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Insurance

Insurance2021-12-29T11:36:26-05:00

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 Carrier Participating Product
Active Care (Workers’ Comp) HMO, PPO, POS
Aetna Health Plans of NJ HMO, PPO, POS, Medicare, Mental Health, Applewood, The Manor
Aetna Better Health Medicaid, Applewood, The Manor
America’s Health Plan HMO, PPO, POS
Amerigroup Medicare, Medicaid, Applewood, The Manor
AmeriHealth HMO, PPO, POS, Medicare
Braven Health Medicare, Applewood, The Manor
Braven Medicare Plus (HMO) (Effective January 26, 2021) Medicare, Applewood, The Manor
BeechStreet PPO HMO, PPO, POS
Cigna HMO, PPO, POS, Applewood, The Manor
Cigna Medicare (Effective October 1, 2021) Medicare
Clover Health Medicare, Applewood, The Manor
Consumer Health Network (CHN) HMO, PPO, POS
Coventry Health Care HMO, PPO, POS, Applewood, The Manor
Devon Health Services HMO, PPO, POS
Empire BlueCross/BlueShield HMO, PPO, POS
Emblem Health Only for plans accessing Qualcare
First Health HMO, PPO, POS, Applewood, The Manor
First MCO (Workers’ Comp) HMO, PPO, POS
Geisinger Health Plan Medicare, Applewood, The Manor
Great-West (Cigna) HMO, PPO, POS
GHI Only for plans accessing Qualcare
HIP of NY Only for plans accessing Qualcare
Horizon BlueCross/BlueShield of NJ HMO, PPO, POS, Medicare, Mental Health, Applewood, The Manor
Horizon BlueCross/BlueShield of NJ OMNIA (Effective April 1, 2020) HMO, PPO, POS, Applewood, The Manor
Horizon Medicare Blue Products*: Medicare
Horizon Medicare Advantage NJ Direct 10-15 (PPO), Medicare, Mental Health, Applewood, The Manor
Horizon Medicare Blue Value (HMO) Medicare
Horizon Medicare Blue Choice (HMO) Medicare
Horizon Medicare Blue Access Group (HMO/POS), Medicare
Horizon Medicare Blue (PPO) Medicare
Horizon Medicare Group (PPO) Medicare
Horizon Medicare Blue Advantage (HMO) (Effective January 26, 2021) Medicare
Horizon Medicare Blue Select (HMO-POS) (Effective January 26, 2021) Medicare
*Horizon Total Care DSNP Not Accepted
Horizon Casualty Services (Workers Comp & No Fault) HMO, PPO, POS, Applewood, The Manor
Horizon NJ Health Medicaid, Mental Health, Applewood, The Manor
Intergroup Services Corp HMO, PPO, POS
Longevity Health Plan Medicare
MagnaCare (also known as Brighton HPS) HMO, PPO, POS
MCS Patient Centered Health Care Network HMO, PPO, POS
Multiplan HMO, PPO, POS
National Provider Network HMO, PPO, POS
Optum Behavioral Health Mental Health
Oxford Health Plans HMO, PPO, POS, Medicare, Applewood, The Manor
Private Healthcare Systems HMO, PPO, POS
QualCare HMO, PPO, POS, Applewood, The Manor
QualCare Workers Comp HMO, PPO, POS, Applewood, The Manor
TriCare (Champus) HMO, PPO, POS
United Healthcare HMO, PPO, POS, Medicare, Applewood, The Manor
Wellcare of New Jersey Medicare, 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

REQUEST MORE INFORMATION

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