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What’s covered?

We provide New Jersey FamilyCare (Medicaid) coverage. You’ll get access to a wide range of benefits and services to help you reach your health goals. For complete info, see our list of covered services English (PDF) | Spanish (PDF). Or check out our member handbook. 

Get the member handbook

The Aetna Better Health® difference

 

We have experience you can count on. And we can help you live your healthiest life. That's why we offer a variety of specialty services to help you feel better.

Healthcare Central

Want to talk with us in person? Come see us at our Healthcare Central Store. It’s our Medicaid (NJ FamilyCare) Guidance Center in Newark, NJ. You can stop by to get answers to your questions face-to-face. We’ll be there to guide you through your benefits and more.  

Maternity care

Are you pregnant or planning to have a baby? We can help you get the care you need. Whether you need help choosing a provider, learning about childbirth classes or getting healthy food, we're here for you.  

No-cost smartphone

You can get a smartphone with an Android™ platform and Assurance Wireless Lifeline cell service at no extra cost to you. If you already have Lifeline, you can switch to Assurance Wireless. You’ll get:

 

  • A smartphone with an Android platform

  • Data each month

  • Unlimited texts

  • Voice minutes each month

  • Health tips and reminders by text

  • One-on-one texting with your health care team

  • Calls to Member Services that won’t count against your monthly minutes 

Benefits in your plan

We take care of the whole you. That means you’re covered if you need to see a specialist, have an emergency or plan to start a family. We also offer a wide range of preventive care and vaccinations. You can start by finding a provider today.

 

Find a provider

A healthy smile goes a long way. Dental care is part of your overall health. That’s why you should see your dentist every six months. We work with LIBERTY Dental Plan to provide you with dental and oral health care. So you can protect your smile and stay healthy. 

 

Learn more about dental benefits

Going to routine eye exams is an easy way to keep your eyes bright and healthy. We work with MARCH® Vision Care to offer you these covered services:

 

  • One routine eye exam every year

  • One pair of glasses or contact lenses every two years

 

You don’t need a referral to see a provider in the network. Just be sure to show your member ID card at every appointment. 

 

To learn more about your vision benefits, contact MARCH Vision Care. Just call 1-844-686-2724 (TTY: 1-877-627-2456). Or reach out to Member Services at 1-855-232-3596 (TTY: 711)

 

Find a provider

 

We make it easy for you to get the medicine you need to feel better. You may have a copay when you see your medicine on our preferred drug list (PDL)/formulary. This is a list of covered medications. If you don’t see your medicine on the list, your provider will help you find one that’s similar. And you can fill your prescription at any pharmacy in our network. 

 

Learn more about pharmacy benefits

Your mental health is part of your overall health. If you need help with mental health or a substance use disorder, we’re here for you. We offer behavioral health treatment to our members who need some extra care. We’ll also connect you with local resources for more support.

 

What to do if you’re having a crisis

 

If you’re thinking of hurting yourself or someone else, get help right away. You can call: 

 

Have other questions? Just call us at 1-855-232-3596 (TTY: 711)

 

Learn about mental and behavioral health services 

Do you need help getting care? Our care management team is here for you. Care managers are nurses and social workers who understand your health conditions and help connect you to the right care. A care manager can help you learn more about your health, find a ride to your appointments and more.  

  
Some diseases call for a little extra care. Our disease management program can help you. Our care managers can help you manage chronic conditions like asthma, diabetes, chronic obstructive pulmonary disease (COPD) and more.  

 

Learn more about care management  

 

Learn more about disease management 

Are you expecting a child? We’ll help you stay healthy during your pregnancy. Our programs can help you get the care and services you need. And you can earn rewards for making healthy choices.

 

You can read more about pregnancy and newborn services on our website. Or call Member Services.  

 

Learn more about pregnancy and newborn services

We’ll help you get birth control counseling and supplies. You can see any in-network or out-of-network provider. Any family planning care that you get is private. You can call Member Services to choose a family planning provider. Or you can read more about family planning.

If you have no way to get to the hospital during an emergency, call 911. We cover ambulance rides on the ground in a medical emergency for all members.  

 

You can also get rides to provider visits through Medicaid Fee-For-Service.  To learn more, you can call ModivCare (formerly LogistiCare) at 1-866-527-9933 (TTY 1-866-288-3133). Be sure to schedule rides at least two business days in advance. 

 

When you call to schedule your ride, make sure to have this info ready:

 

  • Name of the provider

  • Address

  • Phone number

  • Appointment time

  • Type of ride needed (e.g., regular car, wheelchair van)

 

If you have any problems with the services, just call the ModivCare Complaint Hotline at 1-866-333-1735. 

The Personal Preference Program (PPP) offers you greater control, flexibility, and freedom. You can choose who provides your care, what type of care you want and need, when you want care to be provided and where the care will be provided.

 

Click here for more information

 

Application 

 

To apply for PPP, please fill out the above application and email it to ABHNJPPP@AETNA.com

Population health management programs

These programs can help you live your healthiest life possible. We have special programs and services to help you get the care you need. And prevent health issues in the future.

 

Learn more about these programs

Managed long-term services and supports (MLTSS) 

Managed long-term services and supports (MLTSS) 

Do you need extra support for long-term care? We’ll help you get the services you need so you can feel better. If you meet the state’s guidelines for needing a higher level of care, you may qualify for MLTSS benefits. You can get them from the comfort of your home or an assisted living home. We cover these MLTSS benefits:   

  • Skilled nursing facility services (91+ days) 

  • Personal care services  

  • Self-directed personal help services 

  • Community first choice option 

  • Home- and community-based services  

Learn more about your plan


Download for complete coverage info

 

Your handbook is a great resource for all your needs. It has everything you need to know about your health care plan. Plus, phone numbers, addresses, info about copays and much more.

 

Choose your language

 

Fee-For-Service 

 

There are some services that you can get from Fee-For-Service. We don’t cover them, but NJ FamilyCare pays for them directly. You’ll need to show both your Aetna Better Health of New Jersey ID card and NJ FamilyCare card at the visit. 

 

If you have a NJ FamilyCare C or D plan, you may have to pay a copay at your visit. All services must be medically necessary. And your provider may need prior approval before you can get some services. 

 

If you need these services, let us know and we’ll help get you get connected. Just call your primary care physician (PCP). Or reach out to Member Services at 1-855-232-3596 (TTY: 711) to get started.  

 

Be sure to check out the full list of covered services English (PDF) | Spanish (PDF), including those under Fee-For-Service (FFS). 

Other language and format needs 

 

We provide interpreter services free of charge during any service or grievance process. This includes American Sign Language and real-time oral interpretation. If you need something translated into a language other than English, just call us. We can also provide materials in other formats, too. Like braille, audio CD or large print. And if you need an interpreter for your medical visit, you can call us at 1-855-232-3596 (TTY:711). Be sure to call 48 hours before your visit.

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