Each state has its own Medicaid program. Every Medicaid program includes some coverage for women who are pregnant. The exact coverage can vary from one state to another. New Jersey has three Medicaid programs that cover women who are pregnant.
Medicaid is a public, or government run, form of health insurance. It is designed to provide health insurance coverage for individuals and families who are low income and who cannot afford to buy a health plan from a private insurance company. Medicaid is funded, in part, by the federal government. It is also funded by the government of an individual state.
In New Jersey, the Medicaid program has a portion called NJ FamilyCare, or Families and Children. It covers children who are under the age of 18. Some parents might also qualify for coverage through the program. It also covers women who are pregnant.
To be eligible for the Families and Children Medicaid program, women who are pregnant must be a resident of New Jersey. She also must be either a citizen of the United States, or an immigrant “whose papers allow them to reside permanently in the United States”. The woman must come from a family whose income is at or below 200% of the federal poverty level.
Women who qualify for coverage will have it during the pregnancy, and for 60 days following the delivery or date on which the pregnancy ends. A child born to a mother who is eligible for Medicaid will be covered by the program for one year, even if the family’s income changes. Pregnant women must apply for coverage at their doctor’s office or at a clinic.
There is no specific information on the New Jersey website that gives details about what treatment and services the program covers. Instead, it lists the things that the main Medicaid program covers. This is confusing, because it is difficult to tell if things like labor and delivery, post partum care, family planning, or well-baby checkups are included or if they are excluded.
Pregnant women who are not citizens of the United States, or who are not a legal permanent resident of New Jersey, might be eligible for the Medical Emergency Payment Program for Aliens. It might cover treatment that is necessary in an emergency medical condition, including labor and delivery. She may also be eligible for the NJ Supplemental Prenatal Care program.
New Jersey also has a Medically Needy section of the Medicaid program for pregnant women. This is for low income women who are pregnant who cannot qualify for the main Medicaid program because their income and resources are too high. The program includes a spenddown provision.
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