Medicaid Eligibility

With Horizon NJ TotalCare (HMO D-SNP), members get both Medicare and Medicaid benefits in one plan. To keep these benefits, the member must keep his or her Medicaid (NJ FamilyCare) eligibility up to date and renew annually.

Deeming Period

If a member loses his or her Medicaid eligibility, he or she can still remain a Horizon NJ TotalCare
(HMO D-SNP) member for up to 60 days while he or she reestablishes Medicaid eligibility. This is called a deeming period. During the deeming period, Horizon NJ TotalCare (HMO D-SNP) will cover all Medicare benefits. However, the plan will not cover Medicaid benefits.

If the member cannot reestablish his or her Medicaid eligibility after 60 days, we are required to disenroll him or her from Horizon NJ TotalCare (HMO D-SNP). Members should contact their County Board of Social Services to check for or reestablish their Medicaid eligibility.