The state of New Jersey offers income qualified patients access to a hospital care payment assistance program, which is also known as charity care. This is in effect free or reduced cost medical care and it is the states attempt to ensure that all residents have access to some form of health care from a hospital or other provider. This payment assistance program is offered to low income and/or uninsured residents who receive outpatient or inpatient services at acute care hospitals throughout the State of New Jersey.
The service, which is often called the Health Care for the Uninsured Program, is offered at each hospital and patients need to apply where they plan on receiving their care from. While each hospital is structured differently, most have a separate admission or business office that individuals need to apply for charity care at and the applicant should always refer to the terminology or name of “hospital care payment assistance”.
There will be a formal application process in place and you need to prove your hardship and documentation will be required. Usually the patient applying for help, or the party responsible for paying the bills, must answer questions related to his/her assets and income. They will also need to prove everything and be able to document the hardship.
A decision needs to be made by the New Jersey hospital no more than ten working days from the time a complete application is submitted by the prospective patient, so the process needs to work very quickly. Please make sure the application is fully complete and accurate, as if the request does not include adequate documentation, or if the application is missing proof, then it can be denied. While states rules say that you can reapply to the hospital, this will of course add time to the entire process any potentially delay the medical care that the individual may need.
If the medical care received was emergency, then the applicant will have up to one year from the date of their service to apply for financial assistance from the hospital. In these cases they will still need to provide the hospital or medical provider with a fully complete application. Once again, any applicants that are found ineligible or who were denied may reapply at a future time when they present themselves for services. They can reapply if their financial circumstances have changed, such as a job loss or reduction in income.
There are a number of rules and regulations that need to be adhered to by the hospitals in New Jersey. For example, individuals need to be made aware of the availability of hospital care payment assistance from a variety of signs and communication that needs to occur. Hospitals across the state are required to post signs in Spanish, English and any other foreign language which is spoken by 10% or more of the population in the hospital’s immediate service territory. The signs are required to be posted in appropriate areas of the hospital such as the business office, admissions, outpatient clinic areas, and even the hospital’s emergency room. The signs serve many purposes, including they will inform the patient of the availability of charity care, financial assistance from the hospital, and reduced charge care. Information needs to be provided to patients to give them a brief description of the eligibility criteria. Signs must also direct the patient to the business office, financial aid center, or admissions office of the hospital. In addition to there being signage across the medical facility, each and every patient also should receive a written notice of the availability of medical payment assistance and hospital care.
Not all bills can be covered and paid for by the New Jersey program. Hospital assistance, charity care and reduced charges are only in effect for necessary medical procedures and hospital bills. For example, some services such as radiology interpretation, physician fees, outpatient prescriptions, and anesthesiology fees are not paid for. These are considered by the state of NJ to be separate from other necessary hospital charges and may not be eligible for reductions or savings.
There are some income scales in place as follows. They range from patients with an income as a Percentage of HHS Poverty Income Guidelines that is less than 200% of government guidelines will not be responsible for paying any bills. On the other hand, those who income is at 300% or greater than government guidelines will need to pay 100% of the medical bill due. The scale can change over the years as government budgets increase or decrease.
It is understood that patients may have a number of questions about how to qualify for the Health Care for the Uninsured Program. So the government as well as the New Jersey Department of Health and Senior Services has established a toll free number that individuals can call for more information.
Feel free to call 1-866-588-5696 to reach a representative. The individuals will have more information, including details on the application process, for the Health Care for the Uninsured Program. The number is only available during regular business hours.
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