- For Medicaid, CHIP, and BHP, states must accept applications from the applicant, an adult in the applicant’s household, an authorized representative, or if the applicant is a minor or incapacitated, someone acting responsibly for the applicant.
- The agency must make a determination of eligibility for Medicaid/CHIP/BHP expeditiously and without undue delay. Determinations of eligibility must be made within:
- 90 days for applicants who apply for Medicaid on the basis of disability
- 45 days for all other Medicaid applicants
- The timeliness standards are measured from the date the application is submitted to the state.
Effective Dates of Coverage
Effective Dates of Coverage for Eligible Individuals at Application:
- Medicaid: Date application was submitted or first day of the month the application was submitted consistent with the state’s Medicaid state plan (42 CFR 435.915)
- Up to three months of retroactive coverage is available if the individual received Medicaid services during the three months prior to application and met Medicaid eligibility requirements when services were received
To discuss your NJ Medicaid matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at firstname.lastname@example.org. Please ask us about our video conferencing or telephone consultations if you are unable to come to our office.
By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold Township, Monmouth County, NJ Medicaid Attorney