New Jersey Brain Injury Fund, Medicaid MLTSS, and Fair Hearing Help
New Jersey has a state Traumatic Brain Injury Fund and Medicaid managed long-term services and supports. These are different programs. Start with the need, the written decision, and the official agency responsible.
Start here
If insurance and public programs do not cover a needed TBI support: review the New Jersey TBI Fund.
If the issue involves NJ FamilyCare or managed long-term services: contact the plan or agency named in the notice.
If a service was denied, reduced, suspended, or terminated: follow the internal appeal and Medicaid Fair Hearing instructions that apply to your case.
New Jersey Traumatic Brain Injury Fund
The New Jersey TBI Fund may purchase certain brain-injury-related supports for eligible New Jersey residents when insurance, personal resources, or public programs are unavailable. The applicant page explains eligibility and application starting points.
The Fund is not the same as Medicaid. Ask the program which documentation is required and whether the requested item or service fits current Fund rules.
Medicaid managed care and long-term services
For Medicaid managed-care service decisions, read the plan notice and complete any required internal appeal. The New Jersey managed-care appeal page explains the general utilization-management appeal framework. Medicaid and NJ FamilyCare rules may provide additional rights, so follow the Medicaid-specific notice.
New Jersey's current Medicaid fair-hearing communication explains 2026 operational changes. Use the most current notice and agency instructions.
If you disagree with a decision
Save the complete adverse decision, the plan name and member ID, the service requested and prior authorization, assessments, prescriptions, provider letters, care plans, dates, names, reference numbers, and proof of submission.
Ask in writing for the exact reason, rule, records relied on, deadline, and whether existing services can continue during review. If a deadline is close, submit the appeal request first and add supporting records as allowed.
Communication accommodations
Ask for plain language, an accessible electronic or large-print copy, an interpreter, written follow-up, extra processing time, or help using an authorized representative. The New Jersey language-access page lists translated materials across Human Services programs.
Official sources
Scope and safety
ABI Resources provides direct care services in Connecticut. This New Jersey page is national informational content and does not claim New Jersey service coverage, government affiliation, or guaranteed eligibility. Verify current rules and deadlines with the responsible agency and your notice. This is general information, not medical or legal advice. Call 911 for an emergency. Call or text 988 for a suicide or mental-health crisis.
Reviewed: September 19, 2026.
