MedicaidCoverageMedium impact
Senior Services News Vol. 7, No. 06
New Jersey Medicaid·NJ · Pharmacy, Geriatrics·Pharmacy
Effective date
Jan 1, 2004
We identified it
Jun 20, 2026
Summary
The New Jersey Department of Health & Senior Services updated income eligibility limits for pharmaceutical assistance programs (PAAD, Lifeline, HAAAD, and Senior Gold) effective January 1, 2004. Single persons must have annual income ≤$20,437 (PAAD/Lifeline/HAAAD) or $20,437–$30,437 (Senior Gold); married couples must have combined income ≤$25,058 (PAAD/Lifeline/HAAAD) or $25,058–$35,058 (Senior Gold). Billing teams must verify patient eligibility against these thresholds when processing pharmaceutical claims.
Action Required
By January 1, 2004: Billing and front desk staff must update patient eligibility verification procedures to apply the new income limits for PAAD, Lifeline, HAAAD, and Senior Gold programs. Verify patient annual household income against the 2004 thresholds ($20,437 single/$25,058 married for PAAD/Lifeline/HAAAD; $20,437–$30,437 single/$25,058–$35,058 married for Senior Gold) before processing pharmaceutical benefit claims. Update eligibility screening forms and patient intake documentation in billing system to reflect new limits. Direct patients with eligibility questions to the Division of Senior Benefits and Utilization Management toll-free hotline: 1-800-792-9745. Failure to apply correct eligibility limits may result in claim denials or patient financial liability.