NJ WorkAbility

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

• Have low income, no matter how much you have in resources or whether you have a disability. Learn more about income-based Medicaid.
• Get Supplemental Security Income (SSI) benefits or qualify for SSI’s 1619(b) rule, which helps people who used to get SSI. In either case, you automatically get Medicaid coverage and don’t need to worry about the rules discussed here. Learn more in DB101’s SSI article.
• Have low income, low resources, and a disability. Learn more about disability-based Medicaid.
• Have a disability and work, even if your income is higher. Medicaid's NJ WorkAbility program is explained on this page.

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 still get Medicaid’s comprehensive coverage.

Note: NJ WorkAbility used to have an income limit and a resource limit. The rules have changed and since February 1, 2024, there are no more limits!

Do You Meet NJ WorkAbility’s Basic Requirements?

To qualify for NJ WorkAbility, you must:

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

If you live in New Jersey, are at least 16 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:

• Undocumented immigrants do not qualify for full Medicaid coverage, but they may qualify for Medicaid coverage for emergency services.
• Most immigrants who have been lawfully present for less than five years do not qualify for full Medicaid coverage. However, they may qualify for private coverage subsidized by the government.
• Immigrants who have been lawfully present for five years or longer and some other noncitizens who meet specific noncitizen requirements qualify for the same programs that U.S. citizens can get.

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, New Jersey's Disability Determination Service (DDS) checks to see if your disability qualifies for Medicaid.

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.

If your countable income is less than 250% of the Federal Poverty Guidelines ($3,138 per month), there is no monthly premium for NJ WorkAbility coverage. Countable income only counts about half of your earned income. If you have no unearned income, you could actually make as much as $76,332 per year at a job and still not pay a premium!

If your income is higher than 250% of FPG, there's a monthly premium that is $175 per month or higher, depending on how much income you have. Get more information about the premium.

Note: For NJ WorkAbility, your spouse's income is not counted, so it will not affect your premium amount.

Freddy has no unearned income and makes $5,960 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 calculates that Freddy has $2,938 in countable income, so he can get NJ WorkAbility without paying a monthly premium, because his income is below 250% of FPG.

How to Apply

You can apply for Medicaid's NJ WorkAbility program:

• Online using NJ FamilyCare Quickstart, or
• At an outreach and enrollment site in your county.

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, disability status, 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.