By Julie L. Cross

NJ WorkAbility is a program that offers individuals with disabilities who are employed either full-time or part-time, and whose income would otherwise make them ineligible for Medicaid, the opportunity to receive full Medicaid coverage. Previously, to qualify for the program, an individual must have been at least 16 years old, a resident of New Jersey, employed either part-time or full-time, determined as disabled before age 65 and be within the income threshold.

In January, 2022, New Jersey Governor Phil Murphy signed legislation that contained many improvements to the NJ WorkAbility program.  Before the changes could be implemented, they required approval from the federal Centers for Medicare and Medicaid Services (CMS).  Due to the complexity of some changes, New Jersey Medicaid decided to roll out the improvements in phases.  Phase 1 changes are effective as of April 1, 2023.

Under Phase 1, the NJ WorkAbility program is now available to all individuals over age 16 who have a disability as determined by the Social Security Administration or the Medical Review Team at the Division of Medical Assistance & Health Services.  Previously, the program was only available to those under age sixty-five (65).  Phase 1 also includes the removal of asset limits for those who can qualify for the program.  The resource limit was previously $20,000. 

Additionally, the spousal deeming requirement has been removed.  This means that only the individual’s earned and unearned income will be counted towards eligibility. Lastly, any enrolled member who loses his or her job through no fault of their own will remain eligible for the program for twelve (12) months after the job loss.

Phase 2 is anticipated to address excess income issues, particularly regarding Social Security Disability Insurance (SSDI), from disqualifying employees with disabilities from the program.

The NJ WorkAbility program has been effective in enabling individuals with disabilities to earn a living without fear that doing so will disqualify them from receiving necessary health care coverage through Medicaid.  The changes being implemented in Phase 1 and Phase 2 will continue to provide individuals with disabilities the opportunity to lead more productive lives while expanding these benefits to allow more individuals to become and remain eligible for the program.

For more information, contact Julie L. Cross, Esq. at jlc@spsk.com or 201-262-3962.

DISCLAIMER: This Alert is designed to keep you aware of recent developments in the law. It is not intended to be legal advice, which can only be given after the attorney understands the facts of a particular matter and the goals of the client.