Understanding Your Options
This section helps you compare the three key programs you will be engaging with. Your primary goal is NJ FamilyCare, with the other two providing immediate and backup support.
NJ FamilyCare (Plan A)
Primary Goal
- Purpose: Long-term, comprehensive health insurance.
- Coverage: All medical needs (doctors, hospital, etc.).
- Key Requirement: Based on current monthly income.
- Asset Test: No
- Administered by: State of New Jersey
Presumptive Eligibility (PE)
Immediate Bridge
- Purpose: Temporary NJ FamilyCare coverage while you apply.
- Coverage: Comprehensive, but for a limited time (~60 days).
- Key Requirement: Based on your statement of income.
- Asset Test: No
- Administered by: The Hospital (as a certified provider)
NJ Charity Care
Safety Net
- Purpose: Hospital bill assistance (forgives or reduces costs).
- Coverage: Hospital services only.
- Key Requirement: Based on income AND assets.
- Asset Test: Yes (under $15,000)
- Administered by: The Hospital Itself
Will My Baby Qualify for Free Insurance?
This section explains the eligibility requirements for NJ FamilyCare. Based on your situation, the answer is unequivocally yes. The program is designed to cover children in families just like yours.
Household Size: Your household is 3 people (you, the mother, the newborn).
Income: Eligibility is based on your current monthly income (near $0), not past earnings. Your savings are not counted as income.
Asset Test: There is NO asset test for children applying for NJ FamilyCare. Your savings will not disqualify your baby.
NJ FamilyCare Income Limits (Household of 3)
The income limits are very high to ensure all children get coverage. Your current income is well within the limit for free coverage.
How to Apply: The NJ FamilyCare Playbook
This section details the application process. The recommended method is online, as it's the fastest and allows you to track your application's status. Follow these steps carefully to avoid delays.
The fastest and easiest way is to apply online at njfamilycare.org. Create a user account so you can save your progress and check the status later. You can also apply by phone at 1-800-701-0710.
- Define Household: List all 3 members (father, mother, newborn).
- Who Needs Coverage: Select "Yes" ONLY for the newborn.
- Report Income: Report your current monthly household income (e.g., $0 from employment).
- Disclose Other Insurance: Report the mother's insurance plan. This is required and will not disqualify your baby.
You MUST select a Health Plan (also called an HMO or MCO) on the application. Failing to do this will significantly delay processing. Research which plans (e.g., Horizon NJ Health, Aetna, etc.) are accepted by Saint Peter's Hospital and your preferred pediatrician before you apply.
After reviewing and signing, submit the application. Processing takes approximately 30-45 days. You will receive an official approval letter by mail. Use your online account to check the status. Make sure your mailing address is always correct.
How to Eliminate Existing Hospital Bills
The most powerful feature of NJ FamilyCare Plan A is retroactive coverage. This is your legal right and it is the key to paying the bills from your baby's birth. This section explains how to activate it.
What is Retroactive Coverage?
The state can backdate your baby's insurance for up to 3 months BEFORE the month you apply. Since your baby qualifies for Plan A, this will cover all hospital bills from birth, making them the state's responsibility.
How to Request It: A 3-Step Process
- Inform the hospital: Tell the Saint Peter's billing department immediately that you have applied for NJ FamilyCare and will be seeking retroactive coverage. This should put a hold on your account.
- Get the form: After your baby is approved for NJ FamilyCare, you must get and submit a specific form: FD-74, Application for Payment of Unpaid Medical Bills. The hospital's financial counselors can help you get this.
- Submit the form: This form must be sent to the state's Retroactive Eligibility Unit within 6 months of your NJ FamilyCare application date.