# How to Get Medicaid Home Care in New Jersey: Step-by-Step Guide for Essex, Hudson, and Bergen Counties
New Jersey has a robust Medicaid home care system — but for families in Newark, Jersey City, Hackensack, Paterson, and surrounding communities, figuring out how to access it can be genuinely overwhelming.
This is a direct, step-by-step guide to getting Medicaid home care in New Jersey for seniors and adults with disabilities living in Essex, Hudson, Bergen, Passaic, and Union counties.
What Medicaid Home Care Covers in New Jersey
New Jersey’s Medicaid program (called NJFamilyCare for most non-elderly adults) covers a range of home-based services for eligible individuals:
Home Health Aide (HHA): Certified aides assist with bathing, dressing, grooming, meal preparation, medication reminders, and mobility. This is the most common form of in-home Medicaid care.
Personal Care Aide (PCA): Similar to HHA but without a nursing oversight requirement. PCAs help with activities of daily living for individuals who need regular assistance but not skilled nursing.
Private Duty Nursing: For medically complex individuals who need skilled nursing care at home. Requires physician orders and prior authorization.
Respite Care: Temporary relief for family caregivers. Medicaid covers respite for families of individuals enrolled in specific waiver programs.
Assistive Technology and Home Modifications: For individuals enrolled in specific Medicaid waiver programs, certain assistive devices and home modifications (grab bars, ramps, lift systems) are covered.
Step 1: Determine NJ Medicaid Eligibility
Medicaid home care in New Jersey requires active NJFamilyCare/Medicaid enrollment. Eligibility is based on:
Income and assets: NJ Medicaid has income limits that vary based on household size and program category. For seniors (65+) applying for long-term care benefits, the thresholds are different from standard NJFamilyCare.
Residency: Must be a New Jersey resident.
Citizenship/immigration status: US citizens, lawful permanent residents, and certain other documented immigrants may qualify. Undocumented immigrants may qualify for emergency Medicaid only.
Disability or age: For home care specifically, individuals must either be 65+, have a qualifying disability, or be a child with disabilities.
If you are unsure whether your family member qualifies, call Priority Groups NJ at (201) 305-0936. We conduct free eligibility screenings and can tell you quickly whether Medicaid home care is a realistic option.
Step 2: Apply for NJFamilyCare/Medicaid
If not already enrolled, the application for NJ Medicaid is submitted through:
Online: NJFamilyCare.gov (the official state portal)
In person: At your county Board of Social Services office
By phone: 1-800-701-0710 (NJFamilyCare enrollment line)
With help: Organizations like Priority Groups NJ can assist with the application at no cost
For Essex County residents: Essex County Board of Social Services (Newark)
For Hudson County residents: Hudson County Division of Social Services (Jersey City)
For Bergen County residents: Bergen County Division of Social Services (Hackensack)
For Passaic County residents: Passaic County Board of Social Services (Paterson)
For Union County residents: Union County Division of Social Services (Elizabeth)
The application typically requires:
- Proof of NJ residency (utility bill, lease)
- Proof of income (pay stubs, Social Security award letter, pension documents)
- Proof of assets (bank statements, if applying for long-term care Medicaid)
- Social Security card and ID
- Immigration documents (if applicable)
Processing time is typically 45 days for standard applications, 90 days for long-term care Medicaid applications.
Step 3: Get a Physician Order for Home Care
Once Medicaid is active, the next step is obtaining a physician order for home care services. The order must:
- Come from a licensed physician or authorized prescriber
- Specify the care needs in detail (which activities require assistance, how often)
- Indicate the frequency of care needed (e.g., “requires daily assistance with bathing and dressing, meal preparation 3x/day”)
Families should be specific when talking to the physician. The number of authorized home care hours depends directly on what the physician documents. A detailed, thorough description of daily care needs results in more appropriate authorization.
Step 4: Managed Care Authorization
Most NJ Medicaid beneficiaries are enrolled in a Managed Care Organization (MCO) — a private health plan that administers Medicaid benefits. Home care in NJ is authorized by your MCO, not directly by the state.
Common NJ Medicaid MCOs serving northern New Jersey:
- Horizon NJ Health
- AmeriHealth New Jersey
- WellCare of New Jersey
- UnitedHealthcare Community Plan
Your MCO will conduct a needs assessment (often called a “level of care” assessment) to determine how many home care hours are appropriate. The physician order is a key input into this assessment.
Step 5: Choose a Home Care Agency
Once home care is authorized by your MCO, you choose a licensed NJ home care agency to provide services. Priority Groups NJ is a licensed NJ home care agency serving Essex, Hudson, Bergen, Passaic, and Union counties.
When choosing an agency, families should ask:
- Are you licensed by the NJ Department of Health as a home care agency?
- Do you accept my Medicaid managed care plan?
- Do you have caregivers who speak my language?
- What is your caregiver turnover rate?
- How do you handle caregiver absences?
Priority Groups NJ is NJ-licensed, accepts all major NJ Medicaid MCOs, and has multilingual caregivers serving the diverse communities of northern New Jersey — including Spanish, Portuguese, Haitian Creole, Arabic, and Hindi speakers.
Step 6: Care Begins
Once the agency is selected and the authorization is confirmed, care begins. A supervising nurse conducts an initial in-home assessment, creates a care plan, and assigns a certified aide who matches the individual’s language, schedule, and care needs.
Priority Groups NJ monitors care quality through regular nurse supervisory visits and is available 24/7 for family questions and care coordination issues.
Special Programs for Higher-Acuity Needs in NJ
Standard Medicaid home care (HHA/PCA) is appropriate for many individuals. But for those with more complex needs, New Jersey has additional Medicaid-funded programs:
NJ DDD Supports Program: For adults with developmental disabilities (intellectual disability, autism, cerebral palsy). Covers a broader range of community-based services including day habilitation, supported employment, and community integration. See our full guide to the NJ DDD Supports Program.
Personal Preference Program (PPP): NJ’s consumer-directed care option, similar to New York’s former CDPAP. Allows Medicaid-eligible individuals to hire and manage their own personal care attendants, including family members in some cases.
Global Options Waiver: For Medicaid-eligible seniors who need a nursing-facility level of care but want to remain at home. Provides a broader set of home and community-based services, including adult day health care, home modifications, and care management.
Getting Started in Newark, Jersey City, Hackensack, and Beyond
Priority Groups NJ provides Medicaid home care services across northern and central NJ. We serve:
- Essex County: Newark, East Orange, Irvington, Bloomfield, Montclair, Belleville
- Hudson County: Jersey City, Bayonne, Union City, Hoboken, North Bergen
- Bergen County: Hackensack, Englewood, Teaneck, Fort Lee, Paramus
- Passaic County: Paterson, Clifton, Passaic, Pompton Lakes, Wayne
- Union County: Elizabeth, Plainfield, Linden, Cranford, Summit
Call us at (201) 305-0936 for a free Medicaid eligibility screening and to discuss home care options for your family. There is no cost for the initial consultation and no obligation to enroll.