NJ Medicaid & Managed Care
In 1995, New Jersey Medicaid began moving Medicaid clients from a traditional fee-for-service health insurance program, in which healthcare providers bill Medicaid directly, into managed care. Under managed care, clients enroll in an HMO, which manages their healthcare and offers special services in addition to the benefits to which Medicaid clients are entitled.
Four Health Maintenance Organizations (HMOs) participate in this program with NJ FamilyCare/Medicaid. They are:
Horizon NJ Health
UnitedHealthcare Community Plan
Through managed care, New Jersey Medicaid believes clients have better access to healthcare providers than they do through Medicaid's traditional fee-for-service health insurance program. Health Maintenance Organizations are also able to provide a comprehensive package of preventive health services that combined with the full range of Medicaid benefits allows for the best healthcare possible.
Providers and others who are interested can view New Jersey Medicaid's current Managed Care Contract. (PDF File)