Document pack
Medicaid Work and Community Engagement Hours Log: Monthly Hours, Proof and Exemption Records
A monthly record of your activity hours and the papers behind them, ready for renewal time.
$9 one time · Word and PDF · download link by email
Who it is for
Adults 19 to 64 in Medicaid expansion coverage (NJ FamilyCare Plan ABP in New Jersey), and the people who help them keep records.
Why it is different
- Checked against cms.gov, medicaid.gov and nj.gov, November 2026.
- Shows the official rule; never decides who qualifies.
- Word, PDF and an Excel workbook.
What is inside
- Monthly hours log. Daily activity and hours with month totals by type.
- Proof-of-hours document checklist. Records people keep for work, volunteering, job programs, school and income.
- Exemption-document checklist. The federal exemption groups and the records that go with each.
- Renewal and notice tracker. Federal and NJ rules at a glance, your dates, and a log of every notice.
- Hours workbook (Excel). Daily log that totals each month by activity and compares with 80 hours.
A look inside
The first pages, as you will get them
Get it
Medicaid Work and Community Engagement Hours Log
Want every toolkit? The toolkit membership includes all of them, with a lower rate if you pay yearly.
Delivered as a zip of editable Word files and printable PDFs. For one business, your own use. General information and templates, not legal, tax or accounting advice. General information and record-keeping tools, not legal, tax, financial or benefits advice. Your state Medicaid agency decides who must meet the requirement and what proof it accepts. Not affiliated with CMS or NJ FamilyCare. Payment is handled by Stripe. If a file will not open or something looks wrong, reply to your order email and we will make it right.
Buy it with the others
Bundle
Medicaid and SNAP Work Requirements Hours Bundle
This product plus 1 more, in one download.
$15 instead of $18 separately
Month-End Close Workbook
A real month-end close in one Excel file. It tells you when a rec does not tie, which variances still need an answer, and when the period is ready to lock.
$19