I need therapy or services

Moving from “someone recommended therapy” to actually receiving it usually takes a few separate steps: knowing exactly what was recommended, finding out who may pay, and then contacting providers.

Ask the professional who made the recommendation:

• What service, specifically?
• Why is it being recommended?
• How often, if a frequency was specified?
• Was a written referral or prescription provided?

Speech therapy, occupational therapy, physical therapy, feeding therapy, behavioral services, and mental-health treatment address different needs. Which one fits should come from an appropriate evaluation or recommendation.

Depending on the service and your child’s situation, funding may involve:

• Private insurance
• NJ FamilyCare / Medicaid
• School-based services
• Children’s System of Care programs accessed through PerformCare
• Private payment

Eligibility and coverage vary. Not every program pays for every therapy, and being eligible for one system does not mean a specific service is covered.

Use the member services number on your card and ask:

• Is this service covered?
• Do I need a referral?
• Is prior authorization required?
• Which providers are in-network?
• Are there visit limits?
• What will I owe?

Write down the date, the representative’s name, and any reference number you are given.

NJ FamilyCare: 1-800-701-0710 (TTY 711)

When waitlists are long, contact several providers rather than waiting on one. For each one, ask:

• Are you accepting new clients?
• Do you provide the exact service my child needs?
• Do you serve my child’s age?
• Do you accept my insurance plan?
• What is the current wait?
• Is the service in-home, in the office, telehealth, or at school?

Keep one simple list with:

• Provider name
• Date contacted
• Response
• Waitlist status
• Follow-up date