MedicaidCoverageMedium impact
Senior Services News Vol. 18, No. 01
New Jersey Medicaid·NJ · Pharmacy, Geriatrics·Pharmacy
Effective date
Jan 1, 2016
We identified it
Jun 20, 2026
Summary
New Jersey updated income eligibility limits for pharmaceutical assistance programs (PAAD, Lifeline, HAAAD, and Senior Gold) effective January 1, 2016. Due to no Social Security COLA adjustment, income thresholds remain unchanged from 2015: PAAD/Lifeline/HAAAD capped at $26,575 (single) or $32,582 (married); Senior Gold ranges $26,575-$36,575 (single) or $32,582-$42,582 (married). Billing teams must verify patient eligibility against these limits when processing pharmaceutical claims.
Action Required
By December 31, 2015: Billing team must update patient eligibility verification system to reflect 2016 income thresholds for PAAD, Lifeline, HAAAD, and Senior Gold programs. Front desk and intake staff should verify patient income eligibility before processing pharmaceutical claims using the new limits. Maintain current thresholds in billing software to prevent eligibility denials. Staff should direct patients with eligibility questions to 1-800-792-9745 (Division of Aging Services hotline). Failure to verify correct income limits may result in inappropriate claim processing or denials.