill Act) implementations may affect eligibility and program details.

Eligibility

  • Target: New Jersey residents between 19 and 64
  • Immigration Status: Lawful Permanent Resident (LPR) status for at least 5 years. 
    • Refugee/Asylee and LPR: Under OBBBA rules, refugees or asylees who haven’t adjusted to LPR status may lose eligibility starting October 1, 2026.
  • Work and Community Engagement Requirements (OBBBA): Proof of at least 80 hours per month of work, education, vocational training, or community service is required. (Effective January 1, 2027)
*Work exempt groups: ① Children 18 and under, ② ABD (Aged, Blind, and Disabled) beneficiaries, ③ Parents or caregivers of children under 14 or persons with disabilities, ④ Individuals with serious physical or mental health conditions, ⑤ Pregnant women and those within one year postpartum, ⑥ Former foster youth under age 26, ⑦ Individuals who are incarcerated or recently released from incarceration. *For details refer to the NJ DHS page

Income Guidelines (2026)

At or below 138% of the Federal Poverty Level (FPL)

Household SizeMaximum Monthly Income (138% FPL)
1 Person$1,836 or less
2 Persons$2,489 or less
3 Persons$3,142 or less
4 Persons$3,795 or less
5 Persons$4,449 or less
6 Persons$5,102 or less
7 Persons or moreAdd +$654 per additional person
  • No Cost Sharing: Individuals within 0-138% FPL range have no monthly premium and no copayments for any covered medical services.
  • Household Size: Includes total number of parents or caretakers, tax-dependent children under the age of 21, and any other tax dependents residing within the same household.
  • Income Verification: Eligibility is calculated based on Modified Adjusted Gross Income (MAGI) This is typically verified electronically using federal tax reporting data to ensure a streamlined application process.
  • Annual Renewal: Eligibility is re-evaluated on an annual basis. Once renewal documents are received, information must be updated within the specified deadline to maintain health benefits.

Comprehensive Benefits

  • Basic Medical Services: visits to primary care physicians and specialists, routine physical check-ups, and essential immunizations.
  • Diagnostic and Specialized Care: blood tests, X-rays, CT/MRI scans, and both inpatient and outpatient surgical procedures.
  • Dental and Vision Care: basic dental examinations and treatments, eye exams, prescription eyeglasses.
  • Prescriptions and Mental Health: prescription drug support, psychological counseling, and various services for substance use disorder treatments.

How to Apply

  • Online: NJ FamilyCare/quickstart or NJHelps.gov
    • 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).

 

Resources

Resources

Medicaid