Is Medicaid's NJ WorkAbility Program Right for You?

Medicaid, also called NJ FamilyCare, is government-funded health coverage for people in certain situations. You may qualify if you:

Answer the questions on this page to see if you might qualify for NJ WorkAbility. If so, it’s a good option to consider because it lets you earn a lot more money and pay a monthly premium, low copayments, and no deductible to get Medicaid’s comprehensive coverage.

Do You Meet NJ WorkAbility’s Basic Requirements?

To qualify for NJ WorkAbility, you must:

  • Live in New Jersey
  • Be 16 – 64 years old
  • Have a permanent disability
  • Be working, and
  • Be a U.S. citizen or meet specific noncitizen requirements.

If you live in New Jersey, are 1664 years old, working, have a disability, and are either a U.S. citizen or a non-citizen who qualifies, NJ WorkAbility might be an option for you.

Medicaid’s rules for immigrants:

Do You Have a Disability That Meets Social Security’s Standards?

To qualify for NJ WorkAbility, you must have a disability that meets Social Security’s definition of disability. For adults, Social Security says you have a disability if:

  • You have a physical or mental impairment or combination of impairments, and
  • Your condition has lasted or is expected to last for at least 12 months.

Note: For NJ WorkAbility, Social Security’s disability rules related to earned income do not apply.

If you currently get disability benefits, like Social Security Disability Insurance (SSDI), you already meet Social Security’s disability standards. If not, the Disability Review Team at New Jersey's Division of Medical Assistance & Health Services (DMAHS) checks to see if your disability qualifies for NJ WorkAbility.

If you already have a disability determination from Social Security or think that your disability meets Social Security’s standards, NJ WorkAbility might be an option for you.

Do You Have Low Resources?

Resources are money and property you own. For NJ WorkAbility you must have less than $20,000 in liquid assets for an individual, or $30,000 for an eligible couple.

Some resources don’t count towards NJ WorkAbility’s resource limit, like the home you live in, one car, and money you have in an ABLE account or retirement account, such as an IRA or 401(k).

If your resources are below the limit, NJ WorkAbility might be an option for you.

Is Your Income Below NJ WorkAbility’s Income Limit?

Your unearned income must be at or below $1,012 per month for individuals ($1,372 for couples). If you live with a spouse or parents, some of their income may be deemed, meaning it will be counted for eligiblity. The NJ WorkAbility program does not count Social Security Disability Insurance (SSDI) or Railroad Retirement System benefits as income.

Plus, your earned income must be at or below $61,720 per year for individuals. For this limit, only your earned income is counted. You can get a good job and might still qualify for Medicaid's NJ WorkAbility program coverage!

Note: The limits for income and resources are higher for couples where both people have disabilities and are working.

Get more information about the NJ WorkAbility income limits.

If your income is low enough and you meet all other requirements, you should sign up for NJ WorkAbility, after making sure it is better than any employer-sponsored coverage you could get.

NJ WorkAbility’s monthly premium

If your countable income is more than 150% of the Federal Poverty Guidelines ($1,518 per month for an individual), the monthly premium for NJ WorkAbility coverage is $25. If your countable income is less than 150% of the FPG, there is no charge.

Example

Freddy has no unearned income and makes $4,743 per month at his job. He makes way too much money for Medicaid, so his county worker tells him to apply for NJ WorkAbility.

When the county reviews his application, it says Freddy only has $2,329 in countable income, so he easily qualifies for NJ WorkAbility. He has to pay a $25 monthly premium, but it’s less than he’d have to pay for private insurance.

How to Sign Up

Before you apply, NJHelps lets you get an anonymous estimate of whether you qualify for Medicaid's NJ WorkAbility program or other state and federal programs.

You can apply for Medicaid's NJ WorkAbility program:

NJ FamilyCare lists the information and documents you may need when you apply. For help with your application, talk with a Health Benefits Coordinator at 1-800-701-0710 or 1-800-701-0720 (TTY).

Staying on NJ WorkAbility

Usually, once approved for NJ WorkAbility, you continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, let your county Board of Social Services know within 10 days of the change. You can do this in person, by phone, or by email. When you report your changes, the county tells you if you continue to get NJ WorkAbility and if your premium changes.