NJ FamilyCare

<!DOCTYPE HTML> <head> <script src="/familycare/static/111213/js/perf/stub.js" type="text/javascript"></script><script src="/familycare/jslibrary/1739271874254/ui-sfdc-javascript-impl/SfdcCore.js" type="text/javascript"></script><script src="/familycare/static/111213/js/picklist4.js" type="text/javascript"></script><script src="/familycare/jslibrary/1739271841254/sfdc/VFState.js" type="text/javascript"></script><script src="/familycare/resource/1705680287000/JQuery_New_Version" type="text/javascript"></script><script src="/familycare/jslibrary/1739271841254/sfdc/NetworkTracking.js" type="text/javascript"></script><script>try{ NetworkTracking.init('/familycare/_ui/networks/tracking/NetworkTrackingServlet', 'network', '066t0000000TQzO'); }catch(x){}try{ NetworkTracking.logPageView();}catch(x){}</script><script>(function(UITheme) { UITheme.getUITheme = function() { return UserContext.uiTheme; }; }(window.UITheme = window.UITheme || {}));</script><meta HTTP-EQUIV="PRAGMA" CONTENT="NO-CACHE" /> <meta HTTP-EQUIV="Expires" content="Mon, 01 Jan 1990 12:00:00 GMT" /> <title>NJ FamilyCare</title> </head> <form id="j_id0:j_id2" name="j_id0:j_id2" method="post" action="/familycare/ABD_NJFC_GettingStartedPage" enctype="application/x-www-form-urlencoded"> <input type="hidden" name="j_id0:j_id2" value="j_id0:j_id2" /> <html lang="en"> <head> <meta HTTP-EQUIV="PRAGMA" CONTENT="NO-CACHE" /> <meta HTTP-EQUIV="Expires" content="Mon, 01 Jan 1990 12:00:00 GMT" /> <meta content="IE=edge" http-equiv="X-UA-Compatible" /> <meta charset="utf-8" /> <link href="//maxcdn.bootstrapcdn.com/font-awesome/4.2.0/css/font-awesome.min.css" rel="stylesheet" /> <link href="/familycare/resource/1424184814000/Bootstrap_CSS" rel="stylesheet" /> <link href="/familycare/resource/1584466971000/ABDResourcePackage/ABDResource/ABDSTYLES.css" rel="stylesheet" /> <script src="//ajax.googleapis.com/ajax/libs/jquery/1.11.1/jquery.min.js" type="text/javascript"></script> <script src="/familycare/resource/1537210611000/JQuery_V3" type="text/javascript"></script>  </head> <body> <noscript> <style type="text/css"> .container { display: none; } </style> <div style="padding: 1em; background-color:#f0f0f0;"> <strong>You must have javascript enabled in order to use this website.</strong> </div> </noscript> <script> </script> <header class="" id="header"> <nav class="navbar-default"> <div class="container"> <div class="navbar-header"> <img height="45px" src="/familycare/resource/1424184814000/LogoNJTextless" />      <b style="font-size: 35px;color:#014586;"></b> </div> <div> <ul class="nav navbar-nav navbar-right"> <li class="menuItem"> <a class="showWarningIfUnsavedChanges" href="https://dmahs-nj.my.site.com/familycare/ABD_NJFC_GettingStartedPage?lng=es&&&&&">Español</a> </li> <li class="menuItem"><a href="/familycare/NJFCHelp" target="_blank">Help</a> </li> <li class="menuItem"> </li> <li class="menuItem"> </li> </ul> </div> </div> </nav><div id="j_id0:j_id2:j_id3:j_id6:j_id7:j_id35" class="alert alert-info full-span-attention-alert"> <div class="container" style=""> Before you can file an application, you must answer all the below questions and review the description of the NJ FamilyCare program. </div></div>  </header> <body onload="myFunction()"> <div class="gettingStartedContainer containerWrapper" id="mainScrollableContainer" style="overflow: hidden;"> <div class="container"> <div class="col-md-12"> <h1 class="page-header text-center">Getting Started</h1> <p Class="lead-Text">NJ FamilyCare (Medicaid) can provide free or low cost health insurance for New Jersey residents who are citizens of the United States or Qualified Immigrants.</p> <p Class="lead-Text">Before you apply, we have a few questions to help direct you to the program that is right for you.</p> <p> <ol class="gettingStartedQuestions" style="list-style-type:decimal;padding-left:19px;"> <li> <legend class="control-label">Are you age 65 or older?</legend> <input id="ageOptionYes" name="ageOption" required="required" type="radio" value="Yes" /> <label for="ageOptionYes">Yes</label> <input id="ageOptionNo" name="ageOption" required="required" type="radio" value="No" /> <label for="ageOptionNo">No</label> </li> <li> <legend class="control-label" style="display:inline-table;">Do you already have Medicare? Medicare is <u>not</u> NJ FamilyCare (Medicaid). You would have a card like the one below. Click on the image to enlarge.</legend> <p><a href="" onclick="openPopup('/familycare/resource/1562181785000/NJFCResourcePackage/NJFCResource/SampleMedicareCard.jpg','');return false;"><img src="/familycare/resource/1562181785000/NJFCResourcePackage/NJFCResource/SampleMedicareCard_thumbnail.jpg" /></a></p> <input id="ifElgOptionYes" name="ifElgOption" required="required" type="radio" value="Yes" /> <label for="ifElgOptionYes">Yes</label> <input id="ifElgOptionNo" name="ifElgOption" required="required" type="radio" value="No" /> <label for="ifElgOptionNo">No</label> </li> <li> <legend class="control-label">Has the Social Security Administration determined you disabled or do you want to be evaluated by the Division of Medical Assistance and Health Services due to a permanent disability? </legend> <input id="disabledOptionYes" name="disabledOption" type="radio" value="Yes" /> <label for="disabledOptionYes">Yes</label> <input id="disabledOptionNo" name="disabledOption" type="radio" value="No" /> <label for="disabledOptionNo">No</label> </li> <ul class="waitingoptionquestion" id="waitingOptionDiv" style="list-style-type: lower-alpha;display:none;"> <li> <legend class="control-label">Are you in your 24 month waiting period to receive Medicare? </legend> <input id="waitingOptionYes" name="waitingOption" required="required" type="radio" value="Yes" /> <label for="waitingOptionYes">Yes</label> <input id="waitingOptionNo" name="waitingOption" required="required" type="radio" value="No" /> <label for="waitingOptionNo">No</label> </li> </ul> <li> <legend class="control-label">Are you a resident of New Jersey?</legend> <input id="residentOptionYes" name="residentOption" required="required" type="radio" value="Yes" /> <label for="residentOptionYes">Yes</label> <input id="residentOptionNo" name="residentOption" required="required" type="radio" value="No" /> <label for="residentOptionNo">No</label> </li> </ol> </p> <p> <strong> <font color="red">Warning!</font></strong>   This system contains U.S. Government information. By using this information system, you are consenting to system monitoring for law enforcement and other purposes. Unauthorized or improper use of, or access to, this computer system may subject you to state and federal criminal prosecution and penalties as well as civil penalties. At any time, the government may intercept, search, and seize any communication or data transiting or stored on this information system.</p> </div> <div class="col-xs-12" id="Continue"> <div class="pull-right" id="gettingStartedRegisterWrapper"> <a class="btn btn-primary pull-right disabled" disabled="true" id="registerNewAccountButton">Continue</a> </div> </div> </div> </div> </body> <script> var jQuery = $.noConflict(); function warnGuestUser(event) { if(!confirm('Are you sure you want to continue as a Guest User? As a Guest User, you will not be able to save an in progress application. This is not the recommended route. We recommend you to create an account.')) event.preventDefault(); } function checkToSeeIfUserCanFileApplication() { var ageOption = jQuery("input[name=ageOption]:checked").val(); var ifElgOption = jQuery("input[name=ifElgOption]:checked").val(); var disabledOption = jQuery("input[name=disabledOption]:checked").val(); var WaitingOption = jQuery("input[name=waitingOption]:checked").val(); var residentOption = jQuery("input[name=residentOption]:checked").val(); myFunction(); if ( (residentOption === 'Yes' || residentOption === 'No') && (ageOption === 'Yes' || ageOption === 'No') && (ifElgOption ==='Yes' || ifElgOption ==='No') && ((disabledOption === 'Yes' && (WaitingOption === 'Yes' || WaitingOption === 'No'))|| disabledOption === 'No') ) { //Condition_1 if (ageOption === 'No' && ifElgOption ==='No' && disabledOption === 'No' && residentOption === 'Yes'){ jQuery('#registerNewAccountButton').removeClass('disabled').attr('disabled', false); document.getElementById('registerNewAccountButton').onclick=function(){ document.getElementById('registerNewAccountButton').href = "/familycare/ABD_NJFC_GS_NJFC_Result?lng=&ageOptionparam="+ageOption+"&ifElgOptionparam="+ifElgOption+"&disabledOptionparam="+disabledOption+"&residentOptionparam="+residentOption; } } //Condition_2 else if (ageOption === 'No' && ifElgOption ==='Yes' && disabledOption === 'No' && residentOption === 'Yes'){ jQuery('#registerNewAccountButton').removeClass('disabled').attr('disabled', false); document.getElementById('registerNewAccountButton').onclick=function(){ document.getElementById('registerNewAccountButton').href = "/familycare/ABD_NJFC_GS_ABD_Result?lng=&ageOptionparam="+ageOption+"&ifElgOptionparam="+ifElgOption+"&disabledOptionparam="+disabledOption+"&residentOptionparam="+residentOption; } } //Condition_3 else if (ageOption === 'No' && residentOption === 'Yes' && (ifElgOption ==='Yes' || ifElgOption ==='No') && (disabledOption === 'Yes' || disabledOption === 'No')){ //alert('-1-'); jQuery('#registerNewAccountButton').removeClass('disabled').attr('disabled', false); if(disabledOption === 'Yes' && WaitingOption === 'Yes'){ document.getElementById('registerNewAccountButton').onclick=function(){ document.getElementById('registerNewAccountButton').href = "/familycare/ABD_NJFC_GS_NJFC_Result?lng=&ageOptionparam="+ageOption+"&ifElgOptionparam="+ifElgOption+"&disabledOptionparam="+disabledOption+"&residentOptionparam="+residentOption+"&WaitingOptionparam="+WaitingOption; } } else if(disabledOption === 'Yes' && WaitingOption === 'No'){ document.getElementById('registerNewAccountButton').onclick=function(){ //alert('--coming here--'); document.getElementById('registerNewAccountButton').href = "/familycare/ABD_NJFC_GS_ABD_Result?lng=&ageOptionparam="+ageOption+"&ifElgOptionparam="+ifElgOption+"&disabledOptionparam="+disabledOption+"&residentOptionparam="+residentOption+"&WaitingOptionparam="+WaitingOption; } } } //Condition_4 else if (ageOption === 'Yes' && residentOption === 'Yes' && disabledOption === 'No' && (ifElgOption ==='Yes' || ifElgOption ==='No')){ jQuery('#registerNewAccountButton').removeClass('disabled').attr('disabled', false); document.getElementById('registerNewAccountButton').onclick=function(){ document.getElementById('registerNewAccountButton').href = "/familycare/ABD_NJFC_GS_ABD_Result?lng=&ageOptionparam="+ageOption+"&ifElgOptionparam="+ifElgOption+"&disabledOptionparam="+disabledOption+"&residentOptionparam="+residentOption; } } //Condition_5 else if (ageOption === 'Yes' && residentOption === 'Yes' && disabledOption === 'Yes' && (ifElgOption ==='Yes' || ifElgOption ==='No') && (WaitingOption === 'Yes' || WaitingOption === 'No')){ jQuery('#registerNewAccountButton').removeClass('disabled').attr('disabled', false); document.getElementById('registerNewAccountButton').onclick=function(){ document.getElementById('registerNewAccountButton').href = "/familycare/ABD_NJFC_GS_ABD_Result?lng=&ageOptionparam="+ageOption+"&ifElgOptionparam="+ifElgOption+"&disabledOptionparam="+disabledOption+"&residentOptionparam="+residentOption+"&WaitingOptionparam="+WaitingOption; } } //NJ.Gov Condition if (residentOption === 'No' && ifElgOption ==='No') { jQuery('#registerNewAccountButton').removeClass('disabled').attr('disabled', false); document.getElementById('registerNewAccountButton').href = "/familycare/ABD_NJFC_GS_FFM_Result_Page"; } else if (residentOption === 'No' && ifElgOption ==='Yes') { jQuery('#registerNewAccountButton').removeClass('disabled').attr('disabled', false); document.getElementById('registerNewAccountButton').href = "/familycare/ABD_NJFC_GS_FFM_Medicaid_Result"; } } } jQuery('#fileApplicantAsGuest').click(warnGuestUser); jQuery('.gettingStartedQuestions').on('change', 'input', checkToSeeIfUserCanFileApplication); jQuery(document).tooltip({ container: 'body', //selector: '.enable-tooltip' }); function openPopup(page,param){ window.open(page+'?param='+param,'_blank', 'toolbar=yes, scrollbars=yes, resizable=yes, top=0, left=0, width=800, height=800, location=no') } function myFunction() { var disabledOption = jQuery("input[name=disabledOption]:checked").val(); var x = document.getElementById("waitingOptionDiv"); if(disabledOption === 'Yes') { x.style.display = "block"; } else if(disabledOption === 'No') { x.style.display = "none"; } } function showhide(contid,resid) { var iname = document.getElementById(contid); //alert(iname); var x = document.getElementById(resid); if (x.style.display === 'none') { iname.className='fa fa-minus'; x.style.display = 'block'; } else { iname.className='fa fa-plus'; x.style.display = 'none'; } } </script><span id="j_id0:j_id2:j_id3:j_id45"> <footer class="theFooter"> <div class="container"> <p><h3>Division of Medical Assistance and Health Services</h3></p> <p>New Jersey Department of Human Services (DHS)</p> <p class="pull-right">Copyright © State of New Jersey, 2017</p> <p><a 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