Medicaid for Adults

Adults with developmental disabilities that intend to seek services from the Division of Developmental Disabilities (DDD) need to have Medicaid.

How to obtain Medicaid:

Qualify for Supplemental Social Income (SSI): In New Jersey, anyone who qualifies for SSI automatically receives Medicaid. A separate application is not required. (See SSI for Adults)

If denied SSI:

If the individual is denied SSI because the disability is not deemed severe enough, then,

  1. Apply for Aged, Blind and Disabled Medicaid (ABD). If you applied and were rejected for SSI, then you should wait a year before applying for ABD. For ABD, you will need medical documents for proof of disability.
  2. Apply for regular NJ Familycare(Medicaid expansion): To qualify, the adult child cannot be a dependent on the parent’s tax return. Income and asset limits apply.

If there is a loss of SSI due to the receipt of Social Security Disabiity Insurance (SSDI): If an individual loses SSI because they start to receive SSDI due to a parent’s retirement, disability or death, that individual will receive a request for information that, by filling out, enables the individual to maintain Medicaid and DDD services. (see SSDI sheet for more information).

Exception to Medicaid Requirement: If the adult child never qualified for SSI and does not meet the income or asset requirements for Community Medicaid, then he or she may qualify as a Non-DAC to receive DDD services. (See Non-DAC sheet)

Medicaid through NJ WorkAbility

Applies to individuals with disabilities between the ages of 16 and 64 that are working either part-time or full-time. Individuals may earn up to $64,596 (as of 2021) and hold up to $20,000 in assets. 401(k) and IRAs do not count toward eligibility.

If the individual’s employment ends, the individual will have one year to find other employment before Medicaid under NJ Workability ends. This rule is in the process of being implemented in NJ and will replace the existing rule that terminates NJ Workability when an individual is no longer employed.

For information regarding maintaining eligibility, see njwins.org.

Medicaid Information Help: For more information about Medicaid, go to this link: https://www.thearcfamilyinstitute.org/file_download/inline/87992212-a639-42d9-b760-0b0edffe397f

You can also fill out and submit the Medicaid Troubleshooting form: https://www.arcnj.org/file_download/inline/957e1adb-be84-4ead-bc6b-47e96376b774