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I'm trying to understand insurance or Medicaid
Coverage questions decide which doors open. This pathway helps you ask better questions of your plan and providers.
Information reviewed: August 28, 2026
Quick answer
Start by figuring out which type of coverage your family has and what question you’re trying to answer.
Insurance can affect which providers you can use, which services require authorization, and what costs may apply.
If you already have insurance
Find the Member Services number on the back of your insurance card.
When calling about a service, ask:
- Is this service covered?
- Does it require prior authorization?
- Do I need a referral?
- Which providers are in network?
- Is there a copay, deductible, or coinsurance?
- Are there visit or service limits?
- What should I do if I cannot locate an in-network provider?
Write down:
| Date | Representative’s name | Reference number | What you were told |
|---|---|---|---|
| Aug 28 | — | — | — |
What is NJ FamilyCare?
NJ FamilyCare/Medicaid is New Jersey’s publicly funded health coverage program.
It includes Medicaid and CHIP populations and provides coverage to eligible New Jersey residents. Families can apply year-round.
NJ FamilyCare: 1-800-701-0710 (TTY 711)
How do I know whether I qualify?
Eligibility rules can change and depend on the program and household circumstances.
Rather than listing income limits that may go out of date, we direct families to NJ FamilyCare for the current requirements.
Important for families approaching adult DDD services
Medicaid is particularly important in adult developmental-disability planning because DDD’s adult waiver services have Medicaid requirements.
Vicabell provides educational resource information and is not affiliated with the State of New Jersey, PerformCare, or the Children’s System of Care. Program requirements, contact information, and services can change. Always confirm current information with the official agency.