New Jersey Medicaid/NJ FamilyCare (NJFC) created MyNJFCHealthData. MyNJFCHealthData allows members who are 18 years or older and who are enrolled in the NJFC Fee-for-Service (FFS) program to view their NJFC electronic health information. NJFC has now expanded MyNJFCHealthData to allow a member or their legal representative to assign access to a MyNJFCHealthData Designated Authorized Representative (DAR), who may also view their NJFC health information. Please note that this service is not available to those who are enrolled in one of the five NJFC managed care organizations (MCOs). If you are enrolled in a NJ FamilyCare MCO or in a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) MCO, please call the Member Services phone number printed on your MCO ID card to find out more about how to access your health information.

Important Note: The MyNJFCHealthData DAR Forms below are only for online access to electronic health information. If you want to name someone to be your representative when applying for NJ Medicaid/NJFC, or for other business with the Division of Medical Assistance and Health Services (DMAHS), click on this link.

The ability to access your electronic health information, while keeping it secure, empowers you to make the best-informed decisions about your care. NJFC Fee-for-Service member claims information that you or your MyNJFCHealthData Designated Authorized Representative (DAR) can view may include hospitalizations, physician visits, dental visits, vision services, pharmacy products, and other types of medical services and equipment received on or after January 1, 2016. Claims information can be viewed by using a compatible third party application (App) of your choice. To learn more about MyNJFCHealthData and compatible Apps, please read our MyNJFCHealthData Resource Guide.

What is a MyNJFCHealthData Designated Authorized Representative (DAR)?

A MyNJFCHealthData DAR is someone whom you assign to have access to your health information, such as a family member or other trusted person. Some DARs may have legal authority to act on your behalf if you are determined to be mentally incapacitated.

When using MyNJFCHealthData, there may be situations where it is desirable or required that another adult individual, other than the NJFC member, be allowed to access the member’s electronic health information.  This is done by submitting a MyNJFCHealthData Designated Authorized Representative (DAR) Request Form for approval by NJFC.

However, assigning a MyNJFCHealthData DAR does not remove the adult NJFC Fee-for-Service member’s ability to access their health information using MyNJFCHealthData.

Completing the MyNJFCHealthData DAR Request Form

To give someone access to your health information or to request personal access to someone else’s health information, please review the two forms below and click the link to the form that fits your situation.

Form 1 - MyNJFCHealthData Designated Authorized Representative for Adults (No Diminished Mental Capacity)

If the statements below are all true:

• You are a NJFC member but not enrolled in a NJFC MCO or in a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) MCO.
• You are an adult who is not mentally incapacitated.
• You are giving another adult permission to view your health information using the MyNJFCHealthData solution.

Then click here to access the MyNJFCHealthData DAR Request Form (No Diminished Mental Capacity)

PLEASE NOTE: Approved MyNJFCHealthData DAR access is effective for up to one (1) year from the date of approval, unless the authorization specifies a shorter period of time. DAR access is also lost once the member loses coverage in the Medicaid Fee-for-Service program or becomes enrolled in a NJFC MCO during the authorization period.

Form 2 - MyNJFCHealthData Designated Authorized Representative for Adults (Diminished Mental Capacity)

If the statements below are all true:

• You have legal authority to act for another adult who has been determined to be mentally incapacitated and have the necessary documents such as a Power of Attorney or Letters of Guardianship.
• You are an adult who is not mentally incapacitated.
• The NJFC Fee-for-Service member is not enrolled in a NJFC MCO or in a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) MCO.
• You are requesting to become a MyNJFCHealthData DAR for a NJFC member or requesting to assign a MyNJFCHealthData DAR for a NJFC member.
• You or the MyNJFCHealthData DAR are seeking to obtain the NJFC member’s health information using the MyNJFCHealthData solution.

Then click here to access the MyNJFCHealthData DAR Request Form (Diminished Mental Capacity)

PLEASE NOTE: Approved MyNJFCHealthData DAR access is effective for up to one (1) year from the date of approval, unless the authorization specifies a shorter period of time. MyNJFCHealthData DAR access is also lost once the member loses coverage in the Medicaid Fee-for-Service program or becomes enrolled in a NJFC MCO during the authorization period.

Revoking (Taking Back) a Designated Authorized Representative

After a MyNJFCHealthData DAR has been approved, the MyNJFCHealthData DAR can be revoked (taken back) at any time before the end of the authorization period by filling out and submitting this form: MyNJFCHealthData DAR Revocation Form.

If you require further assistance with completing the MyNJFCHealthData DAR Request or Revocation Forms above, click here to submit a Contact Us Form.