Current through Register Vol. 54, No. 7, April 4, 2022
FamilyCare-Children's Program is a program administered by the Division of
Medical Assistance and Health Services, Department of Human Services to provide
plan-defined health care benefits to certain children.
The purpose of the rules contained within
this chapter is to:
1. Set forth eligibility
criteria for the NJ FamilyCare-Children's Program;
2. Specify the rights and responsibilities of
program applicants and eligible persons; and
3. Describe the administration of the
(c) Because the
eligibility criteria established by the rules contained within this chapter are
more liberal than those applicable under AFDC-related Medicaid and SSI-related
Medicaid, children losing AFDC-related eligibility because of financial reasons
should be evaluated under the provisions of this chapter for the possibility of
NJ FamilyCare-Children's Program eligibility.
(d) Children eligible under this chapter are
eligible for NJ FamilyCare-Children's Program-Plan A, Plan B, Plan C or Plan D
services which are set forth in N.J.A.C. 10:49-5. NJ FamilyCare-Children's
Program-Plan A is a means-tested Federal entitlement program.
(e) Plans B, C and D are not Federal
entitlement programs. Enrollment and expenditures shall be monitored closely.
Enrollment shall be stopped when total expenditures are projected to equal the
available funding level. If that point is reached, any additional applicants
shall be placed on a waiting list, with preference determined based on date of
enrollment and income.
financially ineligible for Medicaid under the provisions of N.J.A.C. 10:69,
10:71 and 10:72 and who are income ineligible for NJ FamilyCare-Children's
Program under the provisions of this chapter shall be evaluated for eligibility
as Medically Needy under the provisions of N.J.A.C. 10:70 or shall be referred
to the NJ FamilyCare Advantage Program.
N.J. Admin. Code §
Amended by R.1998 d.154,
effective 2/27/1998 (operative
March 1, 1998; to expire August 31, 1998).
See: 30 N.J.R. 1060(a).
Inserted new (d) and (e); and recodified former (d) and (e) as (f)
Adopted concurrent proposal, R.1998 d.487, effective
N.J.R. 1060(a), 30 N.J.R. 3519(a).
Readopted the provisions of
R.1998 d.154 without change.
Amended by R.1999 d.211, effective
7/6/1999 (operative August 1,
See: 31 N.J.R. 998(a), 31 N.J.R. 1806(a), 31 N.J.R.
In (d) and (e), inserted references to Plan D.
Amended by R.2004 d.42, effective 1/20/2004.
See: 35 N.J.R. 3802(a),
36 N.J.R. 572(b).
In (d), added the last sentence; in (f), amended
the N.J.A.C. references; deleted (g); substituted references to the NJ
FamilyCare-Children's Program for references to NJ KidCare throughout.
Amended by R.2009 d.232, effective 7/20/2009.
See: 41 N.J.R. 945(a),
41 N.J.R. 2793(a).
In (f), inserted "or shall be referred to the
NJ FamilyCare Advantage Program".