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Healthcare Programs and Resources
Healthcare has always been an important consideration. For many in our state, it has become a critical concern. Here is a review of the health resources available in New Jersey. If you need help finding the resource that is right for you, dial 2-1-1 and let one of our experienced resource specialists help you.
There are several medical assistance programs that are jointly administered and funded by the state and federal government.
- Medicaid is designed to help those with very limited or no income.
- NJ FamilyCare is a program that is designed to assist residents who are ineligible for Medicaid but who still cannot afford health care. This program is geared to help New
Jersey’s uninsured children and parents and guardians who fall within certain income criteria.
- Medicare is set up to help older citizens or those who are permanently disabled.
To be eligible for Medicaid
This medical assistance program pays medical bills for certain individuals of any age with low income and limited resources. To be eligible you must be:
- A resident of NJ
- U.S. Citizen or qualified alien (most immigrant who arrived after August 22, 1996 are barred from the program for five years)
- Meet specific standards for financial income and resources
To apply for Medicaid, contact your County Board of Social Services.
NJ FamilyCare
If you are NOT eligible for Medicaid because you fall above the income requirements, you may be able to get medical benefits through NJ FamilyCare. NJ FamilyCare is for families who do not have available or affordable employer insurance, and cannot afford to pay the high cost of private health insurance.
To learn more about this program and eligibility requirements, go to the NJ FamilyCare Web site or call 800-701-0710. Applications are available online.
Medicare
Medicare is for older citizens and those with a disability.
If you are 65 years or older; under the age of 65 with certain disabilities or have permanent kidney failure which requires dialysis or a transplant, than you are eligible for Medicare.
Medicare has two main parts – one that covers hospital costs and another that handles some related expenses.
Part A is hospital insurance and it helps people pay for inpatient hospitalizations, critical access hospitals (small facilities that give limited outpatient and inpatient services to people in rural areas), skilled nursing facilities (not custodial or long-term care), hospice care, and some home health care.
Part B is medical insurance that people pay a monthly premium for. It helps people pay for doctors' services, outpatient hospital care, and some other medical services that Part A doesn't cover, such as the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.
To enroll in Medicare, contact your local Social Security office or call 800-772-1213.
Private Insurance Options
The Individual Health Coverage (IHC) Program was created to ensure that people without access to employer or government sponsored health care programs could purchase health coverage for themselves and their families from a variety of private carriers.
Individuals, regardless of their age or health status, are guaranteed renewable health coverage under standard individual health benefits plans designed by the Individual Health Coverage Program Board as well as under the "Basic and Essential" plans (B&E Plan) sold by carriers.
Learn more about the Individual Health Coverage (IHC) Program, the current rates and coverage options.
Contact program administrators at: Individual Health Coverage Program (IHC),
P.O. Box 325,
Trenton, NJ 08625-0325
By Phone: 609-633-1882; By
Fax: 609-633-2030
Insurance Policies for Small Business Owners
The Small Employer Health Benefits (SEH) Program ensures that small employers have access to small group health benefits plans without regard to the occupation of the group, or the health status of any of the group's members; and that these employers have the ability to renew the coverage from year-to-year regardless of the group's claims experience or any changes in the health status of the group's members.
The Program restricts carrier use of small group participation requirements, employer contribution requirements, preexisting condition limitation provisions, and factors related to rates for health benefits plans offered to small employers. It also establishes standard health benefits plans. In addition, the Program protects employees and past employees because it includes a right for employees and their dependents to continue coverage when no longer eligible for the group's health plan. This continuation right applies even when an employer is not subject to COBRA.
Learn more about insurance coverage options for small employers.
Contact program administrators at: Small Employer Health Benefits Program (SEH),
P.O. Box 325,
Trenton, NJ 08625-0325
By Phone: 609-633-1882; By
Fax: 609-633-2030
Need Help? – Dial 2-1-1
You are encouraged to dial “2-1-1” 24 hours a day, seven days a week if you need help in understanding and finding available assistance services. Language translation and TTY services are offered to any caller. You can also search our database for services in your local community or Chat Live with an experienced community resource specialist. 2-1-1 will help identify with you the best local resources to fit your individual needs during times of financial distress or for life’s everyday situations.
If you know of additional resources that would be appropriate to include in this section, please let us know by contacting us via e-mail at info@nj211.org.
Sources for this page include:
http://www.state.nj.us/health/senior/index.shtml
http://www.state.nj.us/humanservices/dmahs/clients/medicaid/
http://www.njfamilycare.org/index.html
http://www.state.nj.us/dobi/division_insurance/ihcseh/index.html
Page last modified 8.4.11
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