Managed care is a term that is used to describe a health insurance plan that coordinates the provision, quality and cost of care for its enrolled members. In general, when you enroll in a managed care plan, you select a regular doctor, called a primary care practitioner (PCP), who will be responsible for coordinating your health care. Your PCP will refer you to specialists or other health care providers as necessary.

Horizon Health Center, Inc. partners with several managed care providers in New Jersey for Medicaid/Medicare Managed Care and New Jersey Family Care for medical services. If you are enrolling in a managed care plan and want Horizon Health Center providers for medical and dental services, you will need to select anyone of the participating plans of your choosing then select a Horizon Health Center provider as your PCP or you can make an appointment to meet with a Plan representative about enrollment at any of Horizon Health Center locations by logging in and making an appointment.

NOTE: If you are pregnant or require treatment for an emergency medical condition, Medicaid coverage is available regardless of alien status. A doctor must certify that you are pregnant or had an emergency, and you must meet all other eligibility requirements.

Available Programs

  • Medicaid

    Medicaid is a program for New Jersey residents who can’t afford to pay for commercial medical insurance care on the open insurance market. Usually, a resident may be covered by Medicaid if:

    • You have high medical bills
    • You receive Supplemental Security Income (SSI), or
    • You meet certain income, resource, age, or disability requirements.

    If you need assistance with completing your Medicaid application come to any of the 3 HHC locations and ask us for help. When you do come in, you should have the following:

    • Proof of age, like a birth certificate
    • Proof of citizenship or alien status*
    • Recent paycheck stubs (if you are working)
    • Proof of your income from sources like Social Security, Supplemental Security Income (SSI), Veteran’s Benefits (VA), retirement
    • Any bank books and insurance policies that you may have
    • Proof of where you live, like a rent receipt or landlord statement
    • Insurance benefit card or the policy (if you have any other health insurance)
    • Medicare Benefit Card
  • Prenatal (PE) Care Program

    When you are pregnant, the State of New Jersey offers Medicaid coverage for you and your baby. HHC will provide you with assistance to enroll for coverage. Our staff can perform the presumptive eligibility determination, and assist with the completion of the full Medicaid application and assistance with selection of a Medicaid Managed Care. The New Jersey Department of Health’s Perspective Eligibility pregnancy program offers complete pregnancy care and other health care services to women and teens living in the State of New Jersey.

    There is no cost to eligible women who are determined to be eligible for the Medicaid coverage. Since this is a Medicaid program, you will need to bring the information listed above. Pregnant women are eligible for Medicaid coverage with a family income at 250% of the federal poverty level and a pregnant woman is considered a family size of two. Medicaid will cover eligible pregnant women through their entire pregnancy, their delivery, and post-partum visit.

    If you are pregnant, do not hesitate to come to Horizon Health Center and speak to our Patient Care Coordinator about the care you can receive from our doctors and midwives.

  • NJ Family Care Advantage

    To be eligible for either Children’s Medicaid or NJ Family Care, children must be under the age of 19 and be residents of the State of New Jersey. No proof of citizenship or alien status is required. Children who are not eligible for Medicaid can enroll in NJ Family Care if they do not already have health insurance. Some children who were covered by employer-based health insurance within the past six months may be subject to a waiting period before they can be enrolled in NJ Family Care. Determining whether your child is subject to a waiting period will depend on your household income and the reason your child(ren) lost employer-based coverage. If you are eligible for this coverage and have selected a provider at HHC then please choose NJ Family Care to continue your care with us.

    At HHC, we believe every child should have insurance and access to needed medical, and mental health services, and our staff is here to help!

  • NJ Family Care

    Family Health Plus is available to single adults, couples without children, and parents with limited income, who are aged 19 to 64, are residents of New York State and United States citizens or fall under one of many immigration categories. If you have health insurance through a federal, state, county, municipal or school district benefit plan – you are not eligible to enroll. If you have employer–sponsored health insurance available through other types of employers you may be eligible for help to pay for premiums, deductibles, coinsurance and co-payments through the NJ Family Care Premium Assistance program.

    There are limits on the amount of assets or resources that you can have and still be eligible to enroll in Family Health Plus. “Resources” mean money in the bank or credit union, stocks, bonds, mutual funds, certificate of deposit, money market accounts, 401K plans, trust funds, the cash value of life insurance, motor vehicles, or property that someone owns. The value of your home will not be counted. The amount of income and assets/resources you and your family can have and still be eligible for Family Health Plus depends upon how many people are in your family. If you are eligible for this coverage and have selected a provider at HHC, then please choose Hudson Health Plan Family Health Plus to continue your care with us.

    Come to HHC. and speak to a Health Plan enroller about your eligibility for Medicaid, Medicaid Managed Care, NJ Family Care, or Family Health Plus. The enrollers are at all our facilities and are ready to assist.

  • Ryan White Funding - HIV and AIDS Uninsured Program Assistance

    Institute has established programs which provide access to free health care (HIV Drugs, Primary Care, Home Care, and APIC) for New Jersey State residents with HIV infection who are uninsured or underinsured. Our counselors can assist you with the application and enrollment process for these programs.

    The AIDS Drug Assistance Program (ADAP) provides free medications for the treatment of HIV/AIDS and opportunistic infections. The drugs provided through ADAP can help people with HIV/AIDS to live longer and treat the symptoms of HIV infection. ADAP can also help people with partial insurance or who have a Medicaid spend down requirement.

  • ADAP Plus (Primary Care)

    Provides free primary care services including medical evaluation and ongoing treatment at HHC facilities or other clinics and hospitals.

  • APIC

    This program pays for commercial health insurance premiums for ADAP eligible clients. APIC will pay for the continuation of a cost effective policy for people presenting to the program who: have existing coverage purchased directly from an insurance company or agent, coverage through their employer where the employee contribution for the coverage creates a financial hardship or COBRA coverage when a person loses their job and cannot afford the premiums. Policies considered for payment must be comprehensive and provide full prescription and primary care coverage without annual coverage caps.

  • Medicaid Cancer Treatment Program: Breast, Colorectal, Cervical, and Prostate Cancer

    HHC has log partnered with the New Jersey Cancer Education and Evaluation Detection (CEED) program of the State Department of Health in screening and diagnosing breast and/or cervical cancer, colorectal and prostate cancer or pre-cancerous conditions for eligible uninsured individuals in our communities. The Cancer Screening Program is important for the prevention and early detection for our uninsured population, and we encourage you to come and speak with our Patient Care Coordinator about your eligibility.

  • No Insurance and Not Eligible? We can help!

    For those patients who do not qualify for health insurance coverage, we offer a sliding fee scale based on incomes up to 200% of the federal poverty guidelines and family size. In 2012, the sliding fee scale offered will be based on the following guidelines. Proof of income such as pay stubs, 2011 tax forms, alimony or child support should be presented to our front desk/PSR staff member at the time of your visit so we can evaluate you for our sliding fee.

    NOTE: Income and resource levels change annually for all these programs including our sliding fee. Reassessment needs to be done at least annually; more frequently if your financial situation has changed.

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