The New Jersey Department of Human Services, Division of Medical Assistance and Health Services issued Medicaid Communication No. 26-01 on December 26, 2025. The document includes updates to certain eligibility and post-eligibility calculations, and reflects a 2.8% federal cost-of-living adjustment (COLA) to the SSI eligibility standards.
Notable changes effective January 1, 2026, include:
- Assisted Living Residence (ALR) and Comprehensive Personal Care Home (CPCH): Monthly room and board rates set at $996.40, with a maintenance needs allowance of $147.65.
- Adult Family Care (AFC): Monthly room and board rates set at $877.60, with a maintenance needs allowance of $147.65.
- Community Spouse Resource Allowance: Minimum increased to $32,532; maximum raised to $162,660.
- MLTSS Income Cap / Living at Home Monthly Standard: Increased to $2,982.
- In-Kind Support and Maintenance Income Amounts: Updated to $351.33 for an individual and $517.00 for a couple.
For a detailed analysis of In-King Support and Maintenance, read this recent post.
For full details on eligibility calculations, refer to the updated administrative manual sections (N.J.A.C. 10:71-4.8, 5.4-6, and 5.9). Practitioners should be mindful of these changes and update staff to ensure clients receive the most up to date advice. Read the full document here.