Questions and Answers

Below is a general list of frequently asked questions. If you don't see your questions listed below, PLEASE call NJ FamilyCare at 1-800-701-0710 and speak to a Health Benefits Coordinator. It is suggested that at anytime a family member contacts a Health Benefits Coordinator, they keep a record of the day and time and the name of the person who assisted them.

Can parents apply for NJ FamilyCare?
NJ FamilyCare accepts applications from parents at of below 200% of the federal poverty level. For example, parents in a family of four, making up to $3,675 per month, would be able to apply.

What does it mean that I have to renew my insurance every 12 months?
Renewal is simply a way of checking to see if anything has changed in your family's situation. You may be sent a preprinted form to confirm your income status and household size or you may be sent a blank application to fill out. It is very important that you immediately respond to any written request so that your insurance coverage will not be lost or interrupted.

How do I know if my family will qualify for NJ FamilyCare?
NJ FamilyCare is affordable health insurance for children and certain low-income parents. The primary qualifications are simple: 1) they haven't had health insurance in the past 3 months (with a few exceptions) and 2) your family monthly income falls within the guidelines listed in the "Income Eligibility and Cost" section of this web site.

Is it true that applicants for NJ FamilyCare must be without health insurance for 3 months before they can be eligible?
Yes, this is true. However, there are exceptions to this rule, such as if you lost your insurance because your place of work went out of business or you were laid off. Depending on income, other exceptions may apply for families privately paying for health insurance or for COBRA benefits. We strongly urge you to call 1-800-701-0710 and speak with a Health Benefits Coordinator to find out if any exceptions apply to you.

I have a job out of state. The health insurance I receive is not accessible to my family. Will they qualify for NJ FamilyCare in spite of the fact that I have insurance?
Yes, if health insurance is not accessible to your family, they may be eligible to apply for NJ FamilyCare.

I am a single adult. Can I still qualify for the NJ FamilyCare program?
No, to assure that there would be sufficient funding for children, NJ FamilyCare had to stop taking applications for adults and couples without dependent children on September 1, 2001.

My family came to the United State two years ago. Could they be eligible for NJ FamilyCare?
Yes, NJ FamilyCare does not require that legal residents reside in the United States for five (5) years before they can be eligible for the NJ FamilyCare program. Immigrants who are lawfully admitted for permanent residence can be eligible even if they have lived in this country less than five years. Documentation of immigration status will be requested along with the application.

I don't speak English very well and I am afraid to call.
NJ FamilyCare's 800 number is linked with a translation service. Whatever your native language is, we will arrange to have a third person on the line who can speak your language. They will be there to interpret for you and the Health Benefits Coordinator. Don't be afraid! Call 1-800-701-0710!

How do I apply?
There are several ways you can apply:

• By mail - call 1-800-701-0710 and ask for an application. The application will be sent to your home. Complete the application; return all of the required information in the self addressed stamped envelope.
• By downloading the application and mailing it to:
  PO Box 8367, Trenton, NJ 08650.
• By completing the online application and submitting it electronically.

Can I apply at my County Welfare Agency?
Yes, you can. Actually, if your income is low at this time, it would be a very good idea to apply at a County Welfare Agency. There is a possibility that you might be eligible for other programs, such as food stamps. The representatives at the County Welfare Agency will be able to help you. You can find your County Welfare Agency's address and telephone number by going to "Need help enrolling?" and then click on your county of residence. They will be listed there.

Do you think I should make a copy of all the paperwork before I send it?
YES! you should keep a copy of the completed application, as well as all of the documents.

I cannot make up my mind as to which HMO to select. What should I do?
First you should check out the list of NJ FamilyCare HMO's, and see which are available in your County. Then you should contact your family doctor to see if he or she is participating in one of those HMO's - be sure to specify NJ FamilyCare when you ask. If not, we recommend that you call our 800 number to have one of our Health Benefits Coordinators assist you. Make a selection even if you are not sure. Not choosing an HMO will SLOW DOWN your application. Once your family members are enrolled in NJ FamilyCare, you will have an opportunity to change your HMO at a later date, if you are not satisfied.

If I have to pay a monthly premium, how important is it to send in my check once I receive notice?
It is very important that you send in your payment as soon as you know your monthly premium. You will receive notice of your premium by mail. New members cannot be enrolled until the full payment has been received. Once enrolled you will be billed monthly. It must be paid in full and on time in order to continue enrollment.

Can I keep the same doctor I have now?
Yes, if your doctor is a participant of one of the  HMO's providing services for NJ FamilyCare in your county. Call your doctor and ask if he or she is providing services for NJ FamilyCare and if so, under which HMO. Then choose that HMO as your health care provider.

I sent in my application four weeks ago and have not heard anything. What should I do?
If you mailed an application or submitted an online application to the State Health Benefits Coordinator 4 weeks ago and have not heard anything, call 1-800-701-0710 and ask about the status of your application. Ask for your policy ID number for future reference. If your application was sent to your local County Welfare Agency, call them to inquire about the status and to get your case number.

I have lost my job and can no longer afford the premiums for NJ FamilyCare. Is there anything I can do to maintain coverage for my children?
You can call 1-800-701-0710 and request a status change. Your family's eligibility status will then be reevaluated based on current income, and could result in your paying a lower premium or no premium.

What if my family makes too much money to qualify for NJ FamilyCare?
Parents at higher income levels can purchase health insurance for their children at reasonable rates through the NJ FamilyCare ADVANTAGE program administered by Horizon NJ Health if they qualify. The cost is $143 per month for one child; $286 per month for two children; and $429 per month for three or more children. To learn more, please visit http://www.horizonnjhealth.com/members/advantage.html or call 1-800-637-2997.