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NJ FamilyCare

Medicaid

Our NJ FamilyCare plan is for children, parent or caretaker relatives, and adults without dependent children. It’s also for people who need extra support and care to live safely at home. You qualify based on income and health care needs. View the benefits below to see all that our plan offers.

無論您居住於紐澤西何處,都可以使用本計劃。

More information on eligibility and enrollment can be found on the NJ FamilyCare website.

  • NJ FamilyCare Steps to Enroll
  • 檢查資格 (開啟範本視窗)

承保福利和特點

康復與生病照護

Get the care you need to be at your best — or to get better if you are injured or sick. 這包括:

  • Well Visits. Preventive checkups, shots and lab tests.
  • Therapy Services. Physical or other therapy to help you be your best.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Shots and Vaccines. Routine shots to help keep you healthy.
  • Urgent Care. Immediate care for a sudden illness or injury.

沒有什麽比您和您的孩子的健康更重要。這就是為何我們的承保福利包括:

  • Choice of Doctor. Find an OB-GYN you trust in our network.
  • Prenatal Visits. Care for you before your baby is born.
  • Healthy First Steps®. Get extra support to help you and your baby stay healthy.
  • Choice of Birth Center. Pick from over 100 network hospitals across 紐澤西.

如果您有氣喘、糖尿病或其他長期疾病,您可以信賴我們。我們的計劃可以保證您得到所需的照護、支援與服務。承保福利範圍包括:

  • Case Management. Personal support from an experienced professional.
  • Diabetic Supplies. Insulin, needles and more ordered by your doctor.

確保您的視力、牙齒和聽力都健康。承保福利範圍包括:

  • Vision. Routine exams and help paying for eyeglasses and contact lenses.
  • Dental. We cover cleanings, checkups and dental work.
  • Hearing. Tests, check-ups and hearing aids are covered (some limitations apply).

Understanding Dental Coverage - 英文 Spanish

獲得您在家成功康復所需之醫療照護和設備。Benefits may include:

  • Equipment and Supplies. In-home medical and safety equipment are covered.
  • Nurse Visits. Medical care to help you safely recover at home.
  • Chore Services. Someone to do your errands, cleaning or laundry.
  • Personal Care. Someone to help with dressing, bathing and feeding if needed.

有時在使用您的健康計劃時您可能需要少許額外幫助。此時,您可以依靠:

  • Interpreters. An interpreter can go with you to medical visits.
  • Member Services. Your benefit questions are answered 24/7

The MLTSS program is focused on serving frail, elderly, and disabled individuals. This program combines traditional health care benefits (doctor visits, hospital stays, labs) and long term services and supports (providing help in home or community with daily living activities) such as:

  • Care Management. Someone to get you the care and support needed.
  • Home and Vehicle Modifications. In-home medical and safety equipment are covered, plus needed modifications to a vehicle.
  • Home Meal Delivery. If you can't safely make meals, we'll provide them.
  • Mental Health & Addiction Services. Counseling and other treatments are covered.
  • Personal Emergency Response System. Sends an urgent request for someone to help you.
  • Adult Day Care. Friendship and social activities in a safe setting.
  • Respite Care. In-home help to give your caregiver a rest.
  • Personal Care. Someone to help with dressing, bathing and dining.

Learn more about the MLTSS program here

Adult Day Care

Companionship is important. Adult day care provides care and companionship for seniors who need extra help during the day.

Caregivers also benefit, knowing their loved one is well cared for and safe during the day.

Services will vary by the member's coverage type and may include:

  • Social connections and friendship.
  • Bathing and personal care.
  • Meals.

Caregiver Training*

For MLTSS members: Caring for a loved one or a friend is an act of love and devotion. It can also leave the caregiver emotionally and physically exhausted.

Our workshops teach:

  • Caregiving basics.
  • Healthy eating and help with eating.
  • Health insurance basics.
  • How to care for yourself while caring for a loved one.
  • Caring for a loved one with dementia or Alzheimer's disease.

Along with instruction, caregivers have an opportunity to socialize with others and build a network of support.

Care Management*

Do you or a loved one have a serious health problem or a high-risk pregnancy? If so, our care managers are in your corner. They will:

  • Explain medical terms in plain language.
  • Coordinate your doctor appointments.
  • Provide your care team with your medical records.

Your care manager will stay close by throughout the medical journey. He or she will:

  • Think beyond your immediate medical needs.
  • Make sure you have support at home, so you can focus on getting better.

醫師選擇

You or your child gets a primary care provider (PCP) who is your main doctor. 使用醫師查詢來查看您的醫師是否在我們的網路內。

If you don't have a doctor, or if your doctor is not in our network, we can help you find a new one close to you.

您的主要照護醫師 (PCP) 就是為您提供下列服務的主治醫師:

  • 預防照護。
  • 在您生病或受傷時為您治療。
  • 針對您的特殊健康問題,將您轉診給專科醫生。

選擇生產中心

在哪裡生孩子是一項重要決定。That's why you can pick from 100 network hospitals across 紐澤西.

We also encourage you to tour the hospital's birthing center. 這樣您可以熟悉它。And you'll be more relaxed when you have your baby.

Community Transition Services*

For MLTSS members: We want to help you live in the place that is right for you. If needed, our plan will help cover the cost of moving from a nursing facility into your community.

Covered items can include:

  • Household goods.
  • Security deposit.
  • Utility deposit.
  • Your first week of food, as needed.

Chore Services

If you are having difficulty performing day-to-day household activities, chore services can step in. They can take on the routine tasks that may be hard for you to do on your own.

Services will vary by the member's coverage type and may include:

  • 跑腿。
  • 打掃房間。
  • Doing laundry.
  • 做飯。

牙齒保健

Routine exams and cleanings every six months help keep teeth and gums strong and healthy. If there is a dental problem that needs to be fixed, that's covered as well. If approved, the plan covers:

  • Crowns and bridges.
  • Dentures.
  • Oral surgery and root canals.

Understanding Dental Coverage - 英文 Spanish

Diabetic Supplies

If you have diabetes, you may need insulin, needles, wipes and glucose strips. If medically necessary, we cover all that and more.

我們的計劃還推出可幫助您管理糖尿病的服務,包括:

  • Classes on keeping diabetes in control.
  • 協調醫師照護。
  • 飲食計劃和食品選擇。

設備和用品

您在家中的健康和安全很重要。

我們的計劃承保您的醫師或照護經理開立的醫療器材。這包括以下物品:

  • 醫療用床
  • 氧氣罐。
  • Wheelchairs or wheelchairs.

聽力照護

聽力障礙會在很多方面對您的日常生活產生影響。我們的計劃包括幫助您保護聽力的服務和支援。

我們承保:

  • 檢查、治療和檢測。
  • 助聽器及電池。

Some limitations apply.

健康首要步驟 (Healthy First Steps®)

The Healthy First Steps team is here for you. 我們的計劃將幫助您採取正確的步驟來保持您和寶寶的健康。

我們將幫助您:

  • 選擇懷孕服務提供者和兒科醫師(孩子的醫師)。
  • 預約就診和檢查,並安排就診接送服務。
  • 獲取用品,包括哺乳媽媽的擠奶器。
  • 與社區資源聯繫,例如女性、嬰兒和兒童 (Women, Infants and Children, WIC) 服務。

Home Meal Delivery*

For MLTSS members: Taking care of the basics, like cooking, can be hard to do yourself after an illness or sickness. That's why we'll bring nutritious meals to you to help you through tough times. You can get up to 1 meal delivered per day, if needed.

住院

Our plan pays for all expenses related to a hospital stay, so you can rest and heal.

我們的計劃承保:

  • 照護。
  • 病房與餐宿。
  • 用品與設備。
  • 治療。
  • 診斷檢驗和檢查。

在您離開醫院後仍可獲得關懷。我們保證您可獲得後續照護幫助您在家治癒。

翻譯人員

醫師和您需要相互瞭解,無法說流暢的英文會造成困難。We can arrange for a medical interpreter to be at your appointment.

We also have people at our phone centers who speak more than one language. 我們可請到能夠說您的語言的人員,

Lab and X-ray Services

知道健康出了什麼問題,並及早找出問題所在,可能是成功治療的關鍵。

  • 檢驗室檢驗。
  • X 光、掃描和其他影像技術。

我們會協助您取得所需資訊,幫助改善您的健康或達到最佳狀態。

藥物

Our plan includes medicines and refills for prescriptions written by your doctor or specialist. Thousands of drugs are covered.

We also cover some over-the-counter medicines with a written order from your doctor.

And we make getting your medicine easy. You can fill your prescriptions at:

  • Local pharmacies in our network.
  • Services that deliver right to your door.

保戶服務

有時候您可能需要一些協助,以瞭解您的健康照護選擇。With us, you have someone you can call 24/7. 我們將簡潔完整地回答您的問題。

我們還可以協助您尋找:

  • 醫師。
  • 藥房。
  • 醫院或其他保健設施。
  • 當地資源。

護士看診

Sometimes you may need continued care after you leave the hospital or urgent care center. If your health is at risk after a serious illness, surgery or injury, a nurse will visit you at home to:

  • Provide medical care for you.
  • Answer your questions and concerns.

個人照護

在生病或受傷後,有時會難以自行完成基本的日常事情。

Services will vary by the member's coverage type and may include:

  • 更衣。
  • 沐浴。
  • 餵食。

產前看診

A pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

承保推薦的所有產前看診和檢驗。

在看診時,診所將:

  • 確保您和您的孩子都健康。
  • 說明您在懷孕期各個階段可能會有的症狀。
  • 回答您的問題。

Respite Care*

For MLTSS members: 您家中有照護您的家人或朋友嗎?如果是這樣,我們也希望能支援他們的辛苦工作。所以我們提供喘息照護,讓您的照顧者休息一下。留看護理為照護人員提供了時間,讓他們可以離開他們關愛的或需要特殊照護的家人。

預防針和疫苗

Routine shots help keep you healthy.

我們的計劃承保:

  • 建議施打的預防針和疫苗。
  • 診斷檢驗和檢查。

治療服務

物理、職能和語言治療可協助您自嚴重傷害或疾病中恢復,或只是發揮您的全部潛力復原。

我們的計劃提供:

  • 職業治療。
  • 物理治療。
  • 語言治療。

緊急護理

您可能會發生不危及生命但需要立即診治的傷害或急症,

Our plan covers care at:

  • 緊急護理中心。
  • 醫療援助單位。
  • 其他無需預約的診間。

視力照護

You'll get the care, eyeglasses and treatment that let you see life more clearly.

承保範圍包括:

  • Routine exams.
  • Help with paying for eyeglasses and contact lenses.

This benefit is offered by March Vision.

康復看診

康復看診可以幫助您保持健康。這些檢查可以及早發現健康問題並進行治療。

預防保健服務包括:

  • 成人和兒童的健康檢查。
  • 健康寶寶照護。
  • 孕婦照護。
  • 施打例行預防針和檢測。
  • 乳房攝影檢查。

預防性護理無需支付共付額。

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保戶資源

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