Nj Family Care Aged Blind Disabled Programs

Is this person also applying for the aged blind disabled programs.

Nj family care aged blind disabled programs. Nj familycare aged blind disabled program application. State of new jersey department of human services nj familycare division of medical assistance and health services aged blind disabled programs section 1 applicant applicant s name. Financial eligibility will be determined by the latest federal tax return which when filed will be electronically verified. Nj familycare aged blind disabled programs cover individuals who are age 65 years or older as well as individuals determined by the social security adminis tration or by the division of medical assistance and health services dmahs as blind or disabled.

Nj familycare aged blind disabled program application spanish designated authorized representative form this is a supplemental form if you want to designate an authorized representative that will be responsible for the application and the eligibility process. It is designed for people whose income and resources are not enough to meet the cost of necessary care. Children pregnant women parents caretaker relatives single adults and childless couples. If you speak any other language language assistance services are available at no cost to you.

Last first middle maiden name. Section 3 spouse s name. Nj familycare complies with applicable federal civil rights laws and does not discriminate on the basis of race color national origin sex age or disability. No yes please complete the spouse information form.

Aged blind disabled programs including long term care.