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5 expert tips to make the most of NJ FamilyCare (and your health)

Color portrait of Sachi Fujimori By Sachi Fujimori

The world as we know it is changing and you and your loved ones may have been directly affected by COVID-19. In the face of these challenging times, Aetna Better Health of New Jersey is adapting to meet your needs so you can have access to the best health care experience, even from the comfort of home. Whether you’re enrolling for the first time or are a long-time member, it’s normal to have some questions about NJ FamilyCare, the state’s Medicaid and CHIP program: How do I find a provider that accepts my plan? What happens if my medications aren’t covered? How do I know if I even qualify? 

To help you answer these and other commonly asked questions, we turned to a handful of NJ FamilyCare experts. Here’s their best advice on how to make the most of your plan to keep you and your family healthy.

I need help finding a provider. Where do I start? 

Whether you need to get an annual physical or see a specialist about a chronic condition, finding a provider can be confusing and sometimes even stressful. The provider needs to be the right kind of provider and also take your health plan. If you need help finding one in your area, consider contacting your health plan. All Aetna Better Health of New Jersey (Aetna) members, for example, can work with a care manager to find a provider who meets their needs. A care manager is a registered nurse who works one on one with members to help them manage medications, create care plans, communicate with their doctors, and more. 

“When a member calls us for help finding a provider, we start by searching for ones based on the person’s zip code, language needs and any special considerations, like a chronic condition or disability,” says Daryl Callahan, clinical care manager for Aetna Better Health of New Jersey. “Once we’ve narrowed down a list of providers, we can call the provider on the member’s behalf to schedule that first appointment. And if they don’t have a way to get there, we can arrange for free transportation within 20 miles of their home through LogistiCare.”

To speak with a care manager, Aetna members can call Member Services at 1-855-232-3596 (TTY 711).  

If you’re not an Aetna member but want to find out if a provider is in the Aetna Better Health of New Jersey network, you can check Aetna’s online provider directory.

Can my NJ FamilyCare plan help connect me to resources like food and housing? 

“If a member needs something, we will go above and beyond to try and find resources to help them,” explains Joanna Jelleyman, a care management supervisor with Aetna Better Health of New Jersey. She and her team have found housing for homeless members and helped provide new moms in need with free diapers and formula. “We’ll even find you a place to crochet,” she adds. “I’m not joking here. I had a member who was recovering from cancer and wanted something to do to keep busy. We found him a place where he could learn to crochet for free.” 

Before you contact your health plan, Jelleyman suggests writing down a list of what you need, as well as your health goals. That information will be the basis for your care plan. 

“Care managers do the best they can to advocate for all members. That’s the focus of our job,” she says. “And if we don’t have the answer, we will direct you where you can find the answer.”

My medication is no longer covered by my plan. What can I do?

A good first step is to reach out to your pharmacist, says Vineet Parikh, a pharmacist in New Jersey. He or she may be able to give you other prescription options, or contact your provider to find out if you can switch to a similar medicine that’s covered by your plan. 

You can also rely on your pharmacist to answer questions you may have about a medicine’s side effects or interactions with other drugs or supplements you’re taking. “I remember once we had a NJ FamilyCare member come in, and she was in really poor health,” Parikh says. “She was mixing up her nearly dozen medications and not taking them on time. After spending time with her, we arranged her medicines in a pill organizer and taught her how and when to take them. She’s in better health now, and that makes me feels good.”

I have a new job and am worried I no longer qualify for NJ FamilyCare. 

Don’t assume you make too much to qualify for a Medicaid plan, says Dr. Cheryl Reid, medical director for Aetna Better Health of New Jersey. “The state of New Jersey wants people who live here to have health care, and it does its best to make sure a wide range of people are eligible,” she says. 

This includes:

  • Children 18 and under with a household income of up to $7,278/month for a family of four
  • Parents and caretaker relatives who earn up to $2,829/month for a family of four
  • Adults without dependent children who earn up to $1,387/month (for a single person) or $1,868/month (for a couple)
  • Pregnant women who earn up to $4,203/month for a family of four

To find out if you qualify, check out NJ FamilyCare’s income chart

I’m moving to a new neighborhood. How do I make sure I don’t lose my coverage?

It’s a common story: A family moves but forgets to update their address with Aetna Better Health and NJ FamilyCare. And then because their address is outdated, the family can’t receive or respond to the annual renewal notices in the mail, and their health coverage lapses.  

If you move or change your mailing address, call your state case worker at the County Welfare Office or the Health Benefits Coordinator at 1-800-701-0710 (TTY 1-800-701-0720) as soon as possible. “You also need to update this information with your health plan,” says Magdaliza Aviles, manager of Healthcare Central, Aetna’s storefront in Newark, NJ. Doing so will ensure that you receive your annual renewal notices in the mail and that your coverage continues without interruption.

Being healthy means taking care of the whole you. Whether that means finding a provider, connecting you to important resources or taking your prescription medications, NJ FamilyCare and Aetna Better Health of New Jersey can help.

About the author

Sachi Fujimori is a writer and editor based in Brooklyn who focuses on writing about science and health.  A good day is one where she eats her vegetables and remembers to live in the moment with her baby girl.