NJ family care program

amother

Thu, Sep 15 2022, 11:42 am

Thinking of moving to NJ from NY but we currently have managed care Blue Cross, and I am concerned about losing it, and starting the process again applying for NJ Family care.

For those who have done it:

* How long did it take to transfer from NY Medicaid to NJ Family Care? And how was the process?
* Would most doctors in the City hospitals accepting NY Medicaid (Columbia, NYU) also accept NJ Family care? I am being monitored for a high risk condition, and would much prefer not having to switch doctors. (Seeing them privately, including imaging, would be extremely costly).

amother

DarkMagenta

Thu, Sep 15 2022, 11:47 am

amother OP wrote:

* Would most doctors in the City hospitals accepting NY Medicaid (Columbia, NYU) also accept NJ Family care? I am being monitored for a high risk condition, and would much prefer not having to switch doctors. (Seeing them privately, including imaging, would be extremely costly).

Medicaid doesn't work in other states as far as I know

amother

Jasmine

Thu, Sep 15 2022, 12:00 pm

I switched over and the process was pretty easy. took like 3 months.
However, most good Dr's in NJ do not except Medicaid, only private insurance. I'm now switching to private insurance for that reason. especially for a good OB/GYN. and no, you generally cannot use NJ insurance in NY hospitals, only the ER.

amother

Daffodil

Thu, Sep 15 2022, 12:01 pm

amother OP wrote:

I work at Columbia. No you cannot see NY doctors outpatient. Only in rare cases where prior authorization is obtained by the office is this covered

amother

DarkMagenta

Thu, Sep 15 2022, 12:07 pm

amother OP wrote:

I looked it up, and it seems that NJ family care is the equivalent of NY Medicaid, but I really don't know much about it and seeking more information.

Yes family care is NJ Medicaid. However I don't think that Medicaid from one state can be used in a different state.

I have NJ Familycare for my baby and used a pediatrician in NY by my parents after the baby was born. We had to pay out of pocket.

amother

NeonPurple

Thu, Sep 15 2022, 12:18 pm

amother DarkMagenta wrote:

yes they used to make an exception for CHOP (for the kids) but that ended a few years ago. It can be hard finding good specialists on family care. Sometimes I end up paying out of pocket.

realtalk

Thu, Sep 15 2022, 12:31 pm

amother NeonPurple wrote:

yes they used to make an exception for CHOP (for the kids) but that ended a few years ago. It can be hard finding good specialists on family care. Sometimes I end up paying out of pocket.

I actually just got a prior authorization approved for CHOP on family care but it took almost 3 full weeks

amother

Cadetblue

Thu, Sep 15 2022, 12:42 pm

amother OP wrote:

I looked it up, and it seems that NJ family care is the equivalent of NY Medicaid, but I really don't know much about it and seeking more information.

Jersey care is the NJ Medicaid program so in that sense it’s the equivalent but it’s not equal in quality. It’s very limiting for doctors, not like NY where good doctors take it. In NJ it’s very hard to find good doctors especially specialists that take Jersey Care.

amother

Calendula

Thu, Sep 15 2022, 1:21 pm

amother Cadetblue wrote:

Not being snarky but I think one of the issues is that New Jersey doesn't have what is viewed as world class medical facilities so the supply of world class specialists would be lower.

New York City is a destination for medical professionals and people flock to New York City from all over the world to be treated at the facilities or to have consultations with specific doctors. They will also fly into New York to have surgeries done by specific surgeons.

Philadelphia which is close to the southern part of NJ is also has some world renowned medical facilities.

I am not in New York City but I was shocked when I learned that people have no problems finding good doctors in NYC who accept Medicaid because it is almost impossible to find doctors who take Medicaid in other parts of the USA. There must be doctors in New York City who don't take Medicaid but at least based on what I read on imamother, no one has problems finding doctors who accept Medicaid.

FWIW most people are limited by even private insurance to doctors in their state or in their network. If one has a better policy there might be reimbursement for out of network doctors but that is generally at a lower rate (I.e. 50%) and the amount allowed by insurance will often not be the amount that is actually charged.

amother

Thu, Sep 15 2022, 1:30 pm

Thank you all so much for this invaluable information.

Based on the above, it does not look like we would be moving to NJ anytime soon... I very much appreciate the access that we currently have to some of the world's best medical experts, and I would be very hesitant losing such an important resource.

amother

NeonPurple

Thu, Sep 15 2022, 2:54 pm

amother Calendula wrote:

Not being snarky but I think one of the issues is that New Jersey doesn't have what is viewed as world class medical facilities so the supply of world class specialists would be lower.

Not snarky at all, it's very true. Before healthcare reform passed, and back when I had private health insurance, I was able to use doctors in NYC or Philadelphia and have it covered. NJ is a fairly small state and it's not that much travel time. Once the regulations changed it became very hard to get out of state care covered and it's become a real issue.