All the most important information for choosing an HMO in one place
Recipients of NJ FamilyCare must choose which company will be managing their care. These companies are called Health Maintenance Organizations, or HMOs. In Ocean County, there are five options. Each company offers the same benefits. What differs is the network, and extra, non-essential services, often called value-added benefits.
Choosing which HMO to select can be confusing.
That is why we created HMO Central – a page containing all you need to know about each HMO plan organized for you.
Here are some of the many benefits enjoyed by all members of all companies:
- Preventative care including vaccines and well check-ups
- Primary care doctor and prescription drug coverage
- Dental cleanings, check-ups, and dental work
- Eye exams
- Members services helpline
- Mental health professionals
- Maternity care
Since each HMO offers the same medical benefits, when choosing which company will be managing your care you should research the network and value-added benefits that each company offers before making a choice. You can also speak with your primary care physician and any specialists you would like to see for insight and recommendations.
Here are a few important tips:
- To switch HMOs once you are receiving benefits, call the State at 1-800-701-0710. You should call this number to request the switch even if you receive your benefits from the County Office in Toms River. Do not submit the request through their automated system – dial 0 to speak with a representative. We recommend calling back a day after you make the switch to confirm that the request was processed correctly.
- HMO change requests submitted by the 15th of the month are usually processed by the 1st of the following month.
- In most cases, the entire family must be on the same HMO, so make sure to review the network and benefits for each member of your family before making a switch.
- If you are on NJ FamilyCare and would like to switch your HMO for a pregnancy, make sure to request the switch at the beginning of your pregnancy. If you wait until the middle or end of pregnancy, your request to switch HMOs may be denied.
- When completing your NJ FamilyCare application, make sure to check off which HMO you would like to choose. If you do not check one off, you will randomly be assigned one. We also recommend calling 1-800-701-0710 after you receive your approval letter to confirm that you are enrolled in the HMO of your choice.