Get to Know AMERIHEALTH NEW JERSEY

Transcription

1 Get to Know AMERIHEALTH NEW JERSEY

2 Why AM ER I H EA LT H NEW JERS EY? We re focused solely on the state of New Jersey. We live here. We work here. And we re involved in the communities here. This gives us a better understanding of our members and the issues they face with New Jersey health insurance. Our mission is to help our members get access to quality health care coverage and help them to improve their overall health and wellness. That s why we have so many affordable plans, one of the largest provider networks in New Jersey, and various wellness programs. AmeriHealth New Jersey is centrally located in Cranbury, NJ. But what really makes us different is our people. Whether you re an individual, a business, or in the public sector, our dedicated teams can help you find a health insurance plan that best meets your unique needs. AmeriHealth New Jersey is proud to be named one of the Best Places to Work in New Jersey. AmeriHealth New Jersey is dedicated to helping the people of New Jersey improve their health and well-being while helping them gain access to affordable, quality care. Judith L. Roman, President & CEO of AmeriHealth New Jersey 2 3

3 AmeriHealth New Jersey I N TH E COMM UN I T Y Because of our strong connection to New Jersey, service to our communities defines a large part of who we are. We love our state from The Palisades to Cape May, so we do more than promote health care, we help make it happen. From supporting healthy organizations to volunteering at and sponsoring community programs and activities, our associates are devoted to raising health awareness across New Jersey. AmeriHealth New Jersey is on the move. Look for us on the road, at events, and in your community. 4 5

4 Who we SERVE At AmeriHealth New Jersey, we re committed to offering innovative plans and programs to employers and individuals across the state. We are confident that our suite of products has the plan that s right for you. Individuals Have a family? Never had health insurance? Self-employed? Our health insurance plans are as different as the people they cover, so it s important for you to understand what kind of plan will fit you best. We offer a variety of family and individual health plans so whatever your situation, AmeriHealth New Jersey can help meet your health insurance needs. Small Employer Groups Small business. Not so small needs. We have small group health plans of all shapes and sizes to fit the varying types of small businesses across New Jersey. Large Employer Groups Finding the right options for a large group can be difficult. But having easy access to all the information you need makes it a little easier. AmeriHealth New Jersey can help build the right set of options for any large group, and we have the right variety of plans to do it. Public Sector We are committed to our public sector customers. We pride ourselves on providing affordable, comprehensive health care coverage to more than 40,000 members in more than 90 school boards and municipalities throughout the state. AmeriHealth New Jersey offers: Equal to or Better Than Guarantee we will meet or beat any competitor s plan design. Comprehensive line of competitively priced products plan options that work for you. Individualized Account Management dedicated account management representatives. We are committed to offering innovative plans and programs to employers and individuals across the state. 6 7

5 Types of NETWORKS AmeriHealth New Jersey offers a variety of high-quality networks featuring New Jersey-based physicians, hospitals, and ancillary providers at competitive price points making health insurance more affordable for you, your family, or your business. A variety of high-quality networks make health insurance more affordable for individuals, families, and businesses. National Access Our most comprehensive network, offering coverage in all 50 states. 1 Sussex Passaic Bergen Regional Preferred The largest network of doctors, hospitals, and laboratories in the state of New Jersey. 2 Members have access to participating physicians and providers in New Jersey, Pennsylvania, and Delaware. Local Value Quality access, for less. We offer a subset of our Regional Preferred network for individuals or employers looking for a more affordable rate. The Local Value network currently represents 82% of the New Jersey-based Regional Preferred network. 3 Tier 1 Advantage Offering individuals and employers even more affordable plans, we ve added tiered network plans to our portfolio. The Tier 1 Advantage plans work just like a typical Exclusive Provider Organization (EPO) Health Savings Account (HSA) Qualifi ed High Deductible Plan (HDHP) in that members have in-network coverage, no referrals, and the freedom of not choosing a primary care physician (PCP) to coordinate care. These innovative plans group the most effi cient providers into a single network, based on cost and quality measures. Savings are passed down to members by creating two tiers of facility services. After members meet their yearly deductible, the Tier 1 Advantage plan offers fl exibility to pay lower out-of-pocket costs for facility services if they use one of our Tier 1 Advantage providers. Members always have the option to choose providers in Tier 2 and have their services covered by using the AmeriHealth New Jersey Local Value Network. 4 Community Advantage AmeriHealth New Jersey, along with Cooper University Health Care, Shore Medical Center and Cape Regional Medical Center, are working together to offer you affordable, high-quality health care coverage. Our Community Advantage plans are tailored to meet the needs of individuals and employers based in Atlantic, Burlington, Camden, Cape May, and Gloucester counties 5. We have developed these plans to provide South Jersey with new options that focus on affordability, while offering access to exceptional patient care. 6 Lancaster Berks Northampton Lehigh Chester Delaware Montgomery Delaware New Castle Kent Bucks Sussex Philadelphia 1 Coverage provided by Multiplan PHCS National Network. AmeriHealth New Jersey members accessing care in the AmeriHealth New Jersey service area must use the Regional Preferred network. 2 Data derived from analysis of information provided by a third party vendor and is subject to change. 3 The Local Value Network is not available in Hunterdon County. Warren Morris Essex Hunterdon Salem Gloucester Somerset Mercer Camden Cumberland Union Middlesex Burlington Atlantic Cape May Monmouth 4 Tier 1 facility providers are an enhancement to your benefi ts. Tier 2 facility providers are AmeriHealth New Jersey Local Value network providers. 5 Community Advantage plans are only available to individuals and employers based in Atlantic, Burlington, Camden, Cape May, and Gloucester counties. 6 Tier 1 professional and facility providers are an enhancement to your benefi ts. Tier 2 professional and facility providers are AmeriHealth New Jersey Local Value network providers. Hudson Ocean Warren Hunterdon Community Advantage Salem Sussex Gloucester Morris Mercer Camden Cumberland Passaic Burlington Essex Union Somerset Middlesex Atlantic Bergen Cape May Hudson Monmouth Ocean The Local Value network currently represents 82% of the New Jersey-based Regional Preferred network. 8 9

6 Our commitment to WELLNESS LIVE WELL. BE REWARDED. AmeriHealth New Jersey value added Commit2Wellness programs offer you support for living a healthy life and preventing illness. From giving you incentives to help you make smart lifestyle choices, to providing you with individualized solutions and information for health issues that concern you, AmeriHealth New Jersey Commit2Wellness programs are designed to help you and your family stay well, prevent illness, and benefit from healthy lifestyle choices. Best of all, these value added programs are available to you at no additional cost. How does it work? Through AmeriHealth New Jersey Commit2Wellness Rewards, you earn Wellness Dollars for completing a variety of healthy activities, such as seeing your primary care physician (PCP), gynecologist (GYN), or by going to the gym. As you take steps toward a healthier you, you ll work toward receiving a reward. Wellness Dollars are awarded for completing milestones in each program. Once you earn Wellness Dollars, you can redeem them for a wide selection of gift cards from hundreds of retailers. Earn wellness dollars for completing a variety of healthy activities. It s good for you! 10 11

7 TECHNOLOGY & Resources In order to make our members lives easier, AmeriHealth New Jersey has robust online management systems and personalized tools to help manage your health quickly and easily to help you get the most from your benefits. AmeriHealth Express With work, family, and friends, you don t always have the time or the resources to focus on your health. AmeriHealthexpress.com, has all your benefits and claims information in one convenient location. Provider Finder and Hospital Finder help you find the participating doctors and hospitals that are best equipped to handle your needs. You can compare hospitals based on experience, cost, patient satisfaction, and other factors important to you. Symptom Checker provides a comprehensive tool to help you understand your symptoms and possible actions to take. Health Encyclopedia provides information on more than 160 health topics and the latest news on common conditions. Treatment Cost Estimator helps you estimate your costs in a geographic area for hundreds of common conditions including tests, procedures, and health care visits, to help you plan and budget for your expenses. Help manage your health with your smartphone Download the free AHNJ On the Go app for your iphone or Android to help you make the most of your AmeriHealth New Jersey health plan. AHNJ On the Go gives you easy access to your health care coverage 24/7, wherever you are. Members can easily keep track of their doctor s information, track their health spending account balances, view claims, view health history, access temporary ID information if you lose your card, and much more. Finders Locate hospitals, doctors, patient-centered medical homes, urgent care centers, and pharmacies. Doctor s Visit Assistant Members can achieve a more productive office visit by preparing for the visit beforehand display, , or fax an ID card to the provider, view open referrals, or record notes for the conversation with a physician, and capture documents or pictures. Shop for Insurance Make purchasing new insurance policies as easy as possible by learning about AmeriHealth New Jersey s plans and what is new with the Health Care Law. My Health Assistant Members can set health goals, and then build an activity plan to help get and stay healthy. Trackers help monitor progress and manage the plan on the go. Medicine Cabinet Fed from claims data, members can view and keep track of all their medications and identify them with pictures. Medication Reminders Set daily or weekly reminders to take different medications. Food & Drug Interactions Check current medications for potentially dangerous combinations with foods or other medications to avoid complications

8 T EC H N OLOGY & Resources Social Media Looking for a fun way to stay healthy? Follow us on Facebook and Twitter for daily wellness tips, healthy recipes, fitness tips and more. #Good4U AmeriHealth New Jersey has the tools and resources to help you get the most from your benefits. Infographics AmeriHealth New Jersey has a suite of interactive health infographics to help you learn about common health risks in an easy-to-understand way. Learn more on

9 259 Prospect Plains Road, Bldg. M, Cranbury, NJ AmeriHealth March AmeriHealth Insurance Company of New Jersey AmeriHealth HMO, Inc.