Navigating the Medicaid application process in New Jersey can be overwhelming, especially if you’re applying for the first time or trying to help a loved one. Between the paperwork, eligibility requirements, and timelines, many people feel lost before they even get started.

But here’s the good news: with the right guidance and preparation, the Medicaid application process becomes much more manageable. In this blog, we’ll break it all down—step-by-step—so you’ll know exactly what to expect and how to avoid common mistakes.

What Is Medicaid?

Medicaid is a joint federal and state program that provides health coverage for individuals with low income, including seniors, people with disabilities, pregnant women, and families with children.

In New Jersey, Medicaid is managed by the Division of Medical Assistance and Health Services (DMAHS) and includes several different programs, such as:

• NJ FamilyCare – general health coverage for low-income residents
• Managed Long Term Services and Supports (MLTSS) – for seniors and people with disabilities needing home care or long-term care
• Aged, Blind, and Disabled (ABD) Programs – for individuals over 65 or with qualifying disabilities

Who Should Apply?

You or a loved one should consider applying for Medicaid in New Jersey if:

• You are a senior (65+) who needs assistance paying for healthcare or long-term care
• You have a disability and need help covering care services
• You require home care services or are considering a nursing home or assisted living
• Your income and assets fall below specific limits

Even if you’re unsure about your eligibility, it’s worth checking—many people qualify without realizing it.

Step-by-Step: How to Apply for Medicaid in New Jersey

Step 1: Gather Your Documents

Before you begin the application, collect the required documents. Having everything ready will help avoid delays.

You’ll typically need:

• Proof of identity (driver’s license, passport, birth certificate)
• Social Security card
• Proof of residency in New Jersey (utility bill, lease)
• Proof of income (Social Security, pension, wages)
• Bank statements (past 3 to 5 years may be needed for long-term care)
• Information about property, vehicles, life insurance, and other assets
• Medical records or disability documentation (if applicable)
• Health insurance policies or Medicare cards

For seniors applying for long-term care or MLTSS, a “five-year look-back” period may apply, where financial transactions are reviewed to determine eligibility.

Step 2: Complete the Application

There are multiple ways to apply for Medicaid in New Jersey:

Online

Visit www.njhelps.org to complete the application electronically.

In Person

You can apply at your County Board of Social Services. Each county has a local office where staff can help you fill out the forms.

By Mail or Fax

Request a paper application from your county’s office and submit it by mail or fax when complete.

Step 3: Participate in an Interview

Most Medicaid applicants will have a follow-up interview with a caseworker. This may happen in person or over the phone.

During the interview, the caseworker will:

• Review your application and documents
• Ask questions to clarify your financial situation
• Explain next steps and additional forms (if needed)

It’s important to answer honestly and provide any requested documents quickly to keep the process moving.

Step 4: Wait for a Decision

Once your application is submitted and the interview is completed, you will receive a Notice of Determination in the mail. This notice will tell you if your application was:

• Approved
• Denied
• Pending (waiting for additional info)

The processing time varies but typically takes 30 to 90 days, depending on the complexity of your case.

Step 5: Receive Benefits and Choose a Health Plan (if applicable)

If approved, you’ll receive a Medicaid card and may be asked to select a Managed Care Organization (MCO) to manage your services. For example:

• Amerigroup
• Horizon NJ Health
• UnitedHealthcare Community Plan
• Aetna Better Health of NJ

If you are approved for MLTSS, your benefits may include:

• Home care services
• Adult day care
• Assisted living
• Nursing home care
• Transportation
• Care management

Tips for a Smooth Medicaid Application

Here are some helpful tips to make the process easier:

✅ Stay Organized

Create a folder (physical or digital) to keep all documents in one place. Label each section (e.g., “Bank Statements,” “ID,” “Income Proof”).

✅ Don’t Delay

Start early, especially if you or a loved one may soon need long-term care. The process can take time, and benefits cannot be backdated indefinitely.

✅ Be Accurate

Mistakes or missing information can cause delays or denials. Double-check all numbers and documents before submitting.

✅ Ask for Help

Medicaid rules can be confusing. Consider working with:

• Social workers
• Elder law attorneys
• Home care agencies that assist with Medicaid applications
• County Board of Social Services

These professionals can help make sure you meet the criteria and complete forms correctly.

Common Challenges and How to Handle Them

🔹 Denial Due to Excess Assets

If you exceed the asset limit, consider options like:

• Spending down on allowable expenses (medical bills, home repairs)
• Setting up a Qualified Income Trust (QIT) (also known as a “Miller Trust”)
• Consulting with a Medicaid planning expert

🔹 Lack of Documentation

Missing bank statements, ID, or income records? Request replacements ASAP and inform your caseworker. Partial applications can be rejected or delayed.

🔹 Long Processing Times

Check in regularly with your caseworker. Keep a log of who you spoke with and when. If needed, escalate to a supervisor or legal aid if your case is stuck.

How Home Care Agencies Can Help

Many home care agencies in New Jersey—including ours—offer Medicaid application assistance as part of their services. Whether it’s helping you understand the paperwork or connecting you to legal and financial resources, we can guide you every step of the way.

We can also help determine if you or your loved one may qualify for MLTSS, which allows you to receive personal care services at home—covered by Medicaid.