LRRC: Important Health Insurance Tips

The LRRC today released the following important health insurance tips:

NJ FamilyCare Insurance:

  • If you are currently receiving NJ FamilyCare benefits and find out that you are expecting, it is important that you immediately send a signed doctor’s letter to NJ FamilyCare notifying them about the pregnancy. This will ensure that you receive coverage for the duration of your pregnancy, even if your income changes. If you are receiving NJ FamilyCare benefits through the county (Hooper Avenue in Toms River), proofs of pregnancy and proofs of birth can now be e-mailed to [email protected]. You should receive a confirmation e-mail, which you should make sure to keep for your records.
  • If you are planning on going away at any point in the summer, make sure to have a neighbor or friend check your mail for notifications or recertification requests from NJ FamilyCare. Mail from NJ FamilyCare cannot be forwarded.
  • If you have NJ FamilyCare, when making your auto insurance selection, you cannot designate your health insurance as the primary insurer in case of medical expenses incurred as a result of an auto accident. You must choose the auto insurance to be your primary insurance in case of an auto accident. NJ FamilyCare may provide coverage on a secondary basis, such as when the costs of your care exceed the PIP limits in your auto policy.
  • At this time, NJ FamilyCare at the county level (Hooper Avenue in Toms River) is not counting scholarship income towards your eligibility limit.
  • Those who believe that they are no longer eligible for NJ FamilyCare should not ignore a recertification and should not request to be terminated. If you ignore a recertification or request to be terminated, you will receive a letter that you are being terminated from NJ FamilyCare due to “failure to recertify” or “voluntarily ending coverage.” You will not be able to enroll in other coverage (even through a broker or employer) in these situations. If you receive recertification paperwork and believe you are no longer eligible, respond with your current income. NJ FamilyCare will process your application and, if you are in fact over the income limit, they will send you a termination letter due to being income-ineligible. Your termination can then be used to activate a Special Enrollment Period.

Marketplace Insurance

  • Beginning next month, the Marketplace is going to be much stricter about verifying eligibility for a Special Enrollment Period prior to completing enrollment in an insurance plan. Make sure to keep all documentation showing your eligibility (such as a letter of termination from your current insurance).
  • Beginning next month, in order for a couple to be eligible for a Special Enrollment Period due to marriage, one spouse will have to verify that he or she had minimum essential coverage for at least one day in the 60 days preceding the marriage, or prove that he or she lived outside the US for at least one day in the 60 days preceding the marriage.
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5 COMMENTS

  1. “At this time, NJ FamilyCare at the county level (Hooper Avenue in Toms River) is not counting scholarship income towards your eligibility limit”

    Does this imply that the State Ofiice is counting scholarship as income?

  2. Yungerman – The state office generally counts all income that is listed on your federal 1040 towards your eligibility limit. Please call our office at 732-942-9292 to discuss further.

  3. LRRC, if your income increased and you know you are not eligible anymore, is it ok to wait for the re-certification letter or do you have to mail in right away that you are not eligible anymore …

  4. ST – If you are receiving benefits from the County (Toms River office), you need to send proof of any changes in income. If adults are not eligible and your children are receiving benefits from the state (Trenton office), you can wait until recertification time.

    Moshe – You should attach a copy of your baby’s crib card and hospital bracelet to the e-mail.

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