Expanding health care access in New Jersey. Together, we can make a difference in more lives.
Opening the door to health care.
With new NJ FamilyCare eligibility, more people will have the opportunity to get affordable health care coverage. It’s going to take the combined effort of the community and the health care industry to reach the people who will benefit the most, to help them make sense of their new choices and to assist them in getting the right coverage for their needs.
1.
Qualifying for NJ FamilyCare. Your organization is perfectly suited to help people who qualify for NJ FamilyCare take a closer look at all their health care options. In fact, they are some of the people you serve every day. Here is a quick profile of some people who could benefit from New Jersey’s expanded NJ FamilyCare program.
Who may qualify for NJ FamilyCare benefits: Working parents. Meet Teresa. She is the mother of three children, ages 8, 3 and 5 months. Getting her children insured is Teresa’s top priority, but the entire family is at risk without full family coverage.
Income requirements. Beginning January 1, 2014, NJ FamilyCare in New Jersey will include all individuals and families whose income falls below 133% FPL, based on modified adjusted gross income.
Household Size
133% FPL
$15,282 $20,629 $25,975 $31,322 $36,669 $42,015 $47,362
Ways to help: Working parents may be too busy to pay much attention to the new health care law changes. Encourage them to apply and see if they qualify for no-cost coverage. Hold educational events or reach out directly to individuals.
Healthy single adults. Meet Mike. His career in construction has had its ups and downs since the recession a few years ago. He is skeptical about the need for coverage. For Mike and many others like him, health insurance is not a priority — until an illness or an accident strikes that can threaten their livelihoods and financial security. Ways to help: Reach out to healthy young adults to help them appreciate the physical, psychological and financial benefits of health care coverage. And encourage the people in their lives — friends, family and role models — to help influence attitudes toward coverage.
People who have had major life challenges. Meet Barbara. She is employed, but hasn’t had affordable health insurance since she became divorced. A few years ago, she was diagnosed with multiple sclerosis but with a pre-existing condition, Barbara has been unable to afford health coverage. Ways to help: These individuals are ready to apply. Help connect them with the people who can assist them in the application process.
Good news for men and women without dependent children. Adults between the ages of 19–64 without dependent children and who are within the income requirements will be eligible for low- or no-cost health insurance.
The profiles above are fictional and portray common types of people who may now qualify for NJ FamilyCare coverage.
Open enrollment begins
2.
Applying for benefits.
October 1, 2013
Certified Application Counselors and Presumptive Eligibility Providers are volunteers who help people apply for coverage. They can recommend a health plan as long as they act in the best interest of applicants and disclose any relationship with a health plan. How UnitedHealthcare can help: • Events – Let us help you attract and entertain young families and adults at your events. • Training – Tap into our years of experience reaching out to and interacting with the NJ FamilyCare public. • Materials – Let us know how we can help you hold events, educate people on health care and explain insurance options.
Let’s plan an event. We’re ready to work with your organization and your staff to draw people to your community event or create a new event around NJ FamilyCare.
Our mascot, Dr. Health E. Hound®, attracts families with activities and health-related fun.
Coverage begins
3.
January 1, 2014
Becoming a member.
The uninsured often have existing medical needs, such as medications that they haven’t been able to afford or health concerns to discuss with a doctor. At UnitedHealthcare Community Plan, we quickly assess the health of new members and connect them with the care they need.
Meeting immediate needs, providing comprehensive coverage. Immediate Needs:
Primary care provider
Member ID Card
Health risk assessment
Members receive their insurance card and details about their coverage within 5 days. Their card’s arrival marks the start of their coverage.
Members receive a welcome call from our care team to learn more about health needs and concerns. People with more complicated concerns receive extra attention and support.
Members have the freedom to choose their own participating primary care provider and are encouraged to go in for a checkup.
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Core Coverage: Doctor visits
Medications
Dental
Hospital care
Specialists
Emergency care
Vision
Preventive care
Multi-lingual services
Online support
+ Additional Services and Support: (at no cost) 24/7 NurseLine™
Transportation
Pregnancy support programs Chronic care programs
Rewards for healthy choices
Member services
Let’s work together. Please call us at 1-800-941-4647 (TTY: 711). Together, we can help expand health care access in New Jersey.
Learn more about the New NJ FamilyCare eligibility. Here are some resources to help you apply for NJ FamilyCare. Website
Description
State
njfamilycare.org
• Information about New Jersey’s publicly funded health insurance program. • People can contact NJ FamilyCare at 1-800-701-0710, TTY: 1-800-701-0720. They will take applications over the phone.
Federal
healthcare.gov
• Department of Health & Human Services (HHS) destination for the Health Insurance Marketplace. The online resource for consumers to compare and enroll in affordable, qualified health plan.
CuidadoDeSalud.gov
• Resource for Latino community with Health Insurance Marketplace information available in Spanish.
UHCCommunityPlan.com Information on our health plans, including plan benefits, provider networks and covered medications.
©2013 by United Healthcare Services, Inc. All rights reserved. CST3418_NJ 12/13
