NJ FamilyCare for a Grandchild — How to Get Health Insurance When You're the Caregiver

The 355% FPL Threshold

NJ FamilyCare — New Jersey's combined Medicaid and CHIP program — covers children in households earning up to 355% of the Federal Poverty Level. That's one of the highest eligibility ceilings in the country. For a family of three, the monthly income limit is roughly $8,083. For a family of four, about $9,763.

Through 150% FPL, coverage has no premiums or copays. Above 150% and through 200% FPL, there are no premiums and copays are $5 to $10 per visit. Above 200% FPL, monthly premiums apply, along with copays ranging from $5 to $35 per visit.

The Tax-Household Strategy

NJ FamilyCare uses Modified Adjusted Gross Income (MAGI) rules, and how you file taxes directly affects which income counts.

If you claim the grandchild as a dependent on your federal tax return, the state evaluates your household income against the 355% FPL limit. For most grandparents on fixed income, you'd still qualify — but if your retirement income plus pension is substantial, it could push you above the line.

If you don't claim the child as a tax dependent — or you don't file taxes — the child may be evaluated as a separate non-filer household. In that scenario, the child's own direct income is used for the eligibility calculation. A child with little or no income may qualify for the lowest tier if the other program requirements are met; enrollment is not automatic.

This isn't a loophole. It's how MAGI rules work by design. Whether the caregiver claims the child as a tax dependent can affect which household income is counted, so confirm the child's household treatment with NJ FamilyCare before relying on it.

Cover All Kids — Immigration Status Doesn't Matter

Under New Jersey's Cover All Kids expansion, children under 19 qualify for NJ FamilyCare regardless of immigration status, as long as they live in New Jersey and household income meets the program limits. Applying for a child's health coverage does not trigger any public charge determination and the child's or caregiver's immigration status is not reported to federal authorities.

How Enrollment Works

Apply online at NJFamilyCare.org or through MyNJHelps.gov. Once approved, you'll choose a Managed Care Organization — options include Horizon NJ Health, Wellpoint, UnitedHealthcare Community Plan, and Fidelis Care — to access medical, dental, vision, mental health, and prescription services.

Children get 12 months of continuous eligibility, meaning coverage can't be cut mid-year due to temporary income fluctuations. At the end of the year, renewal is automatic through data matching when possible. If the state needs updated documentation, you'll receive a renewal packet with 30 days to respond.

Common Friction Points

Caseworkers sometimes ask for the biological parent's insurance information before processing a grandchild's application. If you don't have it — and many kinship caregivers don't — explain that the child has no known coverage through a parent and ask to proceed with the application. The child's eligibility doesn't depend on whether a parent has insurance.

Another common issue: the MyNJHelps.gov portal requires document uploads in specific formats. If you don't have a scanner, smartphone photos work, but make sure the text is legible and the entire document is visible in the image.

The New Jersey Kinship Financial Help Guide covers NJ FamilyCare alongside every other benefit available to kinship families, with a plan comparison chart, renewal calendar, and the tax-household strategy explained in detail.

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