MedicaidCoverageMedium impact
Senior Services News Vol. 14, No. 02
New Jersey Medicaid·NJ · Pharmacy·Pharmacy
Effective date
Jan 1, 2012
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, 2012, based on a 3.6% Social Security COLA adjustment. PAAD/Lifeline/HAAAD limits increased to less than $25,312 (single) and $31,035 (married); Senior Gold limits are $25,312-$35,312 (single) and $31,035-$41,035 (married). Billing teams must verify patient eligibility against these new thresholds when processing pharmaceutical claims.
Action Required
By December 31, 2011: Billing team must update patient eligibility verification systems and databases to reflect the new 2012 income limits for PAAD, Lifeline, HAAAD, and Senior Gold programs. Update all eligibility screening tools and documentation. Front desk and billing staff must verify patient income against the new thresholds: PAAD/Lifeline/HAAAD (less than $25,312 single/$31,035 married) and Senior Gold ($25,312-$35,312 single/$31,035-$41,035 married) when processing pharmaceutical claims starting January 1, 2012. Failure to apply correct eligibility limits may result in claim denials or patient billing errors. Post the provided notice in public areas accessible to patients and providers.