Costs and coverage
How to apply for NJ FamilyCare when you're in recovery
To apply for NJ FamilyCare, use the online application at njfamilycare.org, call 1-800-701-0710 (TTY 711), or go to your County Board of Social Services; single adults ages 19 to 64 can qualify with income up to 138% of the federal poverty level, listed as $1,836 a month. If you have started an application, submit it by 11:59 p.m. on December 31, 2026: unsubmitted applications close then, and new eligibility rules start January 1, 2027 (NJ DMAHS, 2026). Jump to the application checklist.
- Ways to apply
- Online, by phone at 1-800-701-0710, or at a county office.
- Single adults
- Ages 19 to 64, income up to 138% of the poverty level.
- In recovery
- Substance use treatment is covered; sober living rent is not.
- Deadline
- Submit started applications by 11:59 p.m. on December 31, 2026.
Reviewed against public records, . Sources: NJ Division of Medical Assistance and Health Services (NJ FamilyCare), NJ Division of Family Development, U.S. Code, Code of Federal Regulations. Sources
Who qualifies for NJ FamilyCare as a single adult?
A single adult can qualify for NJ FamilyCare at ages 19 to 64 with household income up to 138% of the federal poverty level, which NJ FamilyCare lists as $1,836 a month for one person and $2,489 a month for a couple. The limits change every year, so check the current figures on the official NJ FamilyCare eligibility page before you rely on them (NJ FamilyCare, 2026).
NJ FamilyCare is New Jersey's Medicaid and CHIP program, run by the Division of Medical Assistance and Health Services (DMAHS) in the state Department of Human Services. Income is counted with the Modified Adjusted Gross Income (MAGI) method, and household size comes from your latest federal tax return (NJ FamilyCare, 2026).
NJ FamilyCare's own pages set four more facts for adult applicants:
- New Jersey residence
- You must live in New Jersey; every resident can apply (NJ FamilyCare, 2026).
- Citizenship or immigration status
- U.S. citizenship or a qualified immigration status. Most non-citizen adults need 5 years as a Lawful Permanent Resident, with exceptions, and from October 1, 2026 some non-citizens may no longer qualify (NJ DMAHS, 2026).
- Past drug convictions
- Since January 1, 2014, prior convictions for possession, use or distribution of controlled substances are not a factor in Medicaid eligibility (NJ FamilyCare, 2026).
- Cost
- No monthly premium for any plan since July 1, 2021 (NJ FamilyCare, 2026).
If your income is above the limit, NJ FamilyCare points you to Get Covered NJ, the state's health insurance marketplace. People 65 or older, blind or disabled, and adults with Medicare, apply under separate Aged, Blind and Disabled rules (NJ FamilyCare, 2026).
How do you apply for NJ FamilyCare: online, by phone or in person?
You can apply for NJ FamilyCare online, by phone with a Health Benefits Coordinator, or in person at your County Board of Social Services or a county enrollment site, and the state calls the online application the fastest and easiest way. All three routes lead to the same application (NJ FamilyCare, 2026).
Without a computer or an email address, the phone line and the county office take the same application, so no one has to apply online.
The three routes, side by side:
- Online
- Use the "Apply Here" link on njfamilycare.org. An online account lets you save an application in progress, check its status, upload documents and renew online the next year; the account needs an email address (NJ FamilyCare, 2023 and 2026).
- By phone
- Call 1-800-701-0710 (TTY 711). A Health Benefits Coordinator helps with the online form or takes the whole application over the phone, Monday and Thursday 8:00 a.m. to 8:00 p.m. and Tuesday, Wednesday and Friday 8:00 a.m. to 5:00 p.m. An interpreter can join the call (NJ FamilyCare, 2026).
- In person
- Your County Board of Social Services (the county welfare agency), or an outreach and enrollment site listed by county on njfamilycare.org. With low income right now, the county agency can also check you for other programs, such as SNAP food benefits. Call before you visit (NJ FamilyCare, 2026).
In Bergen County, for example, the Bergen County Board of Social Services is at 218 Route 17 North, Rochelle Park, phone (201) 368-4200, open 8:00 a.m. to 4:30 p.m. Monday through Friday. Every county's agency is listed on the state's County Social Service Agencies page (NJ DFD, 2026).
What do you need for the NJ FamilyCare application?
The NJ FamilyCare application asks for your New Jersey address, the names and birthdates of everyone in your household, Social Security numbers for those who have one, citizenship or immigration details, and each person's income and tax filing status. The state's application checklist lists these items and adds choosing a health plan (NJ FamilyCare, 2023).
The checklist names six things to have ready:
- The New Jersey address where you live, and a mailing address if mail goes somewhere else.
- Names and birthdates of everyone in your household.
- A Social Security number for each person who has one; you can still apply without one.
- U.S. citizenship or immigration status, with the details from the immigration document.
- Income and tax filing status: employer name and address, start month and year and gross pay (before taxes), plus other income such as unemployment or SSI.
- A health plan choice, ideally one your doctors accept.
After you apply, NJ FamilyCare may write to ask for proof of address, identity (IDs, birth certificates, passports), citizenship or immigration status, and income. Open every letter and answer it quickly (NJ FamilyCare, 2023).
Applying from a sober home or a temporary address
Give an address where letters reach you. NJ FamilyCare sends its requests and renewal notices by mail, and coverage can end over an unanswered letter even when you still qualify (NJ DMAHS, 2026).
How long does NJ FamilyCare take, and what happens after you apply?
Federal rules give a state Medicaid agency up to 45 days to decide most applications (90 days when the application is based on disability), and NJ FamilyCare mails a plastic Health Benefits Identification Card within 1 to 2 weeks of approval. The health plan's own card and information arrive about a week before that plan's coverage starts (42 CFR 435.912; NJ FamilyCare, 2023).
Choose a health plan when you apply: NJ FamilyCare says leaving it blank slows the application down, and you can change plans later. The plans DMAHS names include Aetna, Fidelis Care, Horizon, UnitedHealthcare and Wellpoint. To keep a current doctor, ask the office which NJ FamilyCare plan it takes and pick that plan (NJ FamilyCare, 2026; NJ DMAHS, 2026).
Explainer diagram
From application to renewal, in five steps
SubmitOnline, by phone or in person. Keep the confirmation page: it names the agency handling your case.
Answer lettersSend proof of address, identity, status or income if NJ FamilyCare asks.
DecisionWithin 45 days for most applicants, the federal limit.
Cards arriveID card 1 to 2 weeks after approval; plan card about a week before plan coverage starts.
RenewEvery 12 months now; every 6 months for many adults on Plan ABP from 2027.
Tell NJ FamilyCare about changes to your address, income, job or household. Changes that could affect eligibility, such as income or household size, must be reported within 10 days (NJ FamilyCare, 2023; NJ DMAHS, 2026).
What does NJ FamilyCare cover for substance use treatment?
NJ FamilyCare lists substance use disorder treatment, behavioral health care, treatment in residential treatment centers, and inpatient and outpatient hospital care among its covered services. The same list includes prescription drugs, clinic services and transportation (NJ DMAHS, 2026).
Federal Medicaid law also requires state programs to cover medication-assisted treatment for opioid use disorder: every drug the FDA has approved for it, including methadone, together with counseling and behavioral therapy. The requirement began on October 1, 2020, and a 2024 law removed its end date (42 U.S.C. 1396d).
Care is delivered through the NJ FamilyCare health plan you choose, so ask the plan's member services which treatment programs and prescribers are in its network before you start (NJ FamilyCare, 2026). The guides to evening IOP while living in a sober home and sober living on medication for opioid use disorder explain how outpatient care and MOUD fit with recovery housing. Which medication, and how much, is a decision for you and your prescriber.
Help line
ReachNJ, New Jersey's 24/7 addiction helpline, 1-844-732-2465, screens callers and connects them to treatment, whatever their insurance status or ability to pay (NJ DHS, 2026). In an emergency, call 911.
Does NJ FamilyCare pay for sober living rent?
Generally no: NJ FamilyCare pays for health care, and sober living rent is housing, which is not on its list of covered services. Federal Medicaid rules also deny federal matching funds for room and board in home and community-based services, outside narrow exceptions such as respite care in a facility (NJ DMAHS, 2026; 42 CFR 441.310).
That split shapes an early-recovery budget: NJ FamilyCare can pay for the outpatient program, therapy and medication you attend while you live in a sober home, and the rent is paid another way. The guides to whether insurance covers sober living and how to pay for sober living in New Jersey cover the options for rent.
At a glance
What NJ FamilyCare can and cannot pay for in recovery
Listed as covered
- Substance use disorder treatment
- Residential treatment centers and hospital care
- Medication for opioid use disorder, with counseling
- Behavioral health care and prescriptions
Not covered
- Sober living or recovery residence rent
- Room and board, outside narrow federal exceptions
- Everyday living costs such as food at home
Sources: NJ DMAHS covered services, 2026; 42 U.S.C. 1396d; 42 CFR 441.310
What changes for NJ FamilyCare adults in 2027?
From January 1, 2027, certain adults ages 19 to 64 on NJ FamilyCare Plan ABP (Alternative Benefit Plan) must work, volunteer or go to school to qualify for or keep coverage, and most of them must renew every 6 months instead of every 12. Applications started but not submitted by 11:59 p.m. on December 31, 2026 close, and a new application is needed under the new rules (NJ DMAHS, 2026).
Any one of three activities meets the requirement, for at least one month since the last renewal, or in the month of or the month before a new application:
- Household earnings of at least $580 a month.
- School at least half-time.
- At least 80 hours a month of work, school, job training, volunteering or community service.
Where addiction treatment fits
Two rules matter in recovery. Taking part in a substance use or alcohol treatment program is an exclusion, so the work requirement does not apply. A substance use disorder that makes the requirement hard to meet can also count as medically frail, another exclusion, unless you have been in recovery for 5 or more years. NJ FamilyCare checks medical frailty through claims records and a short screener on the application or renewal (NJ DMAHS, 2026).
NJ FamilyCare's Activity Requirements Checker, at njfcchecker.nj.gov, takes about 10 minutes and shows whether the new rules may apply to you (NJ DMAHS, 2026).
What are the limits of NJ FamilyCare for people in recovery?
NJ FamilyCare covers treatment with no premium, but it does not pay rent, it ties care to a health plan's network, and keeping it means answering mail and renewing on time. Each point below comes from the state's own pages or federal rules (NJ FamilyCare, 2026; NJ DMAHS, 2026).
Where it can help
- No monthly premium for any plan since July 1, 2021.
- Substance use treatment, behavioral health and residential treatment centers are covered services, and federal law requires coverage of medication for opioid use disorder.
- Past drug convictions are not a factor in eligibility.
- A phone line with interpreters, plus in-person help in every county.
Downsides and limits
- It does not pay sober living rent or room and board.
- Your doctor or treatment program must take your health plan.
- Coverage can end over an unanswered letter, even if you still qualify; you then have 90 days to send what was missing.
- From 2027 many adults face work rules and 6-month renewals, and losing coverage over the work rules means Get Covered NJ without financial help.
- Most non-citizen adults must wait 5 years as permanent residents.
- A decision can take up to 45 days.
General information, not legal or benefits advice. NJ FamilyCare rules change; check the official pages or call 1-800-701-0710 before you rely on a detail.
How to apply for NJ FamilyCare when you're in recovery
Handout
NJ FamilyCare application checklist
Tick each item as you gather it, add your dates, then print the sheet or save it as a PDF to keep beside the phone or take to the county office.
Nothing you type or tick here is saved or sent. Your browser's own print command prints this sheet too.
Source: How to apply for NJ FamilyCare when you're in recovery, livesobernj.com/nj-familycare-in-recovery/ (reviewed November 2026). NJ DMAHS (NJ FamilyCare); NJ DFD; 42 U.S.C. 1396d; 42 CFR 435.912, 441.310. General information, not legal or benefits advice.Live Sober NJ (201) 231-1066
Questions about NJ FamilyCare in recovery
Yes. NJ FamilyCare says that since January 1, 2014, prior convictions for possession, use or distribution of controlled substances are no longer a factor in Medicaid eligibility (NJ FamilyCare, 2026).
Yes, if you live in New Jersey and meet the income and status rules. The application asks for the address where you live and a mailing address if it is different, so give one where you reliably get letters (NJ FamilyCare, 2023).
Federal Medicaid law requires coverage of every FDA-approved medication for opioid use disorder, including methadone, with counseling and behavioral therapy (42 U.S.C. 1396d). Ask your health plan which prescribers are in its network, and choose a medication with your clinician.
There is no monthly premium. NJ FamilyCare stopped requiring premiums for all plans on July 1, 2021, although an unpaid premium balance from before then is still owed (NJ FamilyCare, 2026).
Not while they take part in a substance use or alcohol treatment program, which is an exclusion. A substance use disorder that makes the requirement hard to meet can also count as medically frail, unless you have been in recovery for 5 or more years (NJ DMAHS, 2026).
NJ FamilyCare points people above its income limits to Get Covered NJ, the state's official health insurance marketplace (NJ FamilyCare, 2026).
If coverage ended because a letter went unanswered, you have 90 days to send the missing information. If you think the decision was wrong, ask for a fair hearing within 30 days of the notice date. You can also apply again at any time (NJ DMAHS, 2026).
Sources
This guide is general information from the sources below, not legal or benefits advice. NJ FamilyCare rules change; the official pages are the final word.
- NJ Division of Medical Assistance and Health Services (2026). Apply for NJ FamilyCare. njfamilycare.dhs.state.nj.us. Accessed November 1, 2026.
- NJ Division of Medical Assistance and Health Services (2026). Who is eligible? njfamilycare.dhs.state.nj.us. Accessed November 1, 2026.
- NJ Division of Medical Assistance and Health Services (2026). Need help enrolling? njfamilycare.dhs.state.nj.us. Accessed November 1, 2026.
- NJ Division of Medical Assistance and Health Services (2026). Questions and answers. njfamilycare.dhs.state.nj.us. Accessed November 1, 2026.
- NJ Division of Medical Assistance and Health Services (2023). NJ FamilyCare application checklist, revised April 20, 2023. njfamilycare.dhs.state.nj.us. Accessed November 1, 2026.
- NJ Division of Medical Assistance and Health Services (2026). Federal changes to NJ FamilyCare / Medicaid, updated June 22, 2026. nj.gov. Accessed November 1, 2026.
- NJ Division of Medical Assistance and Health Services (2026). Community engagement / work requirements. nj.gov. Accessed November 1, 2026.
- NJ Division of Medical Assistance and Health Services (2026). Health care services covered by NJ FamilyCare. nj.gov. Accessed November 1, 2026.
- NJ Division of Family Development (2026). County Social Service Agencies. nj.gov. Accessed November 1, 2026.
- NJ Department of Human Services (2026). ReachNJ: New Jersey's addiction helpline. nj.gov. Accessed November 1, 2026.
- U.S. Code. 42 U.S.C. § 1396d(a)(29) and (ee), medication-assisted treatment, as amended by Pub. L. 118-42 (2024). law.cornell.edu. Accessed November 1, 2026.
- Code of Federal Regulations. 42 CFR § 435.912(c)(3), timely determination of eligibility. law.cornell.edu. Accessed November 1, 2026.
- Code of Federal Regulations. 42 CFR § 441.310(a)(2), limits on federal financial participation (room and board). law.cornell.edu. Accessed November 1, 2026.