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For emergency care, the law protects you

New Jersey law mandates that New Jersey insurance companies always cover emergency room services as in-network*, including hospital stays.

That means you are only responsible for your deductible or out-of-pocket expenses, no matter where you receive care. 

Because you shouldn’t have to worry about insurance status when you or a loved one is experiencing a medical emergency.

 

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Visit the State of New Jersey online to review your insurance rights, including possible exceptions of certain plans covered under Federal ERISA law.

 

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It is important to know what type of policy you are covered under, and the rights and responsibilities arising from that coverage.

Contact your insurer:

QualCare »

Cigna »

Oxford »

Aetna »

Clover Insurance »

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Q: How am I protected?

A: New Jersey law and regulation states that when a patient is seen for emergency services, NJ insurance companies are required to hold the patient harmless. That means that your insurance company is legally obligated to only hold you responsible for your in-network,* out of pocket amount. This state mandate also applies to any inpatient admission resulting from an emergency room visit. CarePoint Health will bill accordingly to hold your insurance company to this state regulation. Read the mandate.

*Not all plans issued in the state of NJ are governed by NJ law. Certain employer sponsored plans may fall under Federal ERISA law. Coverage for Emergency services for these plans should be clearly defined in your summary of benefits. If you have any questions regarding your coverage, we encourage you to contact your insurance carrier.

 

Q: Does CarePoint Health accept all insurances?

A: Yes.  In accordance with NJ law, emergency patients are always treated as though we participate with your insurance company. For information or appointments regarding elective services, please contact our CarePlus team 
at 201-884-5329.

 

Q: How are medical emergencies treated when out of network?

A: We will not turn you away for having out of network coverage, but will treat you as if you are in-network. In nearly all circumstances, the insurance carrier is obligated to limit the patient’s financial responsibility to the same benefit amount they would be responsible for at an in-network provider. This is to protect patients in a medical emergency to ensure they receive access to the closest, most appropriate care in the event of a medical emergency, regardless of network status.

 

Q: What if I received a bill for services and suspect it was not paid correctly by the insurance, or if the balance I owe is not correct?

A: Do not pay the balance if you receive a bill for any amount that does not seem correct. First, please contact the Insurance Help Desk at 866-600-3100 so that we may review the account and balance with you and, if necessary, with your insurance carrier, to ensure that the statement is accurate per the services received and the applicable insurance benefit level.

 

Q: Will my stay in the hospital be covered if CarePoint Health is “non-participating” with my insurance carrier, but I arrived to the emergency room and now my physician wants to admit me to the hospital?

A: Yes, your stay will be covered. When there is a medical necessity to be admitted to the hospital following a visit to the emergency room, in nearly all cases, your insurance carrier is required to limit your patient responsibility to the same amount you would otherwise pay at any other participating provider.

 

Q:  Whom can I speak with if I still have questions?

A: Please refer to the Insurance Help Desk 
at 866-600-3100 for any patient inquiries that may not be addressed above. The Help Desk 
is ready to answer any patient billing or insurance questions and can also escalate resources for unique issues. 

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Before your visit: 

Contact our CarePlus team at 201-884-5329

 

After receiving care:

Contact our Insurance Help Desk at 866-600-3100

 

 

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See ways the CarePoint Health Foundation supports emergency needs of at-risk people so that everyone in Hudson County can achieve their best possible health and well-being.