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N.J.A.C. 10:72-1.1 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 72. NEW JERSEY CARE ... SPECIAL MEDICAID PROGRAMS MANUAL > SUBCHAPTER 1. INTRODUCTION § 10:72-1.1 Program scope (a) This chapter contains the criteria for Medicaid eligibility for certain pregnant women and infants not eligible under the provisions of N.J.A.C. 10:69, as well as, certain aged, blind and disabled persons not eligible under the provisions of N.J.A.C. 10:71. 1. Because the eligibility criteria established by the rules contained within this chapter are more liberal than those applicable under AFDC-related Medicaid and SSI-related Medicaid, pregnant women, infants, and aged, blind or disabled individuals losing Medicaid eligibility because of financial reasons should be evaluated under the provisions of this chapter for the possibility of continuing Medicaid eligibility. 2. Except for children between the ages of one and 19, persons financially ineligible for Medicaid under the provisions of N.J.A.C. 10:69 and 10:71 and who are income ineligible for Medicaid under the provisions of this chapter shall be evaluated for eligibility as Medically Needy under the provisions of N.J.A.C. 10:70. i. Persons determined eligible for the Medically Needy Program may be also determined eligible as specified low-income Medicare beneficiaries. 3. Infants not eligible under the provisions of N.J.A.C. 10:69, 10:71 or 10:72 should be evaluated for NJ FamilyCare under the provisions of N.J.A.C. 10:79. (b) Medicaid eligibility under the provisions of this chapter is limited to: 1. Pregnant women; and 2. Infants under the age of one. 3. Aged, blind, and disabled individuals (as defined by Title XIX of the Social Security Act), who otherwise meet the requirements specified in this chapter. For purposes of this chapter, an aged individual is a person who is 65 years of age or older. 4. Aged, blind and disabled individuals (as defined in (b)3 above) who qualify as specified low-income Medicare beneficiaries. i. Specified low-income Medicare beneficiaries must be residents of the State, must be receiving Medicare benefits, Parts A and B, and must meet the income and resource requirements specified in N.J.A.C. 10:72-4.1(b) and 4.5(b). ii. The enrollment and outreach process for specified low-income Medicare beneficiaries is administered by the Department of Health and Senior Services, through the Office of Pharmaceutical Assistance to the Aged and Disabled (PAAD), using the standard PAAD application form.