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 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: This form is 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 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 only 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 Designated Authorized Representative (DAR)?

A 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 Designated Authorized Representative (DAR) Request Form for approval by NJFC.

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

Completing the 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 - Designated Authorized Representative for Adults (No Diminished Mental Capacity)

If the statements below are all true:

• You are an NJFC member but not enrolled in an NJFC MCO.
• You are an adult who is not mentally incapacitated.
• You are giving another adult permission to view your health information using MyNJFCHealthData.

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

PLEASE NOTE: Approved DAR access is effective for up to one (1) year from the date of approval, unless the authorization specifies a shorter period of time.

Form 2 - 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 DAR for a NJFC member or requesting to assign a DAR for a NJFC member.
• You or the DAR are seeking to obtain the NJFC member’s health information using the MyNJFCHealthData solution.

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

PLEASE NOTE: Approved DAR access is effective for up to one (1) year from the date of approval, unless the authorization specifies a shorter period of time.

Taking Back (Revoking) a Designated Authorized Representative

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

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