Medicaid Programs page 1
Medicaid information page 1

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.

Breast And Cervical Cancer Program

This program provides full Medicaid benefits to uninsured individuals 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, individuals must be screened through the New Jersey Cancer Education and Early Detection Program administered by the Department of Health and Senior Services. Once an individual is determined eligible for this program, they continue to be eligible, without regard to changes in their financial circumstances, until they no longer require cancer treatment. As long as an individual is eligible, they are entitled to receive all Medicaid-covered services from a Medicaid-participating provider.

Burial Assistance Program

Federal, state, and county funding enables Board to provide burial assistance for Ocean County residents who had been recipients of Supplemental Security Income (SSI), Medicaid Only, New Jersey Care, Temporary Assistance for Needy Families (TANF), Medically Needy, General Assistance (GA), and Managed Long Term Services and Supports (MLTSS). Payment is made directly to funeral homes.

The Community Project – Community Medical Center (CMC)

Board staff that is stationed onsite at Community Medical Center screen patients and secure applications for Board programs.

Early Periodic Screening, Diagnosis, And Treatment (EPSDT)

New Jersey FamilyCare and Temporary Assistance for Needy Families (TANF) recipients, whose children are under age 21, are informed of special preventive health services available through Early Periodic Screening, Diagnosis, and Treatment. Recipients participating in well-child yearly examinations are also provided with support services which assist them in locating medical providers.

Family Planning

Professional family planning services are available to all recipients of Medicaid. Board provides information and literature on these services through the Early Periodic Screening, Diagnosis, and Treatment staff.

Managed Long-Term Services and Supports (MLTSS)

MLTSS provides home care to disabled Medicaid beneficiaries meeting the income, asset, and nursing facility level of care requirements established by Medicaid, who otherwise would be unable to safely live in the community. MLTSS is designed to expand home and community based services and includes assistance for persons with traumatic brain injuries, AIDS, and those requiring hospice services. Case management services are provided by the Managed Care Organization. MLTSS also provides comprehensive services and supports, whether at home, in an assisted living facility, in community residential services, or in a nursing home.

Medicaid Extension

Extended Medicaid benefits are available to families who lose eligibility for Medicaid due to employment-related criteria based upon the income standards and methodologies in effect for the Aid to Families with Dependent Children Program as of July 16, 1996. Thus, extended Medicaid benefits will begin with the loss of Work First New Jersey cash assistance only when that loss is coincident with the loss of Medicaid eligibility under the July 16, 1996, Aid to Families with Dependent Children Program income standards and methodologies.

Medicaid Only

Medicaid Only is available to the 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 services at Ocean Health Initiatives in Lakewood, NJ and Ocean Health Initiatives in Toms River, NJ. An additional outstationing site is The Community Project at Community Medical Center (CMC) in Toms River, NJ.

Medicaid Special

Medicaid Special 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.

Medically Needy

The Medically Needy Program provides limited medical benefits to New Jersey residents who may not be able to afford health care services but have income and/or assets that are too high for them to qualify for Medicaid. Medically Needy provides assistance for persons in the community who are not otherwise Medicaid eligible. The Medically Needy Program is unique in that if the income of the household exceeds the standard, the client may spend down their income and attain eligibility if they have outstanding medical bills.

New Jersey FamilyCare

The NJ FamilyCare Program provides health insurance for families, single adults, and childless couples as well as pregnant women who are unable to afford prenatal care. Eligible women receive health care coverage during their pregnancy and for 60 days following delivery or the date on which the pregnancy ends. Health care and immunizations are also provided for eligible infants and children. Applicants must meet program income guidelines. There is no resource
limit in determining financial eligibility.

NJ FamilyCare Aged, Blind, Disabled (ABD) Programs

Low-income individuals aged 65 and over or individuals who meet the Social Security Administration guidelines for disability or blindness are eligible for the ABD segment of the NJ FamilyCare Program.

NJ WorkAbility Program

This is a state and federally funded program that provides Medicaid benefits to permanently disabled individuals between the ages of 16 and 64 who are employed either full or part time. Financial eligibility is determined using the individual's earned income while disregarding their Social Security disability benefits. A disability determination either from the Social Security Administration or from the Disability Review Team of the New Jersey Division of Medical Assistance and Health Services is required.

Transportation Services

Emergency Assistance (EA) - Transportation services are provided to eligible recipients of Emergency Assistance.

Fair Hearings - Beneficiaries receive transportation to attend fair hearings concerning adverse actions to the beneficiary.

Friendship Corner - Transportation for Friendship Corner clients is provided for several annual events held during the year.

Persons With AIDS (PWA) Transportation - The Board provides health related transportation to HIV clients referred from various service providers. Transportation services are provided by contracted vendors.

Safe Housing and Transportation Program - Escorted transportation and housing rehabilitation are provided to senior citizens in Ocean County.