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Insurance

Insurance2020-04-01T09:15:22-04:00

At CentraState, our goal is for you to focus on getting healthy, not on insurance claims or payment hassles. CentraState accepts a wide variety of health insurance plans. Because insurers generally offer a variety of plans with different levels of coverage, you should always check with your insurance carrier to verify what services are covered, the extent of coverage provided, and information about deductibles, co-pays or other expenses you may be responsible for under your particular insurance plan.

CentraState is Now an OMNIA Tier 1 Provider

Horizon Blue Cross Blue Shield of New Jersey has designated CentraState Healthcare System as a Tier 1 provider. For OMNIA plan members this means greater access to CentraState’s care for less cost. To learn how CentraState’s Tier 1 status benefits OMNIA members, visit our OMNIA Q&A.

Resources

Always check with your insurance carrier to verify coverage. List is subject to change.

Insurance CarrierParticipating Product
Active Care (Workers’ Comp)HMO, PPO, POS
Aetna Health Plans of NJHMO, PPO, POS, Medicare, Mental Health, Applewood,  the Manor
Aetna Better HealthMedicaid, Applewood, The Manor
America’s Health PlanHMO, PPO, POS
AmerigroupMedicare, Medicaid, Applewood, The Manor
AmeriHealthHMO, PPO, POS, Medicare
BeechStreet PPOHMO, PPO, POS
CignaHMO, PPO, POS, Applewood, The Manor
Clover HealthMedicare, Applewood, The Manor
Consumer Health Network (CHN)HMO, PPO, POS
Coventry Health CareHMO, PPO, POS, Applewood, The Manor
Devon Health ServicesHMO, PPO, POS
Empire BlueCross/BlueShieldHMO, PPO, POS
Emblem HealthOnly for plans accessing Qualcare
First HealthHMO, PPO, POS, Applewood, The Manor
First MCO (Workers’ Comp)HMO, PPO, POS
Geisinger Health PlanMedicare, Applewood, The Manor
Great-West (Cigna)HMO, PPO, POS
GHIOnly for plans accessing Qualcare
HIP of NYOnly for plans accessing Qualcare
Horizon BlueCross/BlueShield of NJHMO, PPO, POS, Medicare, Mental Health, Applewood,  the Manor
Horizon BlueCross/BlueShield of NJ OMNIA (Effective April 1, 2020)HMO, PPO, POS
Horizon Medicare Blue Products*:Medicare
Horizon Medicare Advantage NJ Direct 10-15 (PPO),Medicare, Mental Health, Applewood, the Manor
Horizon Medicare Blue Access Group (HMO/POS),Medicare
Horizon Medicare Blue (PPO),Medicare
Horizon Medicare Group (PPO)Medicare
*Horizon Medicare Blue Advantage (HMO), Horizon Medicare Blue Select (HMO-POS), and Horizon Total Care DSNPNot accepted
Horizon Casualty Services (Workers Comp & No Fault)HMO, PPO, POS, Applewood, The Manor
Horizon NJ HealthMedicaid, Mental Health, Applewood, The Manor
Intergroup Services CorpHMO, PPO, POS
MagnaCare (also known as Brighton HPS)HMO, PPO, POS
MCS Patient Centered Health Care NetworkHMO, PPO, POS
MultiplanHMO, PPO, POS
National Provider NetworkHMO, PPO, POS
Optum Behavioral HealthMental Health
Oxford Health PlansHMO, PPO, POS, Medicare, Applewood and the Manor
Private Healthcare SystemsHMO, PPO, POS
QualCareHMO, PPO, POS, Applewood and The Manor
QualCare Workers CompHMO, PPO, POS, Applewood and The Manor
TriCare (Champus)HMO, PPO, POS
United HealthcareHMO, PPO, POS, Medicare, The Manor
Wellcare of New JerseyMedicare, Medicaid, Applewood, The Manor

If you have an HMO, PPO or other managed care program, your plan may have special requirements, such as a second surgical opinion or pre-certification for certain tests or procedures. It is your responsibility to make sure the requirements of your plan have been met.
If your plan’s requirements are not followed, you will be financially responsible for all or part of the services rendered in the hospital. Some physician specialists may not participate in your health care plan and their services may not be covered. Deductibles and co-payments are due on or before discharge. Patients seeking an estimate of out-of-pocket expenses prior to receiving care at CentraState, can contact our Insurance Verification line at 732-294-2632.

In accordance with the New Jersey Hospital Care Payment Assistance Program NJAC 8:31B (“Charity Care”), patients who are interested in public assistance medical plans and/or qualifying for Charity Care for medically necessary services, may contact CentraState’s Financial Assistance office at 732-294-2641. The CentraState team will assist you in reviewing payment options, including payment arrangements and eligibility for financial assistance.

Download the NJ Hospital Care Assistance Program (Charity Care) Application

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