N.J. Admin. Code § 10:69-3.30 - Absence for reasons other than institutional

(a) Temporary absence of a child that has not lasted more than 30 consecutive days does not affect eligibility. When the absence of a child lasts longer than 30 days or it appears that an absence will last longer than 30 days, the CWA shall review the situation.

1. If it is found that the parent or parent person lacks or will lack both physical custody and responsibility for day to day care of the child and the situation is likely to continue for more than 90 days, the child is no longer eligible for Medicaid coverage. In situations in which the whereabouts of the child is unknown, or the parent or parent-person is precluded from contact, or the time period is otherwise indefinite, the child is no longer eligible for Medicaid coverage.

2. If it is found there is reasonable expectation that the child will return to the home within 90 days, the child remains eligible.

3. The child remains eligible during the time that the review under (a) above is in process, but not longer than 90 days.

4. In unusual situations involving particular hardship, the CWA may consult with the Division of Medical Assistance and Health Services.

(b) Regarding parent or parent-person, temporary absence of not more than 30 days for whatever reason shall not affect eligibility provided that adequate care and supervision of the child(ren) has been arranged in advance. When necessary, arrangements shall be made by the CWA regarding changing the receiver of the Health Benefits Identification (HBID) Card or HBID Emergency Services Letter.

1. The CWA shall obtain approval from the DMAHS for continuing eligibility in unusual situations of temporary absence lasting more than 30 days.

(c) When the entire family unit leaves the State for a temporary visit, the provisions of N.J.A.C. 10:69-3.19 and 3.20 shall apply.

Notes

N.J. Admin. Code § 10:69-3.30

Amended by 49 N.J.R. 3729(a), effective 12/4/2017