N.J. Admin. Code § 10:90-10.7

Current through Register Vol. 56, No. 19, October 7, 2024

Section 10:90-10.7 - Medical assistance and medical expense spend-down

(a) Regarding Medical assistance, State eligibility standards for Title XIX shall apply to a refugee's eligibility for medical assistance except:

1. Requirements for categorical relatedness for medical assistance shall not be imposed. Actual receipt of financial assistance for living expenses shall not be required as a condition of eligibility for medical assistance;

2. The WFNJ allowance standard for the appropriate unit size shall constitute the medical assistance financial standard. However, the Medicaid "Cap" shall apply to eligible refugees in Title XIX-approved facilities;

3. No financial resources which are in fact not available to the refugee, including resources remaining in the place of national origin owned by a refugee or a responsible relative, shall be considered in determining eligibility for medical assistance;

4. The income and resources of sponsors, and in-kind services and shelter provided to refugees by their sponsors, shall not be considered in determining eligibility for medical assistance;

5. All refugees who have been in the U.S. for eight months shall no longer be eligible for medical or cash assistance under RRP. Any subsequent update to this eligibility period for medical or cash assistance under RRP will be published as public notice by the Department of Human Services in the New Jersey Register (see 10:90-10.6(b) );

6. WFNJ/GA type refugees who lose eligibility for financial assistance due to increased earnings are eligible for Medicaid extension for up to eight months. This eight month extension is only allowable during the refugee's first eight months in the country. In cases where a refugee obtains private medical coverage, any payment of refugee medical assistance for that individual must be reduced by the amount of the third party payment;

7. A refugee is not required to actually receive or apply for refugee cash assistance as a condition of eligibility for refugee medical assistance;

8. Determination of eligibility for refugee medical assistance (RMA), shall be based on the applicant's income and resources on the date of application, rather than on a refugee's income averaged prospectively over the RMA application processing period. A newly arrived refugee, who applies for RMA soon after arrival and becomes employed within the first 30 days in the U.S. subsequent to filing the RMA application, shall not lose RMA eligibility; and

9. Cash assistance payments made under the publicly administrative Refugee Cash Assistance (RCA) program, the Department of State's Reception and Placement program, the Matching Grant program, a Wilson/Fish Alternative project, and the public/private RCA program shall not be considered in determining eligibility for refugee medical assistance.

(b) Those refugees who may be eligible for New Jersey's Medically Needy Program shall be referred to that Program.

N.J. Admin. Code § 10:90-10.7

Amended by R.1998 d.42, effective 1/20/1998.
See: 29 New Jersey Register 3971(b), 30 New Jersey Register 389(a).
Amended by R.2003 d.226, effective 6/16/2003.
See: 34 New Jersey Register 2713(a), 35 New Jersey Register 2670(a).
In (a), added 8.
Amended by R.2004 d.292, effective 8/2/2004.
See: 36 New Jersey Register 1695(a), 36 New Jersey Register 3545(a).
In (a), added 9.