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

Childhood Cancer Lantern
Search Saved

New Jersey program

Nursing and care at home

NJ FamilyCare can cover nursing and personal care at home when your child needs them.

What it is

NJ FamilyCare can cover nursing and personal care at home when your child needs them.

Nursing at home depends on the tasks your child needs, not just the diagnosis. The hospital discharge planner and health plan review the request together. A separate personal-care option can let families direct who provides approved care.

Eligibility rules
  • Private-duty nursing is available under Medicaid's under-21 EPSDT benefit and qualifying MLTSS coverage. Your care manager checks the child's actual FamilyCare category and medical-necessity rules. CHIP categories need a separate benefits check.
  • The plan or state reviews medical necessity. Ordinary Medicaid nursing and the separate MLTSS route have different eligibility tests.
What you get
  • Covered nursing and personal-care hours based on the assessment.
  • A way to direct approved personal care through the Personal Preference Program.
What the help covers
  • A clinician's order supports the request for nursing and the clinical justification for the hours.
  • Personal care and skilled nursing are different services. A self-directed personal-care arrangement does not make every nursing task a paid-parent task.
  • The Personal Preference Program lets you choose who gives approved personal care, once your child has Medicaid and is expected to need that care for six months or more. For a child, a parent acts as the unpaid representative and cannot also be the paid worker; ask the plan in writing whether the other parent or a relative can be hired and at what rate.
If you decide to apply
  1. You can ask the hospital discharge planner and NJ FamilyCare care manager to review the help needed at home.
  2. You can ask the oncology team to document the tasks and hours. If a parent hopes to be paid, ask about the Personal Preference Program rules.

NJ FamilyCare plan care manager; Personal Preference Program: 609-631-2481 · Official page ↗

After you ask
  • The NJ FamilyCare plan's ordinary decision period is seven calendar days, or 72 hours for an urgent request.
  • Before a plan is chosen, the state handles the request.
Good to know

The plan must confirm whether a parent of a minor can be paid. The unpaid representative cannot also be the paid worker.

Other details
  • An approved number of hours and an available worker are separate parts of a workable discharge plan.
Official sources
Ask your social worker

“What help could we receive at home, and could a parent be paid for some care? What responsibilities would that bring, and could you help us arrange an assessment before discharge?”

Why I’m asking: I want a realistic home-care plan that accounts for the tasks and hours our child needs.

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

Ask before discharge, not after. Name the hours you need and ask when the decision is due.

Your social worker

The discharge planner and the plan's care manager put the request in and chase it.

The care team

The oncology team writes the order and the clinical justification for the hours.

Who decides
The child's NJ FamilyCare health plan, or the state before a plan is chosen.
Ask your social worker
“We need nursing hours at home before discharge. Can the plan decide this week, and can a parent be paid through the self-directed programme?”

How to apply

First step: Ask the discharge planner and the plan's care manager for nursing hours at home, and ask when the decision is due.

  1. Ask the discharge planner and the plan's care manager for nursing hours at home, by name, before discharge.
  2. Ask for the decision date: seven calendar days ordinary, 72 hours urgent.
  3. If a parent will do the care, ask about the self-directed programme on 609-631-2481 and who can be named to manage it.

Official application / program page ↗

Where it starts: Ask the plan's care manager and the hospital discharge planner together. The self-directed programme is on 609-631-2481.

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: Seven calendar days for an ordinary request, 72 hours for an urgent one.

What a yes looks like

An authorisation naming hours a week and an agency, starting before discharge.

What a no looks like, and the next move

Fewer hours than asked for, or a refusal on necessity. Quote the children's rule that services cannot be limited in volume, scope or duration, and appeal.

Watch out

  • Ask before discharge. After discharge it takes longer.
  • Ask for the children's benefit by name; the long-term-care route comes second for a child.
  • PPP requires Medicaid personal-care approval and an expected need of at least six months. The plan and fiscal intermediary must confirm whether a legally responsible parent of a minor can be hired. The authorized representative is unpaid and cannot also be the worker.

Dates that change this

2026-03-01: The company that handles the self-directed payroll changed for Horizon members during 2026. If pay stops, call the programme on 609-631-2481 and ask who your intermediary is now. (not yet confirmed against the final rule)

2026-09-11: The seven-day and 72-hour clocks come from the state's contract template; the signed version and any child-specific nursing clock were not published. (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

Nursing hours and a personal care aide at home through the NJ FamilyCare plan, decided in seven calendar days, or 72 hours when urgent.

  • $7 — Plan decision time on an ordinary prior-authorisation request
  • $72 — Plan decision time on an urgent prior-authorisation request

Covers: Private-duty nursing at home for a child under 21 · A personal care aide through the child's NJ FamilyCare health plan · A self-directed option where the family hires and manages the worker

Legal protection: For a child, services are set by medical necessity and are not limited in volume, scope or duration by ordinary limits · PPP requires Medicaid personal-care approval and an expected need of at least six months. The plan and fiscal intermediary must confirm whether a legally responsible parent of a minor can be hired. The authorized representative is unpaid and cannot also be the worker.

What it costs the family: No charge under NJ FamilyCare.

The eligibility facts, as published

Age
private-duty nursing is a benefit for children under 21
Coverage
Under-21 Medicaid/EPSDT or qualifying MLTSS coverage; a FamilyCare CHIP category requires a separate benefit check.
Level of care
medical necessity, assessed by the plan or the state
Order
the children's benefit must be used before the long-term-care nursing route

The trap: For a child, the state must use the ordinary children's benefit before the long-term-care route. Ask for it by name, and ask for a decision date: the contract gives seven calendar days for an ordinary request and 72 hours for an urgent one.

Where I read this

← Back to your options