New Jersey
Protection and Advocacy, Inc.
New Jersey's
designated protection and advocacy system for people with disabilities
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New Jersey
Protection and Advocacy, Inc.
New Jersey's
designated protection and advocacy system for people with disabilities
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Goverment Programs
Insurance Related Programs
Legal Help
Medicaid
Medicare
Mental Health
New Jersey Commercial HMO and POS Plans
Other Programs
Physicians
Self-Insured Plans
Senior Citizens
CHILDREN'S ISSUES
Association for Children of New Jersey
35 Halsey Street, 2nd Floor
Newark, New Jersey 07102
973-643-3876
Fax: 973-643-9153
www.acnj.org
ACNJ is a statewide child advocacy organization. Information and telephone consultation is provided on a broad range of children's issues.Catastrophic Illness in Children's Relief Fund Commission
New Jersey Department of Human Services
P.O. Box 700
Trenton, New Jersey 08625-0700
Toll free: 800-335-3863
Catastrophic Illness in Children Relief Fund was created to provide financial assistance to families whose children have experienced an illness or condition, which is not fully covered by a state or federal program or private insurance, and have unpaid medical bills. To be eligible, you must have lived in New Jersey for at least three months immediately before the date of your application and have incurred health care expenses exceeding 10% of your family income (plus 15% of any income over $100,000). Also, the bills must have been incurred when the child is 18 years or younger.
Family Voices of New Jersey (in collaboration with Statewide Parent Advocacy Network, Inc.- SPAN)
35 Halsey Street, 4th Floor
Newark, New Jersey 07102
Toll free: 800-654-7726 (SPAN)
Fax: 973-642-8080
email: lkmcintosh@aol.com
A network of families and friends speaking on behalf of children with special health care needs. The Family Voices national office produces a variety of advocacy and informational materials on health care for children with special needs.New Jersey Department of Health and Senior Services
Special Child, Adult and Early Intervention Services
P.O. Box 364
Trenton, New Jersey 08625-0364
609-984-0755
Fax: 609-292-3580
www.state.nj.us/health
The Special Child Health Services Program, together with individual county boards of chosen freeholders, funds case management units in each of New Jersey's 21 counties. The case management units work to promote family-centered, community-based care and coordinate service delivery for children with special needs. Case managers, who are health professionals, frequently assist with health care issues and problems.DEVELOPMENTAL DISABILITIES
The Arc of New Jersey
985 Livingston Avenue
North Brunswick, New Jersey 08902
732-246-2525
Fax: 732-214-1834
www.arcnj.org
The Arc of New Jersey is a statewide parent and consumer advocacy organization for persons with developmental disabilities, particularly people with mental retardation. The Arc devotes considerable resources to train, educate and advocate for a New Jersey-based managed health care system that addresses the comprehensive needs of its members.Division of Developmental Disabilities (DDD)
Capital Center, P.O. Box 726
Trenton, New Jersey 08625-0726
609-292-7260
Toll free: 800-832-9173
Fax: 609-292-6610
DDD administers the State's Community Care Waiver, which provides personal care (residential); habiliation (day program); respite (vacation for skill providers); case management services; integrated therapeutic network (OT, ST, PT); environmental/vehicle accessibility adaptations; and individual supports (residential, including self-determination). In addition, the CCW provides all medically necessary (Medicaid) services. DDD also provides an array of services to individuals who qualify for Division services pursuant to N.J.S.A. 30:6D-3; N.J.A.C. 10:46.The Elizabeth M. Boggs Center on Developmental Disabilities
The University Affiliated Program of New Jersey
UMDNJ
335 George Street, 3rd Floor
P.O. Box 2688
New Brunswick, New Jersey 08903-2688
732-235-9300
TDD: 732-235-9328
Fax: 732-235-9330
http://rwjms.umdnj.edu/boggscenter
The Boggs Center-UAP provides training, technical assistance, consultation, program development and research in a variety of areas relevant to persons with developmental disabilities, including a training curriculum on managed health care.Cerebral Palsy of New Jersey, Inc. (CPNJ)
354 South Broad Street
Trenton, New Jersey 08608
609-392-4004
Toll Free: 888-322-1918
TTY: 609-392-7044
Fax: 609-392-3505
www.cpofnj.org
CPNJ works with people with all types of disabilities, particularly people with developmental disabilities. The organization provides case management services and is available to advocate for appropriate services for consumers and their families in areas such as housing, transportation and health care.GENERAL DISABILITIES
Division of Disability Services (DDS)
P.O. Box 700
Trenton, New Jersey 08625-0700
609-292-7800
Toll free: 888-285-3036
TDD: 609-292-1210
Fax: 609-292-1233
www.state.nj.us/humanservices/dds
The New Jersey Division of Disability Services' mission is to promote and facilitate maximum independence and participation of people with disabilities in community life through information and access to services and supports. DDS administers the following programs: NJ WorkAbility; Personal Assistance Services Program (PASP); Medicaid Waiver Programs; Traumatic Brain Injury (TBI) Waiver; AIDS Community Care Alternatives Program (ACCAP) Waiver; Model Waivers 1, 2, 3; The ABC Waiver; Personal Care Assistant (PCA) Services; Personal Preference: and New Jersey's Cash & Counseling Demonstration Project.Eastern Paralyzed Veterans Association (EPVA)
Executive Office
75-20 Astoria Boulevard
Jackson Heights, New York 11370-1177
718-803-3782
Fax: 718-803-0414
www.epva.org
EPVA fights for the enactment of strong health care consumer rights legislation and works closely with state and federal agencies to ensure quality health care for individuals with disabilities enrolled in managed health care systems. EPVA is dedicated to enhancing the lives of veterans with a spinal cord injury or disease by assuring quality health care, promoting research and advocating for civil rights and independence.GOVERNMENT OFFICES
New Jersey Department of Banking and Insurance (DOBI)
Enforcement and Consumer Complaint Division
P.O. Box 329
Trenton, New Jersey 08625-0329
609-292-5316
Toll free: 800-446-7467
www.njdobi.org
The Department will accept written complaints against health insurers regulated by the State of New Jersey on business practices such as claims payment, member enrollment, or termination of coverage. The NJ DOBI publishes Buyer's Guides for individual and small employer coverage. You may obtain a copy of the Buyer's Guide for individuals at (800) 838-0935 and for small employers at (800) 263-5912. These are also available at DOBI's web site: www.njdobi.org.DOBI also publishes a Managed Care Compendium each year. This contains information on enrollment by county, premiums, expenses, hospital utilization, net worth and profitabiity for all New Jersey HMOs as well as summary information on other managed care companies. Information about this Compendium and related matters are available at the DOBI Managed Care web site: www.njdobi.org/managed.htm.
New Jersey Department of Health and Senior Services (DOHSS)
Office of Managed Care (OMC)
P.O. Box 360
Trenton, New Jersey 08625-0360
609-633-0660
Toll free: 888-393-1062
http://www.state.nj.us/health/index.html
The Office of Managed Care receives complaints regarding any aspect of an MCO's health care services, including quality of care, choice of providers, or general access issues. OMC monitors the compliance of managed care plans with New Jersey rules through annual examinations and in-depth reviews of each plan conducted every three years. OMC investigates consumer complaints and oversees the Independent Health Care Appeals Program (IHCAP).New Jersey Department of Human Services (DHS)
P.O. Box 700, Capital Place One
222 South Warren Street
Trenton, New Jersey 08625-3717
609-292-3717
Fax: 609-292-3824
www.state.nj.us/humanservices
The Department of Human Services is responsible for the Medicaid program (administrated by the Division of Medical Assistance and Health Services), as well as providing information and services to the developmentally disabled, the blind and visually impaired, the deaf and hard of hearing and those in need of mental health services. The Department handles Medicaid complaints (see Government Programs, below).State Health Benefits Commission (State Pensions)
Division of Pensions and Benefits
P.O. Box 295
Trenton, NJ 08625-0295
609-292-9211
www.state.nj.us/treasury/pensions/shbp.htm
The State Health Benefits Commission is the executive body established by statute to be responsible for operation of the State Health Benefits Progam. The Commission meetings are open to the public and are conducted at the Division of Pensions and Benefits in Trenton. Plan members are entitled to appeal to the Health Benefits Commission for resolution of any complaints after they have completed the formal grievance procedure of their plan administrator.GOVERNMENT PROGRAMS
NJ FamilyCare
Toll-free: 800-701-0710
For hearing impaired: 800-701-0720
www.njfamilycare.org.
NJ KidCare is now NJ FamilyCare. Under this program, uninsured kids can enjoy affordable health coverage. NJ FamilyCare is not a welfare program, rather, it is low-cost health coverage through a variety of recognized HMOs.INSURANCE RELATED PROGRAMS
Commercial Insurance
Contact your health plan's member services department or your employer's health benefits administrator.New Jersey Individual Health Coverage Program
Toll free: 800-838-0935
www.naic.org/nj/bgihc98.htm
The New Jersey Legislature created the Individual Health Coverage Program in 1992 to ensure that people without access to employer or government-sponsored health care programs can purchase health coverage for themselves and their families from private carriers. The Individual Health Coverage Program's Buyer's Guide provides a list of participating carriers, their telephone numbers, and current rates.New Jersey Small Employer Health Benefits Program
Toll free: 800-263-5912
www.naic.org/nj/sehguide.htm
New Jersey law guarantees small New Jersey employers with 2-50 employees access to small group health benefits plans for their employees. The Small Health Benefits Plans Buyer's Guide explains the program and may be obtained at no cost.LEGAL HELP
Community Health Law Project (CHLP)
185 Valley Street
South Orange, New Jersey 07079
973-275-1175
TTY: 973-275-1721
Fax: 973-275-5210
email: chlp@erols.com
www.chlp.orgCommunity Health Law Project is a statewide legal aid society for people with disabilities and senior citizens.
Legal Services of New Jersey (LSNJ)
100 Metroplex Drive at Plainfield Ave.
Suite 400
Edison, New Jersey 08817
Toll free: 888-LSNJLAW
LSNJ provides legal representation to low-income persons in civil matters. The telephone hotline can be used to access advice and possible representation on managed health care through LSNJ's Health Access program.New Jersey Protection and Advocacy, Inc. (NJP&A)
210 South Broad Street, Third Floor
Trenton, New Jersey 08608
609-292-9742
Toll free: 800-922-7233
TDD: 609-633-7106
Fax: 609-777-0187
www.njpanda.org
NJP&A is a non-profit agency designated to serve as the State's federally funded protection and advocacy system for people with disabilities. For eligible individuals, it provides information and referral, legal and non-legal advocacy, and outreach and education.Private Law Firms
Contact your County Bar Association for Lawyer Referral Services. Ask for names of attorneys or firms that specialize in health care issues.MEDICAID
The Center for Medicare and Medicaid Services (CMS, formerly HCFA)
7500 Security Boulevard
Baltimore, Maryland 21244-1850
410-786-3000
Toll free: 877-267-2323
TTY: 866-226-1819
www.cms.hhs.gov
or
314 G Health & Human Services Building
200 Independence Avenue, S.W.
Washington, DC 20201
202-690-6726
Fax: 202-690-6262
Acts mainly as the purchaser of health care services for Medicare and Medicaid beneficiaries; assures proper administration by its contractors and state agencies; establishes policies for the reimbursement of healthcare providers; etc.Regional Office:
Federal Building, Room 3811, 26 Federal Plaza
New York, New York 10278
212-264-4488
Medicaid Division: 202-264-1121Division of Medical Assistance and Health Services - (DMAHS - Medicaid)
P.O. Box 712
Trenton, New Jersey 08625-0712
609-588-2600
Medicaid Managed Care Hotline 800-356-1561
www.state.nj.us/humanservices/dmahs
The Division of Medical Assistance and Health Services, under the Department of Human Services, administers the State Medicaid program.Medicaid Office on Quality Assurance
609-588-7379
Toll free: 800-356-1561 (Medicaid Hotline)
The role of the Medicaid Office on Quality Assurance is to monitor HMO compliance with governing contract; perform quality reviews and overall monitoring of the HMOs (e.g., quality; access issues). Their office also performs studies on the fee-for-service, as well as for the HMOs, and acts as a liaison between plans servicing the Medicaid population and Medicaid members.New Jersey Care 2000+
To enroll in a Medicaid HMO, for questions about Medicaid Managed Care, or to resolve questions/concerns related to Medicaid managed care, contact a health benefits coordinator at 1-800-701-0710 (translation services available); TTY: 1-800-701-0720. For information on Medicaid health plan options, quality information and complaints, call the New Jersey Department of Human Services at 800-356-1561 or visit www.state.nj.us/humanservicesMedical Assistance Customer Centers
Medicaid District Offices (contact by county)
Burlington and Mercer Counties
856-787-3855
Camden, Gloucester and Salem Counties
856-614-2870
Cumberland, Cape May and Atlantic Counties
856-690-5208
Essex County
973-648-3700
Hudson County
201-217-7100
Middlesex, Hunterdon, Somerset and Union Counties
732-603-3151
Monmouth County
732-761-3600
Morris, Sussex and Warren Counties
973-631-6440
Ocean County
732-255-0731
Passaic and Bergen Counties
973-977-4077
MEDICARE
Social Security Administration (for information about Medicare enrollment)
6401 Security Boulevard
Baltimore, Maryland 21235
410-965-8882
Toll free: 800-772-1213
TTY: 800-325-0778
www.ssa.gov
Administers a national plan of contributory social insurance for retired or disabled persons and their survivors and dependents.The Center for Medicare and Medicaid Services (CMS)
(formerly Health Care Financing Administration)
Toll free: 800-MEDICARE (1-800-633-4227)
TTY/TDD: 877-486-2048
Spanish speakers available.
www.medicare.govNew Jersey Department of Health and Senior Services
Division of Senior Affairs
State Health Insurance Program (SHIP)
240 West State Street
P.O. Box 807
Trenton, New Jersey 08608-1002
Volunteer counselors are available to provide individual counseling for Medicare beneficiaries having questions or problems concerning Medicare, including help with billing questions and free health insurance counceling. Call 1-800-792-8820 or 1-800-633-4227 for the name of the SHIP office/counselor in your community or visit www.medicare.gov.County SHIP Counselors
Atlantic County
1-888-426-9243
Bergen County
201-336-7400
Burlington County
609-894-9311, ext. 7498
Camden County
1-800-955-2446
Cape May County
609-886-8138
Cumberland County
856-453-8066
Essex County
973-673-0640, ext. 24
Gloucester County
856-271-4322
Hudson County
201-271-4322
Hunterdon County
908-788-1361 or 1362
Mercer County
609-924-7108
Middlesex County
732-745-3295
Monmouth County
732-531-5511
Morris County
973-538-7947
Ocean County
732-929-2091 or
1-800-668-4899
Passaic County
973-881-4950
Salem County
856-935-7510
Somerset County
908-704-6319
Sussex County
973-579-0557
Union County
908-497-3948
Warren County
908-475-6591
The Peer Review Organization of New Jersey (PRO-NJ)
732-238-5570
Toll free: 800-624-45570
TDD: 800-792-9745
PRO-NJ is a non-profit health care quality improvement corporation that has a contract with the federal government for the state of New Jersey. PRO-NJ takes complaints from Medicare beneficiaries about the quality of care received from hospitals, skilled nursing facilities, home health agencies, and Medicare HMOs.MENTAL HEALTH
The Mental Health Association of New Jersey (MHANJ)
88 Pompton Avenue
Verona, New Jersey 07044
973-571-4100
Fax: 973-857-17776
www.MHANJ.org
MHANJ is a nonprofit volunteer advocacy organization for adults, children and families impacted by mental illness. The Association provides information and referral, individual advocacy and systems advocacy on issues related to health care.Division of Mental Health Services (DMHS)
50 E. State Street, P.O. Box 727
Trenton, New Jersey 08625-0727
609-777-0702
Fax: 609-777-0662
DMHS is responsible for development, coordination and operational support for a comprehensive mental health system.NEW JERSEY COMMERCIAL HMO & POS PLANS
Aetna Health, Inc.
New Jersey (800) 323-9930
www.aetna.comAmeriChoice of New Jersey
(800) 941-4647
www.americhoice.comAMERIGROUP New Jersey
(800) 600-4441
www.amerigroupcorp.comAmeriHealth HMO
(800) 877-9829
www.amerihealth.comCIGNA HealthCare of New Jersey
(800) 345-9458
www.cigna.com/heathcareHealth Net of New Jersey, Inc.
(800) 441-5741
www.health.netHorizon Healthcare of New Jersey
(800) 355-2583
www.horizon-bcbsnj.comOne Health Plan of New Jersey
(800) 663-8081
www.onehealthplan.comOxford Health Plans – New Jersey
(800) 444-6222
www.oxhp.comUnitedHealthcare of New Jersey, Inc.
(866) 223-5802
www.uhc.comUniversity Health Plans, Inc.
(800) 564-6847
www.uhpnet.comWellChoice HMO of New Jersey
(888) 476-6986
www.wellchoice.comOTHER PROGRAMS
NJ EASE
Toll free: 877-222-3737
NJ EASE (New Jersey Easy Access, Single Entry) is a New Jersey Department of Health and Senior Services initiative, in partnership with county governments, that provides a new and easy way for senior citizens and their families to learn about and obtain needed services, such as transportation, nutrition programs, health insurance counseling, and home health care.PAAD
Toll free: 800-792-9745
PAAD (Pharmaceutical Assistance to the Aged and Disabled) helps eligible New Jersey residents pay for prescription drugs approved by the Food and Drug Administration, as well as insulin, insulin needles, and diabetic testing materials.SENIOR GOLD
Toll free: 800-792-9745
The Senior Gold Prescription Plan provides to eligible New Jersey residents prescription drugs, insulin, insulin supplies, and diabetic testing materials to New Jersey residents for $15 per prescription plus one-half the cost of the prescription.PHYSICIANS
New Jersey State Board of Medical Examiners
609-826-7100
www.state.nj.us/lps/ca/medical.htm
For information on New Jersey physicians, including disciplinary actions.SELF-INSURED PLANS
United States Department of Labor (US DOL)
Employee Benefits Security Administration
201 Varick Street
New York, New York 10014
212-337-3228
or
Curtis Center
170 S. Independence Mall W., Suite 870 West
Philadelphia, Pennsylvania 19106-3317
215-861-5300
Toll free: 866-275-7922
http://www.dol.gov/ebsa/
The Department of Labor takes complaints about self-funded health benefits plans, which are governed by federal law. The New York office covers complaints from Bergen, Essex, Hudson, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Passaic, Somerset, Sussex, Union and Warren counties. The Philadelphia office takes complaints from all other New Jersey counties.SENIOR CITIZENS
AARP
New Jersey State Office
Forrestal Village, 132 Main Street
Princeton, New Jersey 08540
609-987-0744
www.aarp.org
The New Jersey State Office of the AARP contains a health advocacy network and will provide, upon request, written materials on Medicare, managed health care, health insurance choices, and other related topics.AARP Fulfillment
601 E. Street, NW
Washington, DC 20049
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