Beware Of The Big Medicaid Application Companies
BEWARE OF MEDICAID APPLICATION COMPANIES. THEY ARE NOT STAFFED BY ATTORNEYS. OFTEN TIMES THEY MAKE MANY MISTAKES AND/OR GIVE POOR AND/OR GROSSLY INACCURATE LEGAL ADVICE THAT CAN COST YOU ELIGIBILITY. THESE COMPANIES ARE IN BED WITH THE LARGE NATIONAL AND REGIONAL NURSING HOMES AND ASSISTED LIVING COMPANIES. THEY ARE NOT OUT TO PROTECT YOU. THEY DO NOT OFFER STRATEGIES AND LEGAL ADVICE TO ASSIST FAMILIES IN PROTECTING A LIFETIME OF SAVINGS AND INCOME FROM LONG-TERM CARE COSTS. THEY ARE RECOMMENDED BY THE BUSINESS OFFICE OF THE LARGER NURSING HOME AND ASSISTED LIVING CHAINS BECAUSE THEY WILL MAXIMIZE THE $ SPENT BY FAMILIES AT THESE FACILITIES. THEY ARE NOT YOUR FRIENDS!
Contact Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright on any questions concerning eligibility for NJ Medicaid or applying for Medicaid approval. Call toll-free 376-5291or email him at . His team of experienced medical lawyers and paralegals have filed many hundreds of applications throughout New Jersey.
Unitedhealthcare Senior Care Options Plan
UnitedHealthcare 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 plans 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. 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 SCO program.
New Jersey Has Accepted Federal Medicaid Expansion
- 2,053,575 Number of New Jerseyans covered by Medicaid/CHIP as of October 2021
- 769,724 Increase in the number of New Jerseyans covered by Medicaid/CHIP fall 2013 to October 2021
- 40% Reduction in the uninsured rate from 2010 to 2019
- 54% Increase in total Medicaid/CHIP enrollment in New Jersey since Medicaid expansion took effect
Recommended Reading: How To Find Out If You Qualify For Medicaid
Health Care Claims Fraud
- Its illegal to submit a false claim form to an insurance company in order to be paid for health care services which were not received or provided.
- This is a violation of the New Jersey Health Care Claims Fraud Act, N.J.S.A. 2C:21-4.2 and 2C:21-4.3.
- In addition, this person can be required to pay a fine of up to $150,000 or up to five times the amount of the claim.
- A person who is not a doctor, chiropractor, etc., could be sentenced to 3 to 5 years in jail for filing just one false claim.
Contact MFCU
What Are The Medicaid Plans In New Jersey
PACE program
The state will add long-term services and supports, mental health programs, and host-based and network services to its managed care programs from 2013 to 2014. Many of these populations will be moving from fee-for-service to managed care.
Delivery System and Reform Incentive Payment
Due to unanticipated delays in completing the DSRIP Going to Plan Protocol and DSRIP Funding & Mechanics protocols, CMS approved an amendment request to modify the Delivery System and Reform Incentive Payment program so that the Hospital Relief Subsidy Fund .
The NJ Family Care program
Under the NJ Family Care program, New Jersey now has agreements with four managed care plans, including three for-profit national plans and one not-for-profit regional plan .
Read Also: Medicaid And Other Health Insurance
New Jersey Medicaid And The Trump Administration
The Trump Administration vowed to repeal the ACA and replace it, but that did not come to pass. There were several legislative efforts to repeal or change various aspects of the ACA in 2017, including bills that would have ended the enhanced federal funding for Medicaid expansion and switched general Medicaid funding to block grants or per-capita allotments, with an overall goal of sharply cutting federal Medicaid spending. But none of those bills passed. The only part of the ACA that was repealed was the individual mandate penalty.
For New Jerseys population that was already eligible for Medicaid prior to 2014, the federal matching rate was only 50%, but for those newly eligible for Medicaid under the ACAs expansion, the federal government paid 100% of the costs through 2016, and is now paying 94% of the costs. As of 2020, the federal government paid 90% of costs, and the funding split remains at that level going forward.
If the ACA had been repealed, nearly two-thirds of the adults who would have lost access to Medicaid have jobs or are in a household where someone has a job . These are the people who work in the service industry, construction, home health care, retail, and the education system. They are vital to our economy and our lives, but their employers often dont provide coverage , and their income just isnt high enough to purchase health insurance, particularly in a high cost-of-living state like New Jersey.
New Jersey Medicaid Contact Phone Number Is : 1
AddressmedicalStateServicesStateGovernmentmedicalProgramIncomeProgramServicesStateChildrenHospitalServicesmedicalNew Jersey Medicaid fee scheduleNew Jersey Medicaid Income limitsNew Jersey Medicaid expansionNew Jersey Medicaid providersNew Jersey Medicaid provider manualNew Jersey Medicaid provider enrollmentNew Jersey Medicaidd eligibility verificationNew Jersey Medicaid eligibility requirements
Don’t Miss: Medicaid Office In Vicksburg Mississippi
Dual Special Needs Plans In 2022
New Jerseyans on a UnitedHealthcare Dual Special Needs Plan get many extra benefits beyond those you get with either Original Medicare or Medicaid .
- OTC + Healthy Food $2,700 yearly/ $225 a month for over-the-counter products and healthy food in-store or online
- Post-hospital meal benefit $0 cost for post-discharge meals, up to 84 meals a year
- Personal emergency response device that can get you help quickly, 24 hours a day at no cost
Medicaid: More For You In 2022
As a UnitedHealthcare NJ Medicaid member, youll get great benefits like:
- Prenatal and postpartum care
- Dental includes cleanings, exams, fillings, and other dental work
- One of the largest provider networks available in New Jersey
- Vision including eye exam, glasses or contacts
- Prescription drugs
Don’t Miss: Dentist That Take Straight Medicaid
What Is New Jersey Familycare Fax Number
New Jersey Familycare fax number where you can send fax messages including application forms for New Jersey state health insurance is 732-863-4450.
Are you looking for additional information for New Jersey Familycare and New Jersey state health insurance? Do you need any assistance with New Jersey Familycare? Please contact us and we will be happy to help you with any Medicaid application related matter.
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 plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711, or use your preferred relay service for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.
You May Like: Pediatric Dentist That Accept Medicaid In Jacksonville Fl
Virtual Medical And Mental Visits
$0 copay virtual provider visits to discuss non-emergency medical concerns or general mental health conditions from home.
Speak to network medical or mental health providers using your computer or mobile device. Find participating providers online.
- For medical providers, visit amwell.com
- For mental health providers, visit virtualvisitsmentalhealth.uhc.com
New Jersey Consumer Assistance
New Jerseys participation in the federal Consumer Assistance Program grant was completed in October 2011, however, the New Jersey Department of Banking and Insurance continues to provide assistance to consumers with health insurance questions or problems. You can contact them at 1-800-446-7467.
If you need health insurance, be sure to check out HealthCare.govs Plan Finder. It will help you find and compare health care coverage options in your area.
If you have questions about insurance you bought for yourself and/or your family or you have insurance provided by an employer who does business only in New Jersey, contact:
New Jersey State Insurance DepartmentOffice of Consumer Protection ServicesNJ Department of Banking and Insurance20 Wes State Street
Recommended Reading: How Do I Add My Newborn To My Medicaid
The Costs Paid For Filing A Medicaid Application Are A Permissible Spend Down In New Jersey
DID YOU KNOW THAT THE COST OF HIRING PROFESSIONAL ASSISTANCE IN PREPARING AND FILING A MEDICAID APPLICATION IS PERMITTED AS PART OF THE SPEND DOWN PROCESS? THE LEGAL FEE PAID TO OUR OFFICE, FOR EXAMPLE, IS CREDITED TOWARD THE APPLICANTS ELIGIBILITY. SINCE A PERSON CAN KEEP ONLY $2,000/$4,000 IN RESOURCES TO BECOME MEDICAID ELIGIBLE, IT SELDOM MAKES SENSE FOR THE FAMILY TO ASSUME THE RESPONSIBILITY FOR FILING THE APPLICATION. THE MONEY WILL ONLY GO TO THE NURSING HOME OR OTHER PARTIES WHO WILL BE PAID BY THE STATE ONCE ELIGIBILITY IS ESTABLISHED.
See Why New Jerseyans Choose Unitedhealthcare
Whatever plan you choose, UnitedHealthcare will help you get the care you need.
- Large variety of network providers
- No-cost virtual visits
- Low- or no-cost prescription drugs
- Pre- and postnatal care for pregnant moms and newborns
- Well visits to help catch health problems early, routine shots to help protect against disease, community events, health education workshops and more
Its easy to enroll. Visit njfamilycare.org or call the NJ FamilyCare phone number at , TTY .
Find COVID-19 resources and information in New Jersey, including local vaccination sites near you.
Recommended Reading: Texas Medicaid Find A Provider
How To Apply For Medicaid In New Jersey
Understanding how to apply for Medicaid in New Jersey is extremely helpful during the sign-up process. While there are many different components to understanding a Medicaid application form, once the basics are mastered, everything will be much more straightforward. Learning how to apply for Medicaid might seem daunting, but potential applicants can find ways to make it simpler with a little bit of additional knowledge. For example, understanding where to apply for Medicaid can often be half in the battle, as it also determines how to apply for Medicaid. Learning whether or not an applicant can apply for Medicaid online can often alleviate any unnecessary stress associated with the program. All prospective applicants should know the variety of ways in which an application for Medicaid can be submitted, along with the supporting documents and items needed to complete the application. Applying for Medicaid correctly can often be the difference between an accepted Medicaid application and one that is denied eligibility. For more information regarding how to apply for Medicaid in New Jersey, along with whether or not potential beneficiaries can apply for Medicaid online, continue reading the outlined sections below.
Where do you sign up for Medicaid in New Jersey?
NJ FamilyCare
Renew Active Fitness Program
Renew Active is the gold standard in Medicare fitness programs for body and mind and can help keep you active at a gym or from home. Its available with many UnitedHealthcare Dual Complete® plans, at no cost.
You get a free gym membership at a nearby fitness location that you select from our network.* Most members have a location within just a few miles, some with a pool. You can also bring a family member or a friend to the gym with you to assist in your workout at no cost. If you prefer to work out from home, you can view thousands of on-demand digital videos and live streaming fitness classes.
- Gym membership at no additional cost to you
- Large and extensive fitness network of gyms and fitness locations
- On-demand workout videos and live streaming classes
- Social activities
- Online Fitbit® Community
- AARP® Staying Sharp® online brain health program
*The Renew Active program varies by plan/area. Access to gym and fitness location network may vary by location and plan.
Don’t Miss: How To Hide Money From Medicaid
What You Need To Know Before You File For New Jersey Medicaid
In New Jersey, Medicaid Applications are filed in person or in some cases by mail with the County Board of Social Services of the county where the applicant resides, either at home or in a facility. Some counties maintain outreach offices within the county, otherwise the application must be filed at the home office of the County Board of Social Services. You should contact your County Board of Social Services for their current policy on filing Medicaid applications.
Many documents are required to be filed in connection with a Medicaid application.
You dont just file an application. Much more information is demanded. In NJ, you dont just file an application much more information is required. Required documentation begins with a birth certificate to establish proof of US citizenship. A marriage certificate must be produced if the applicant is or has been married or a death certificate or divorce decree if the marriage has been dissolved or ended by death or divorce. In addition, five years of complete and detailed financial records are required.
Recent Medicaid Changes Written for Proof of Eligibility Demands Video
Many people ask what to do if they are unable to locate a birth certificate, marriage certificate, death certificate or divorce decree.
Medicaid examines and may verify that the financial information you submit going back five years is truthful and complete.
Helping People Is At The Heart Of All We Do
All New Jerseyans deserve affordable health care, including you. At UnitedHealthcare Community Plan, we help people live healthier lives. Weve worked hard to deliver on that mission in New Jersey since 1989.
We offer plans to help New Jerseyans get healthy and stay healthy. We cover adults, people with disabilities, expecting moms and children with our New Jersey Medicaid and NJ FamilyCare plans. We offer a Dual Special Needs Plans for those who qualify for both New Jersey Medicaid and Medicare.
Were proud that our NJ Medicaid plan is accredited by the National Committee for Quality Assurance . NCQA is a private, non-profit organization dedicated to improving health care quality. UnitedHealthcare Community Plan of NJ has also achieved NCQAs Long-Term Services and Supports Distinction for our UnitedHealthcare Dual Complete® plan.
Don’t Miss: Does Ohio Medicaid Cover Prescriptions
New Jersey Medicaid Office
Below is the contact information for the Medicaid office in New Jersey. They can assist you with questions or concerns about the New Jersey Medicaid program, including the eligibility requirements and Medicaid enrollment in New Jersey. You can view their site online at state.nj.us/humanservices/dmahs/home/index.html. To find out if you are eligible for this program, New Jersey Medicaid eligibility.
The Medicaid program in New Jersey covers basic medical care. This may include doctor services, inpatient hospital care, laboratory and x-ray services, inpatient short-term skilled nursing or rehabilitation-facility care, outpatient hospital or clinic care, short-term home healthcare, ambulance service and prescription drugs for people not covered by Medicare. We suggest contacting the Medicaid office to find out specifically what coverage is provided as it can be different in each state.
Who Is Eligible For Medicaid In New Jersey
In addition to the aged, blind, and disabled, the following New Jersey residents are eligible for Medicaid:
- Adults with incomes up to 138% of poverty
- Children with household incomes up to 350% of poverty are eligible for CHIP in New Jersey. This is one of the most generous thresholds in the country.
- Pregnant women with incomes up to 200% of poverty .
You May Like: Medicaid Office In West Palm Beach
The Following Is A Sample List Of Medicaid Application Issues That Should Be Addressed To Avoid Unnecessary Delays And Denials
1. Select the Program Right for You Before You File
Applicants for long-term care assistance must decide which care program is best for him/her. The choice of programs depends on the applicants living situation, physical condition, and financial status. Certain benefit programs are specifically geared to victims of traumatic brain injuries or Alzheimers Disease. Many states, including New Jersey, have dual institutional Medicaid programs including MLTSS which have slightly differing income and asset standards and offer different coverage with respect to hospital stays and community setting. If you have any questions on selecting the appropriate Medicaid program for you, contact Fredrick P. Niemann toll-free 376-5291.
2. Make Sure Your Medicaid Application is Timely Filed
3. Authorization to Apply for NJ Medicaid
4. Medical Criteria for Medicaid Eligibility
Qualifying for Medicaid involves not only financial criteria but also physical and medical eligibility requirements. Therefore, applicants must undergo a physical exam to establish that he or she is unable to perform a certain number of activities of daily living commonly referred to as the ADLs, including feeding, dressing, bathing, toileting and continence. If it cannot be proven to Medicaid that a nursing home level of care is necessary, the Medicaid application will be denied.
5. Intake Procedures for Filing a Medicaid Application
6. Substantiating the Data Needed for Approval of Your Application
Understanding The Medicaid Application Process
Actual Client Testimonial
My aunt is 80 years old and a widow. Shes in good health and lives alone. My cousin and I are very close to her, but I live in North Carolina and my cousin in California. That makes it hard for us to help her as much as we would like to. She wanted to do some estate planning and asked us to help her find an elder law attorney. I did some homework and research and after many inquiries, found Mr. Niemann. He came recommended to me by several sources. Mr. Niemann was the perfect match for my aunt. He demonstrated a kindness and sensitivity that made us feel welcomed and comfortable. He met with us right away and was caring and patient with my aunt and answered all our questions. He even called my aunt to make sure she was following up on his advice. Mr. Niemann offered us ideas and solutions we hadnt even thought of. We very much appreciated that. My aunt truly values having Mr. Niemann as her attorney. So do I
Robert Newell, Raleigh, NC
You May Like: Where Can I Get A Medicaid Application
