Written by a parent, not a doctor. Nothing here is medical advice.

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New Jersey program

NJ FamilyCare above the Medicaid line

NJ FamilyCare also covers children whose family income is above the Medicaid line. This part is called CHIP.

What it is

NJ FamilyCare also covers children whose family income is above the Medicaid line. This part is called CHIP.

The same NJ FamilyCare application checks the higher income bands. The state places your child in the right band. The household income limit is much higher than the limit for a parent.

Eligibility rules
  • Children must be under 19 and live in New Jersey. Their immigration status does not affect eligibility.
  • The January 2026 monthly ceiling, including the five-point allowance, is $6,402 for two, $8,083 for three and $9,763 for four. The top effective percentage is 355% of poverty.
  • CHIP is for a child who is not enrolled in other insurance. Work coverage you were offered but did not take does not count as enrolled. Do not drop work insurance to try to qualify; ask the counselor to check the exact situation first.
What you get
  • No monthly premium in any CHIP band since July 2021.
  • Child health benefits, with copays in some CHIP bands.
  • No waiting period.
What the help covers
  • Plans B, C and D are the CHIP bands within NJ FamilyCare.
  • The state has charged no CHIP monthly premium since July 2021.
  • Plan B has no copays. Plans C and D charge $5 for many visits and $1 for a generic or $5 for a brand-name prescription, with a yearly family cap. Ask the plan what applies to oncology visits and chemotherapy.
If you decide to apply
  1. You can ask the hospital counselor to go through the NJ FamilyCare application with you.
  2. For that discussion, it helps to have this month's income and any work-plan details ready. You can ask the counselor to check your cancer team's network.

NJ FamilyCare: 1-800-701-0710 · Official page ↗

After you ask
  • One application checks the Medicaid and CHIP categories.
  • Children generally keep coverage for 12 months.
Good to know

The effect of existing work insurance needs a separate check before a family changes coverage.

Other details
  • The application decides the child's household and income category. A simple household-size comparison is a starting screen.

Federal background: CHIP.

Official sources
Ask your social worker

“Could our child qualify for the higher NJ FamilyCare band? How would it work with our insurance, what might we pay, and would you help us apply if it fits?”

Why I’m asking: I want to know whether the child coverage limit reaches our family even if the Medicaid limit does not.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

File the one NJ FamilyCare application and report this month's income. Tell them about any work plan and ask whether it changes anything.

Your social worker

The hospital financial counsellor files with you and checks the oncology group is in the plan.

The care team

Records and letters when the application asks for them.

Who decides
The Division of Medical Assistance and Health Services decides the band; the health plan runs the coverage.
Ask your social worker
“We earn too much for the Medicaid column. Can you check which NJ FamilyCare band my child falls into and whether there is anything to pay?”

How to apply

First step: Apply at njfamilycare.org or call 1-800-701-0710. There is one application for the whole programme.

  1. Use the same NJ FamilyCare application; the state places the child in the right band.
  2. Ask which band the child landed in and confirm there is nothing to pay.
  3. Check the hospital and the oncology group are in the plan you pick.

Official application / program page ↗

Where it starts: The same application as the Medicaid column: njfamilycare.org or 1-800-701-0710.

What to gather

The diagnosis letter, the child’s insurance card, and the last two pay stubs cover most applications. The official page lists the rest.

How long: The same 45-day standard as the Medicaid column. Once approved, a child keeps 12 months.

What a yes looks like

A notice naming the band (B, C or D) and a plan choice, with no premium to pay.

What a no looks like, and the next move

If income is the reason, you are above the ceiling; the hospital's Charity Care screening and the Catastrophic Fund are the next doors.

Watch out

  • It is the same application as the Medicaid column. Do not file twice.
  • The rule about a child who already has a work plan was not published. Ask; do not drop the work plan first.

Dates that change this

2026-01-01: The state did not publish whether a child offered or enrolled in a work plan can take these bands. Ask when you file; do not drop the work plan first. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

The same NJ FamilyCare coverage to $9,763 a month for four, $8,083 for three, with no premium and no waiting period.

  • $9,763/month — NJ FamilyCare ceiling, family of 4, published line with the five-point allowance (355%)
  • $8,083/month — NJ FamilyCare ceiling, family of 3, published line with the allowance (355%)
  • $6,402/month — NJ FamilyCare ceiling, family of 2, published line with the allowance (355%)
  • $0/month — Published CHIP monthly premium in every band since July 2021

Covers: The same managed-care services and products the health plan gives its Medicaid members · Hospital, clinic, chemotherapy and prescriptions · Dental and vision

Legal protection: 12 months of continuous coverage; a child found eligible for the Medicaid column can move across straight away

What it costs the family: No premium in any band since July 2021. No waiting period.

The eligibility facts, as published

Age
under 19
Age max exclusive
19
Income
Published CHIP columns B 150%, C 185% and 200%, D 250% / 300% / 350% and 355% FPL; the starred columns include the five-point allowance
Insurance status condition
unknown: the employer-offered and employer-enrolled rule was not published
Residency
New Jersey; a child's immigration status does not affect eligibility
Continuous eligibility
12 months

The trap: The state did not publish whether a child who is offered or enrolled in a work plan can take these bands. Apply and ask; do not assume a work plan rules the child out, and do not drop the work plan first.

Where I read this

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