NJ FamilyCare

Your benefits include:

• Primary care provider (PCP) visits
• Immunizations and wellness visits
• Specialist visits
• Hospital care
• Urgent care
• Emergency care
• Lab and X-ray services
• Pregnancy services
• Family planning services
• Physical, occupational and rehabilitative therapies
• Speech and hearing services
• Behavioral health care (mental and substance abuse services)
• Smoking cessation services
• Home health care services
• Hospice services
• Disease management for asthma, diabetes and more

See your member handbook for a full list of covered benefits.

Referrals and preapprovals

A referral and/or preapproval may be needed for certain services. Visit our Referrals and preapprovals page to learn more.

Your health and well‐being are important to us. That’s why you need to select a primary care provider (PCP) for your main health care needs. Your PCP can be a doctor, nurse practitioner or physician assistant. For special care, your PCP can also refer you to specialists, hospitals and other facilities. Amerigroup has many doctors for you to choose from as your PCP. To find and choose a plan doctor in your area, use our Find a Doctor search tool.

NJ Smiles program allows trained licensed medical staff to apply fluoride varnish, provide a dental risk assessment, anticipatory guidance, and a dental referral for children through the age of 5. Your child should have a dental home by 2 years of age through assignment of a PCD, dental referral, or outreach by Amerigroup. You can also choose your child’s dentist from the NJFC Directory of Dentists Treating Children under the age of 6.

The family planning benefit provides coverage for services and supplies to prevent or delay pregnancy and may include: education and counseling in the method of contraception desired or currently in use by the individual, or a medical visit to change the method of contraception. Also includes, but is not limited to: sterilizations, defined as any medical procedures, treatments, or operations for the purpose of rendering an individual permanently incapable of reproducing.

Covered services include:

• Medical history and physical examination (including pelvis and breast),
• Diagnostic and laboratory tests
• Drugs
• Biologicals
• Medical Supplies
• Devices (including pregnancy test kits, condoms, diaphragms, Depo-Provera injections, and other contraceptive supplies and devices)
• Counseling
• Continuing medical supervision
• Continuity of care
• Genetic counseling

See your member handbook for a full list of covered benefits.

Childbirth education prepares expectant mothers and their partner for the last stages of pregnancy. They cover topics like:

• What to expect during labor, delivery, and after the baby arrives.
• Breathing and delivery relaxation methods.
• Anesthesia and medicine use.
• ​How to change your newborn’s diaper.

We recommend you take these classes during the last two months of your pregnancy.

Your provider is responsible for billing Amerigroup directly for each class you take. Please do not pay for these services out of pocket because they are a covered benefit. Amerigroup will reimburse providers directly for childbirth classes. The childbirth educator can call us to join the Amerigroup network.

We believe that good dental care is important to your overall health. Your dental benefits include:

• Dental exams
• Teeth cleaning
• Fluoride
• Sealants
• Extractions
• Fillings
• Dentures (removable or partial)
• Orthodontics

Your dental benefits are provided through LIBERTY Dental. To find or change your dentist, call LIBERTY Dental at 1-833-276-0848 or visit their website.
Go to LIBERTY Dental

Your routine vision benefits include eye exams and prescription lenses and frames, when medically needed.

Your vision benefits are managed through Superior Vision. To find a vision provider, call Superior Vision at 1-800-735-2258 or visit their website.

Your benefits include a wide range of prescription and many over-the-counter (OTC) drugs. We work with CarelonRx to provide these benefits.

Visit the pharmacy page to find a pharmacy near you and check if your medicine is covered.

Healthy Rewards is program that pays you for taking control of your health. Members can earn rewards for completing healthy activities, like:

• Prenatal and postpartum visits for pregnant members.
• Screenings for diabetes management and lead.

Log in to the Benefit Reward Hub to redeem your Healthy Rewards. You can also call the Healthy Rewards Customer Service Line at 1-888-990-8681 (TTY 711) Monday through Friday from 9 a.m. to 8 p.m. Eastern time.

Premiums

A premium is a monthly payment you pay to get health care benefits. Most NJ FamilyCare D members make these payments. The State’s Health Benefits Coordinator tells you if you have to pay.

This payment will go toward your family cost-share. Your family cost-share is based on your total family income. If you have a monthly premium, be sure to make your payment so you keep your benefits.

Copays

Copays are a set dollar amount you pay for a covered service, like going to the doctor or getting a prescription filled.

Only certain NJ FamilyCare C and D members have copays. The amount of the copay is listed on your member ID card. Copays are usually $5-10 per visit or prescription.

When NJ FamilyCare C and D members reach their family cost‐share limit, they will no longer have a copay for more services.

Alaskan Natives and Native American Indians under the age of 19 don’t have premium payments or copays.

Eligible NJ FamilyCaremembers can receive a free cellphone and service through SafeLink Wireless, the federal Lifeline program. It includes:

• A smartphone with monthly data, minutes, and texts — or, if you already have a phone, Safelink will provide you with a free SIM card.
• An extra 100 minutes during your birth month, just for being an Amerigroup member.
• Unlimited, free calls to Amerigroup Member Services and case managers, even if you run out of minutes.
• No bills.

You can enroll in one of the following ways:

• Visit SafeLink.com to apply online.
• Print and fill out the application, and mail it back.
• Call SafeLink at 877-631-2550 (TTY 711).