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N.J.A.C. 10:69-4.1 This file includes all Regulations adopted and published through the New Jersey Register, Vol. 57 No. 12, June 16, 2025 NJ - New Jersey Administrative Code > TITLE 10. HUMAN SERVICES > CHAPTER 69. AFDC-RELATED MEDICAID > SUBCHAPTER 4. MEDICAID SPECIAL § 10:69-4.1 General provisions (a) An individual under age 21, who would not have qualified as a dependent child for AFDC-related Medicaid, whether or not he or she lives with his or her parent(s), may be eligible for Medicaid Special. (b) When the individual lives in the same household as his or her birth or adoptive parent(s), financial eligibility shall in all cases include the parent's(s') income. If applicable, the deemed income of the stepparent shall be included. For the determination of financial eligibility of an individual under the age of 21, he or she shall be considered to be in an eligible family consisting of the applicant, his or her parent(s) and the parent(s) dependent children. (c) When an individual does not live with his or her birth or adoptive parent(s), eligibility shall be determined for an eligible family of one, considering only the individual's income (see N.J.A.C. 10:69-4.2(c) regarding LRRs). 1. An individual under age 21 who would not have qualified as a dependent child for AFDC-related Medicaid shall be evaluated for Medicaid Special in accordance with this subchapter, but without regard to income or resources, if that individual was, at age 18, in foster placement under the supervision of the Division of Youth and Family Services with his or her maintenance paid in whole or in part from public funds. Such individual shall be eligible for medical coverage up to the age of 21. 2. If the individual is married and living with his or her spouse, they shall be considered a family of two and the income of both parties shall be considered. i. Medicaid coverage shall not be extended to a spouse age 21 or older, although his or her income shall be considered. If the spouse is under 21, both individuals shall be included. 3. College attendance shall be construed as a temporary absence from the home. College students shall be considered to be living with their parent(s), even if away from home during the school year. College students under age 21 who claim permanent residence apart from their parent(s) shall be evaluated in accordance with N.J.A.C. 10:69-4.3. (d) Rules concerning pregnant women under age 21 are as follows: 1. Medicaid Special may be provided to a pregnant woman under age 21 if the pregnant woman meets all the Medicaid Special requirements as set forth in this chapter. 2. Eligibility is determined for an eligible family of two, or more if a multiple pregnancy (woman and unborn children), based on her income only, or, if she is married and living with her spouse, on an eligible family of three or more (woman, spouse and unborn children) including income of both spouses. Medicaid coverage does not include the spouse even though his income is included in the eligibility determination. i. The income and household size provision at (d)2 above cannot be used prior to the date it was medically determined the woman became pregnant. ii. A pregnant woman with other dependent children should be assisted in making immediate application for AFDC-related Medicaid based on AFDC rules in effect as of July 16, 1996, and for