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NJ FamilyCare Frequently Asked Questions
Will there be any eligibility changes for kids or parents because of new NJ FamilyCare rules?
Yes. Adults with income over 133% of the Federal Poverty Level are ineligible for NJ FamilyCare but will be referred to the new Federal Health Insurance Marketplace. Visit www.healthcare.gov for other affordable health insurance programs.
For Pregnant Women: There is no change to eligibility. Pregnant women already enrolled in NJ FamilyCare should contact 1-800-941-4647 (TTY 711) and advise them. NJ FamilyCare wants to be sure they are receiving all of the benefits pregnancy entitles them to receive.
For Children: Eligibility for coverage remains up to 350% FPL.
Can parents/guardians apply for NJ FamilyCare?
NJ FamilyCare is accepting applications from adults age 19-64 with income at or below 133% of the federal poverty level.
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 the plan?
NJ FamilyCare is an 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.
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 1-800-941-4647 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 the plan.
I am a single adult. Can I still qualify for the NJ FamilyCare?
Yes. NJ FamilyCare is accepting applications for all adults with income under 133% of the Federal Poverty Level. Immigrants who are legal permanent residents of the US must have that status for at least five years in order to be eligible for NJ FamilyCare.
My family came to the United States two years ago. Could they be eligible for NJ FamilyCare?
Children age 18 or under who are lawfully admitted for permanent residence can be eligible even if they have lived in this country less than five years. Immigrant parent/guardians who are legal permanent residents of the US must have had that status for at least five years in order to be eligible for the plan. Documentation of immigration status will be requested along with the application.
I don't speak English very well and I am afraid to call.
The NJ FamilyCare 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 1-800-941-4647 (or TTY 711 for hearing impaired)!
How do I apply?
A. There are several ways you can apply:
- By mail — call 1-800-941-4647 (or TTY 711 for hearing impaired) 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 from the NJ FamilyCare website.
- By completing the online application and submitting it electronically.
I really need help completing the application. What should I do?
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.
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.
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.
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 1-800-941-4647 (or TTY 711 for hearing impaired) 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 1-800-941-4647 (or TTY 711 for hearing impaired) 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 I'm Pregnant?
A. NJ FamilyCare covers low income pregnant women too! Apply online at www.NJFamilyCare.org or visit your County Welfare Agency. Pregnant women already enrolled in NJ FamilyCare should contact 1-800-941-4647 (TTY: 711) and advise them. NJ FamilyCare wants to be sure they are receiving all of the benefits that pregnancy entitles them to receive.
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