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Learn About CHIP in New Jersey

The New Jersey Children’s Health Insurance Program (CHIP) assists low-income family members with providing health insurance for their children. NJ CHIP provides basic doctor’s visits, dental care and hospital stays for qualified applicants in the state of New Jersey. The program aims to give qualifying children access to preventative and early intervention medical treatments at low or no cost. However, not everyone is eligible for CHIP, and not all treatments are covered. For those still wondering, “What is CHIP Medicaid?” and “What is covered by CHIP Medicaid?” review the sections below.

What is the Children’s Health Insurance Program (CHIP) in New Jersey?

New Jersey CHIP and Medicaid enrollment both fall under the NJ FamilyCare umbrella. NJ FamilyCare covers Medicaid for children, the Children’s health insurance program, Medicaid for adults and Medicaid for those with disabilities. All government-funded health insurance in New Jersey is called NJ FamilyCare. Note that NJ FamilyCare is separate from other governmental support programs, such as Temporary Assistance for Needy Families (TANF) and Supplemental Security Income (SSI). To learn more about the CHIP and Medicaid programs, download our free guide.

Is CHIP considered Medicaid in New Jersey?

The NJ Children’s Health Insurance Program (CHIP), Medicaid, Medicaid for Children and Medicaid expansion programs are all covered under NJ FamilyCare. Medicaid covers low-income or disabled adults and children, while NJ CHIP is available to children from higher-income families that still need help finding affordable health insurance. The applicant’s household income level will determine if he or she will qualify for New Jersey children’s Medicaid, CHIP or another type of program. The income and other factors will also determine if the NJ FamilyCare beneficiary will have to pay any premiums or copays. Since CHIP in New Jersey is designed for higher-income families, CHIP beneficiaries will most likely have to pay small premiums or copays, while most children on Medicaid will not have to pay premiums or copays. Since CHIP is not considered Medicaid, if an applicant does not have Medicaid eligibility children can still be covered under CHIP.

Who qualifies for CHIP in New Jersey?

When it comes to the Medicaid eligibility children in NJ can meet, the qualifying guidelines should be the first consideration. How to apply for CHIP and Medicaid under NJ FamilyCare requires an applicant to:

  • Be a citizen of the United States or be a legal alien.
  • Be age 18 or younger.
  • Have been without health insurance coverage for three or more months.
  • Come from a family with a qualifying income.

Even if an applicant originally didn’t qualify for NJ CHIP or Medicaid eligibility, he or she can still apply for CHIP at a later date if a major change happened in his or her life. For example, the loss of a parent’s job or a change in the number of people living in a household can affect if the applicant is qualified. For legal alien adults interested in NJ FamilyCare, they must have resided in the United States for a required time period in order to learn how to apply for benefits. However, Children’s Medicaid and Children’s Health Insurance Program (CHIP) applicants are exempt from this rule. In addition, pregnant women can still enroll in NJ Medicaid if their incomes fall within the guidelines for coverage.

How to Apply For CHIP in New Jersey

Since CHIP is considered Medicaid expansion and it is covered under NJ FamilyCare, both CHIP and Medicaid enrollment applicants can apply using the same online process. If an applicant is accepted, he or she will have up to five insurance plans from major health insurance providers to choose from. Not every county has all five insurance plans available, so it is important for CHIP beneficiaries to review which plans they can access. The status of a child’s Medicaid eligibility will affect the type of plan he or she can choose, and the cost associated with it. Download our guide to review more information on how to apply for CHIP.

What is covered by CHIP Medicaid in New Jersey?

The CHIP and Medicaid programs under NJ FamilyCare cover many essential and preventative services and treatments. NJ FamilyCare eligible children will have access to:

  • Check-ups.
  • Prescription medication.
  • Eye exams.
  • Laboratory tests.
  • X-rays.
  • Mental health treatment.
  • Dental care.
  • Preventative screenings.

NJ CHIP programs and other Medicaid options cover the services above, as well as many others, when deemed medically necessary. These services are covered by CHIP and Medicaid; only a small percentage of beneficiaries have to pay nominal copays for treatments. Experimental or scientifically unproven medical treatments are unlikely to be covered by NJ FamilyCare.

To learn more about CHIP coverage, download our guide.