New Jersey Medicaid and 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 the program directly, into managed care. Under managed care, clients enroll in one of five HMOs , which manage their healthcare and offer special services in addition to the benefits that Medicaid clients are entitled.

The move to managed care started in 1995.

As of February 2008, close to 750,000 or 83% of enrollable NJFC/Medicaid individuals are enrolled in managed care.

Five Health Maintenance Organizations (HMOs) participate in this program with New Jersey Medicaid. They are:

AmeriChoice

AMERIGROUP NJ

Horizon NJ Health

Health Net of New Jersey, Inc.

University Health Plans

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 Medcaid's current Managed Care Contract. Contract: [Volume 1] [Volume 2] (PDF File)