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Senior Services News Vol. 28, No. 02
Act
by Dec 15, 2025
Effective date
Jan 1, 2026
Identified
Jun 20, 2026
Summary
New Jersey has updated income eligibility limits for pharmacy assistance programs (PAAD, Senior Gold, Lifeline, and HAAAD) effective January 1, 2026, with a 2.8% increase based on Social Security COLA. PAAD limits are now less than $54,943 for singles and less than $62,390 for married couples; Senior Gold ranges from $54,943-$64,943 for singles and $62,390-$72,390 for married couples. Billing teams must update patient eligibility verification and ensure accurate program enrollment documentation.
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What to do
by Dec 15, 2025 · 6 steps
01Update billing system eligibility verification rules to reflect new PAAD and Senior Gold income thresholds for calendar year 2026.
02Billing team must verify patient income against updated limits when processing pharmaceutical claims.
03Front desk staff should update patient eligibility verification procedures and communicate new limits to patients during enrollment.
04Update patient-facing materials and website with new income thresholds.
05Failure to apply correct eligibility limits may result in claim denials or improper program assignment.
06Direct patients with eligibility questions to 1-800-792-9745 or the Division of Aging Services.
Original notice
Senior Services News Vol. 28, No. 02
njmmis.com · Always check the source before changing claims.
Related changes
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