NJ FamilyCare/Medicaid benefits

As a Wellpoint NJ FamilyCare/Medicaid member, you get many benefits with little to no costs or copays.

Medical care is just the beginning

With Wellpoint, you’ll also have access to a wide range of services including dental and vision care, family planning, childbirth education, and our Healthy Rewards program.

Visits with a Wellpoint network primary care provider (PCP) of your choice
Referrals to a specialist (if needed)
Hospital care
Labs and X-rays
Urgent and emergency care
Preventive care
Pregnancy services
Medical supplies
Physical, occupational, and rehabilitative therapies
Speech and hearing services
Behavioral healthcare (mental and substance abuse services)
Smoking cessation services
Home healthcare
Hospice services
Condition Care (CNDC) for asthma, diabetes, and more

Diabetes Self-Management Education (DSME): Learning to take care of your diabetes

Diabetes Self-Management Education (DSME): Learning to take care of your diabetes DSME is a class where you can learn how to take steps to become an expert on your diabetes. It teaches you:

What diabetes is and how it affects your body.
How to eat in a way that keeps your blood sugar levels in a healthy range.
Ways to stay active and strong.
The correct way to check your blood sugar levels.
How to take medicine correctly if you need it.
Tips to stay safe and feel your best while living with diabetes.
The DSME class has many benefits. It can:
Help you understand your diabetes better.
Give you the knowledge and skills to stay healthy and feel confident about managing your condition.
Help you better your health with diabetes.
You can use this listing for local organizations offering diabetes support and education.
DSME Providers

Find care

Children receive a comprehensive dental benefit including orthodontics with services based on medical necessity. Some services require prior authorization.

Dental/oral health care is arranged through LIBERTY Dental Plan.
Your child should have a dental home by 2 years of age. Review the NJFC Directory of Dentists Treating Children under the age of 6.

Find a dentist

Wellpoint members also have access to behavioral healthcare including:

Mental Health services

Mental health therapy / counseling
Mental health partial hospitalization
Mental health partial care
Mental health outpatient hospital or clinic services
Acute partial hospitalization
Acute partial hospitalization
Adult mental health rehabilitation
Outpatient mental health services
Acute inpatient psychiatric hospitalization
Medication Assisted Treatment
Partial care/psychiatric partial hospitalization

Substance Use Disorder (SUD) services

Substance use disorder therapy / counseling
Substance use disorder intensive outpatient
Substance use disorder detoxification / ambulatory withdrawal management
Substance use disorder partial care
Substance use disorder services — including outpatient, intensive outpatient, partial care, ambulatory withdrawal management, short-term residential, and detoxification services

To find a behavioral health provider in Wellpoint’s network, search our network directory at www.wellpoint.com/find-care.

Medical history and physical examination (including pelvis and breast)
Diagnostic and laboratory tests
Drugs
Biologicals
Medical supplies
Devices (including pregnancy test kits, condoms, diaphragms, Depo-Provera injections, and other contraceptive supplies and devices)
Contraception education and counseling
Continuing medical supervision
Continuity of care
Genetic counseling
Sterilizations

Check your member handbook for more information

What are copays?

Copays are a set dollar amount you pay for covered services, like doctor visits or prescriptions. They’re usually $5-10 per visit or prescription.

Only certain NJ FamilyCare C and D members have copays. If you have them, they’re listed on your member ID card. When you reach the family cost‐share limit, copays no longer apply.