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Pensions and Benefits Graphic
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PLAN
&
TELEPHONE #
TRADITIONAL1
(800) 414-7427
#001 - NJ PLUS #19
AETNA—US HEALTHCARE
(800) 309-2386 Retiree on Medicare (800) 345-4432
#20
CIGNA HEALTHCARE
(800) 244-6224
#28
OXFORD
(800)
760-4566
#33
AMERIHEALTH
(800) 877-9829
#34
HEALTH NET6
(800)
441-5741
PLAN
&
TELEPHONE #
NJ PLUS
In-network
(800)
414-7427
NJ PLUS
Out-of-network1
(800)
414-7427
SERVICE AREA Unrestricted All of NJ, DE, VA AND FL; parts of NY and PA Unrestricted All of NJ, CTand DE; parts of AZ, FL, IL, IN, MD, NY, NC, OH, PA, TX, and VA All of NJ, CT, DE, PA, AZ, SC and Washington DC; Parts of CA, FL, GA, MD, NY, VA, AND WV, All of NJ; parts of NY All of NJ and DE; parts of PA All of NJ and CT; Parts of NY (Parts of PA pending approval) SERVICE AREA
IMMUNIZATIONS Not covered 100% after $5 copayment per visit (except for travel) 70% for children under 12 months, after deductible 100% after $5 copayment per visit (except for travel) 100% after $5 copayment per visit (except for travel) 100% after $5 copayment per visit (except for travel) 100% after $5 copayment per visit (except for travel) 100% after $5 copayment per visit (except for travel) IMMUNIZATIONS
MATERNITY Basic benefits at 100%; balance at 80% after deductible $5 copayment for first prenatal office visit then 100% covered 70% after deductible $5 copayment for first prenatal visit then 100% covered $5 copayment for first prenatal visit then 100% covered $5 copayment for first prenatal visit then 100% covered $5 copayment for first prenatal visit then 100% covered $5 copayment for first prenatal visit then 100% covered MATERNITY
PHYSICAL EXAMS Not covered 100% after $5 per visit copayment Not covered 100% after $5 per visit copayment 100% after $5 copayment per visit (1 visit per calendar year) 100% 100% after $5 per visit copayment 100% after $5 per visit copayment PHYSICAL EXAMS
WELL BABY Not covered 100% after $5 per visit copayment Not covered 100% after $5 per visit copayment 100% after $5 per visit copayment 100% 100% after $5 per visit copayment 100% after $5 per visit copayment WELL BABY
1Benefits, excluding hospital expenses, are based on the PACE allowance or the "reasonable and customary" fee schedule at the 90% percentile.

6Referral is not required from a PCP to a participating specialist.
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Copyright © State of New Jersey, 1996-2003
Division of Pensions and Benefits
PO Box 295
Trenton, NJ 08625-0295

All Technical issues regarding this Web site should be sent to the Division of Pensions and Benefits Webmaster.

Last Updated: June 27, 2003

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