MedicaidCoverageMedium impact
Senior Services News Vol. 26, No. 01
New Jersey Medicaid·NJ · Pharmacy, Geriatrics·Pharmacy
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
New Jersey raised income eligibility limits for pharmaceutical assistance programs (PAAD, Lifeline, HAAAD, Senior Gold) effective January 1, 2024. PAAD eligibility increased to less than $52,142 for single persons and less than $59,209 for married couples (up $10,000). Senior Gold now covers incomes between $52,142–$62,142 (single) and $59,209–$69,209 (married). Billing teams must verify patient eligibility against these new thresholds to ensure proper program enrollment and avoid claim denials.
Action Required
By December 31, 2023: Billing and eligibility verification teams must update patient intake systems and eligibility verification tools to reflect new PAAD and Senior Gold income thresholds effective January 1, 2024. Update internal reference materials and patient communication templates with new limits: PAAD (≤$52,142 single / ≤$59,209 married) and Senior Gold ($52,142–$62,142 single / $59,209–$69,209 married). Train front desk and verification staff on new thresholds. Beginning January 1, 2024, verify all New Jersey Medicare/Medicaid beneficiaries against updated limits before processing pharmacy benefit claims. Direct patients with questions to NJ Division of Aging Services at 1-800-792-9745. Post the provided notice in patient-accessible areas. Failure to verify correct program eligibility may result in incorrect benefit application and claim denials.