Njfamilycare 2015-2019 form-2025

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  1. Click ‘Get Form’ to open the njfamilycare 2015-2019 form in our platform.
  2. Begin by filling out Step 1, which requires personal information. Enter your first name, middle name, last name, and suffix. Provide your home address, city, state, ZIP code, and county.
  3. Proceed to Step 2 to include details about your family members. List all individuals living with you who need coverage. Ensure you provide their names and relationships accurately.
  4. In Step 3, indicate if any family member is Native American Indian or Alaska Native. If yes, complete Appendix B for additional benefits.
  5. Complete the income section for each family member needing coverage in Step 4. Include employer information and income details as required.
  6. Review all entered information for accuracy before signing the application in Step 6. Use our editor's features to make any necessary adjustments easily.
  7. Finally, mail your completed application to the provided address on page 7 of the form.

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NJ FamilyCare - New Jerseys publicly funded health insurance program - includes CHIP, Medicaid and Medicaid expansion populations.
Citizens or qualified immigrants. For an adult to qualify for NJ FamilyCare, the total family income must be at or below 138% of the Federal Poverty Level. For a single person, that is $1,800 a month; for a family of 4, that is $3,698 a month (2025 guidelines).
You must renew your NJ FamilyCare (Medicaid) benefits every year. Watch for a renewal notice in the mail. NJ FamilyCare will send the notice. It may be a preprinted form or a blank application.
0:06 3:11 While a household of two must have less than $3,41. These limits apply to most households. ButMoreWhile a household of two must have less than $3,41. These limits apply to most households. But there are exceptions exceptions for seniors and people with disabilities.
Who is Eligible? Children under 19 are eligible with higher incomes up to 355% of the Federal Poverty Level (FPL) ($9,512/month for a family of four). Adults age 19-64 with income up to 138% FPL ($1,800/month for a single person and $2,433/month for a couple).

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Previously, premium tax credits were only available up to certain income levels ($51,040 for an individual or $104,800 for a family of four). Effective in 2021, there are no longer income limits for consumers to qualify for financial help through Get Covered New Jersey.

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