Medicaid Program Descriptions

Medicaid is a program that pays medical bills for low-income individuals who qualify for assistance through programs administered by either the Ocean County Board of Social Services or the federal government. All payments are made directly to the providers of medical and other health-care services.

AIDS Community Care Alternatives Program (ACCA)

ACCAP provides services to individuals with Acquired Immune Deficiency Syndrome (AIDS). The purpose is to help individuals remain in the community rather than a long-term facility or hospital setting.

Breast And Cervical Cancer Program

This program is to provide full Medicaid benefits to uninsured women under the age of 65 who have been diagnosed with breast and/or cervical cancer and who are in need of treatment. As part of the eligibility requirement for this program, women must be screened through the New Jersey Cancer Education and Early Detection Program administered by the Department of Health and Senior Services. Once a woman is determined eligible for this program, she continues to be eligible without regard to changes in her financial circumstances until she no longer receives cancer treatment. As long as a woman is eligible, she is entitled to receive all Medicaid-covered services from a Medicaid-participating provider.

The Community Project – Community Medical Center (CM)

This program is a co-operative effort with Community Medical Center (CMC). Board staff stationed on-site at CMC screen patients and secure applications for Board programs.

Community Resources For Persons With Disabilities

This extends Medicaid services to eligible individuals to help them remain in the community rather than be cared for in a long-term care facility or hospital setting. Home services, including case management, are provided to aged and disabled persons who meet the eligibility requirements of the program. The Ocean County Board of Social Services provides case management services to both the client and the caregiver.

Early Periodic Screening, Diagnosis, And Treatment (EPSD)

This is a preventive health-care program for Medicaid eligible persons under the age of 21. The purpose is early detection of medical and dental problems and follow-up care for any serious health problems. Medicaid eligible persons who are part of a health maintenance organization (HMO) also receive these services as part of their membership.

Family Planning

Family planning services are covered by Medicaid. Board staff explains to clients the availability of family planning services through private physicians and the local family planning clinic.

Hospice Program

This program provides care for the terminally ill, emphasizing supporting and palliative rather than curative care. Services include bereavement counseling and pain control.

Medicaid Extension

Extended Medicaid benefits are available to families who lose eligibility for Medicaid due to employment-related criteria based on the income standards and methodologies in effect for the AFDC program as of July 16, 1996. Thus, extended Medicaid benefits will begin with the loss of WFNJ cash assistance only when that loss is coincident with the loss of Medicaid eligibility under the July 16, 1996 AFDC income standards and methodologies.

Medicaid Only

Medicaid Only is available to aged, blind, and disabled residents of Ocean County. Eligible individuals may reside in the community, a nursing home, or may be confined to a general or rehabilitation hospital. Eligibility is based on the applicant’s income, as well as resource guidelines which relate to the individual’s living arrangements.

Medicaid Outstationing Service

As a result of federal and state mandates, the Board implemented outstationing at Kimball Medical Center (KMC) in Lakewood, NJ in 1991. In addition, three other sites were added: Ocean Health Initiative, Lakewood, Ocean Health Initiative, Toms River, and Ocean Medical Center, Brick.

Medicaid Special

This is designed to provide adequate medical care for children under the age of 21. Financial eligibility is based on the income and resources of the individual and/or his or her parents. The income of the spouse is also considered if married.

Medical Transportation

Transportation services to and from medical appointments are available for most Medicaid-eligible persons. Recipients may drive their own cars and be reimbursed for mileage when authorized or take public transportation and be reimbursed. Other methods of transportation include taxi service, volunteer drivers, social service aides employed by Board, or the Ocean Ride Program through the Ocean County Department of Transportation and Vehicle Services. Board determines the most feasible method on a per-case basis.

Medically Needy

This provides limited medical benefits to certain New Jersey residents who may not be able to afford health care services but have income and/or assets that are too high to qualify for other Medicaid services. Must be 65 or older, blind, disabled, pregnant, or needy child under 21 years of age.

Care For The Aged, Blind, & Disabled (ABD)
Low-income individuals aged 65 and over and individuals who meet the Social Security Administration guidelines for disability or blindness are eligible for the ABD segment of the New Jersey Care Program.

New Jersey Family Care

This is a state subsidized health insurance program that provides Medicaid coverage for pregnant women, children, and some parents and caregivers. Eligibility is based upon income and alien status. Comprehensive health services are provided through health maintenance organizations (HMO’s).

Persons With AIDS Transportation

The Ocean County Board of Social Services provides health-related transportation to HIV clients referred from various service providers. Transportation services are provided by contracted vendors.
Transportation Unit & Services

The Transportation Services unit administers the following programs or services:
• Title 4A Emergency Assistance
• Holiday Program
• Retired & Senior Volunteer Program
• Safe Housing and Transportation Program
• Title XIX Medical Transportation
• Transportation Assistance Program
• Persons With AIDS
• Fair Hearings
• General Assistance
• Friendship Corner

Traumatic Brain Injury

This provides services which enable eligible individuals to remain in or return to the community rather than be cared for in a nursing facility. Services include case management, personal care assistance, night supervision, respite, and day care.

Voter Registration

The National Voter Registration Act was implemented in New Jersey. Accordingly, staff offers all applicants/clients the opportunity to register to vote at each application, address, change, recertification, or redetermination interview.