New Jersey NJ FamilyCare Find a provider or pharmacy (2024)

Looking for the federal government’s Medicaid website? Look here atMedicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare.Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotlinedisclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time.Nurse Hotline not for use in emergencies, for informational purposes only.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® (Medicare-Medicaid plan)

UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts withboth Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook.

UnitedHealthcare Senior Care Options (HMO SNP) plan

UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system.The 5-Star rating applies to plan year 2024.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsem*nt of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, emailprovider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call1-888-638-6613/ TTY 711, or use your preferred relay service.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.

New Jersey NJ FamilyCare Find a provider or pharmacy (2024)

FAQs

How do I speak to someone at NJ FamilyCare? ›

If you don't see your questions listed below, please call NJ FamilyCare at 1-800-701-0710 (TTY: 711) and speak to a Health Benefits Coordinator. How is the NJ FamilyCare health plan appeal process changing?

How long does it take for NJ FamilyCare to be approved? ›

Applications currently take about 30 to 45 days to process. If you create a NJ FamilyCare account, you can check the status of your application after you submit it. You will get a letter in the mail whether or not you qualify for coverage. Receiving NJ FamilyCare does not make you a public charge.

Is NJ Medicaid and NJ FamilyCare the same thing? ›

NJ FamilyCare - New Jersey's publicly funded health insurance program - includes CHIP, Medicaid and Medicaid expansion populations.

Which hmo is best for NJ FamilyCare? ›

According to the NJ FamilyCare/Medicaid “HMO Performance Report” released last month, Horizon NJ Health received a 92% overall performance score, the highest of all New Jersey's Medicaid managed care plans and the only plan to improve its overall score from previous reports.

What is the maximum income to qualify for NJ FamilyCare? ›

Who is eligible for New Jersey FamilyCare (NJFC)?
Household Size*Maximum Income Level (Per Year)
1$52,710
2$71,540
3$90,370
4$109,200
4 more rows

Is NJ FamilyCare the same as Horizon NJ Health? ›

As a member of Horizon NJ Health, you get the benefits and services you are entitled to with the NJ FamilyCare Program. The medical care and services you get through Horizon NJ Health are free or low cost.

How does NJ FamilyCare verify income? ›

NJ FamilyCare includes New Jersey residents; all are eligible to apply. Financial eligibility will be determined by the latest federal tax return which, when filed, will be electronically verified.

Does NJ Medicaid check your bank account? ›

Once determined eligible for Medicaid, annual redeterminations are done to ensure a Medicaid recipient still meets the financial eligibility requirements. However, a Medicaid agency can ask for bank statements at any time, not just annually.

How do I know if my NJ FamilyCare is active? ›

If you applied for NJ FamilyCare coverage through the website www.njfamilycare.org, or by phone, you can track your application's status by calling 1-800-701-0710.

Is NJ FamilyCare free? ›

Qualifying New Jersey residents of any age may be able to get free or low-cost health insurance through New Jersey's publicly funded health insurance program, NJ FamilyCare. It includes people who qualify for Children's Health Insurance Program (CHIP) or Medicaid.

Does NJ FamilyCare have dental? ›

The NJ FamilyCare Program (Medicaid) provides dental benefits so members can have regular dental check-ups, cleanings and needed dental treatment. Cavities and gum disease are preventable dental problems.

Can I use NJ FamilyCare in another state? ›

Because each state has its own Medicaid eligibility requirements, you can't just transfer coverage from one state to another, nor can you use your Medicaid coverage when you're temporarily visiting another state, unless you need emergency health care.

Does NJ FamilyCare have OTC benefits? ›

Prescription Drug Coverage: For the medicine you need to stay in good health and $15 every quarter for Over the Counter (OTC) items. Wellpoint (formerly Amerigroup) has proudly served NJ FamilyCare members since 1996 and we understand what you want from your health plan. Let us help you get the most from your benefits.

Is it better to choose PPO or HMO? ›

An HMO is a good choice if you want the cheapest health insurance and don't mind staying within the plan's provider network. A PPO would probably be the better option if flexibility is what you prefer, even if it means higher health insurance costs. Out-of-network care? Need to name a primary care physician (PCP)?

Does NJ FamilyCare cover eye exams? ›

Routine eye exams and glasses or contact lenses are not necessarily included in health insurance coverage. If you are insured, check your Summary of Benefits and Coverage to figure out whether it's a part of your plan. FYI - NJ FamilyCare does cover medically necessary eye exams and prescription glasses.

How do I check my NJ FamilyCare status? ›

If you applied for NJ FamilyCare coverage through the website www.njfamilycare.org, or by phone, you can track your application's status by calling 1-800-701-0710. If you applied for NJ FamilyCare coverage through a county welfare office or board of social services, your application still may be in process.

What is the phone number for Horizon NJ FamilyCare? ›

The NJ FamilyCare telephone number is 1-800-701-0710 (TTY: 1-800-701-0720).

How do I speak to a live person at NJ child support? ›

If you have any questions, the Child Support information line at 1-877-NJKIDS1 can help. Click here for the Guide to NJ Child Support Hotline Short Cuts.

How do I contact DHS NJ? ›

Telephone: (609) 292-9490. Email: Internal.Affairs@dhs.state.nj.us. Facsimile: (609) 341-2399. Regular Mail: 222 South Warren Street; Post Office Box 700 Trenton, New Jersey 08625 {If choosing this option, please include as much information pertaining to your complaint / compliment as possible in your letter}

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