Line Charity Care: New Brunswick's Schedule

The New Jersey Hospital Care Payment Assistance Program, or Charity Care, is available to patients for inpatient and outpatient services at all acute care hospitals in the state. Charity Care is free or reduced-charge care for patients who meet income and asset criteria. It is available for emergent or medically necessary hospital care. The program is open to New Jersey resident patients whose household gross income is at or below 300% of the federal poverty guidelines and who have no health coverage or are underinsured. Patients can apply for Charity Care online or by calling the financial counselling office.

Who is eligible for New Jersey Charity Care?

The New Jersey Hospital Care Payment Assistance Program (Charity Care) is available for inpatient and outpatient services at all acute care hospitals across the state. To be eligible for Charity Care, you must meet certain financial requirements.

Firstly, you must be a New Jersey resident. Secondly, you must have no health coverage or have coverage that only pays for part of your bill. Thirdly, you must be ineligible for any private or government-sponsored coverage, such as Medicaid. Lastly, you must meet the income and asset eligibility criteria.

For full Charity Care coverage in 2023, your annual gross income must not be more than 200% of the federal poverty level (FPL). For reference, if you are a single individual, 200% FPL is $29,160, and 300% is $43,740. If your income is more than 200% but does not exceed 300% of the FPL, Charity Care will cover a percentage of the bill, ranging from 20% to 80% based on a sliding income scale. The FPL is based on family size and is adjusted annually based on increases in the cost of living.

Additionally, individual assets cannot exceed $7,500, and family assets cannot exceed $15,000. If your assets exceed these limits, you may "spend down" by paying the excess towards the hospital bill and other approved out-of-pocket medical expenses to become eligible.

How to apply for Charity Care

The New Jersey Hospital Care Payment Assistance Program (Charity Care) is available for patients who require inpatient or outpatient services at all acute care hospitals across New Jersey. This program is intended for those who require medically necessary services and meet the income and asset criteria.

Eligibility

To be eligible for Charity Care, you must meet the following criteria:

• Have no health coverage or have coverage that only partially covers the bill
• Be ineligible for any private or government-sponsored coverage (such as Medicaid)
• Meet the income and asset eligibility criteria

Income and Asset Criteria

The following income and asset criteria must be met to qualify for Charity Care:

• Household gross income is at or below 300% of the federal poverty guidelines
• Individual assets cannot exceed $7,500, and family assets cannot exceed $15,000

If your assets exceed these limits, you may "spend down" the assets to the eligible limits by paying the excess towards the hospital bill and other approved out-of-pocket medical expenses.

Application Process

To apply for Charity Care, you can either apply online or by calling the financial counseling office at 201-833-3157. The office hours are Monday through Friday, from 8:30 am to 2:30 pm. No in-person walk-ins are allowed, so be sure to call for assistance with your application.

Required Documents

When applying for Charity Care, you will need to provide the following documents:

• Valid identification for the patient and all immediate dependents (spouse and minor children)
• Proof of New Jersey residency
• Proof of all earned and unearned income, including employment, self-employment, pensions, disability, rental income, child support, alimony, and monetary support
• Proof of all assets (individual, joint, and immediate family), including bank account statements, investment statements, 401k and other retirement accounts, life insurance with cash value, and equity in real estate other than the primary residence

Eligibility Determination

Once you have submitted your completed application and all the required documents, the eligibility determination will be made at the hospital where the medical service is provided. If you have any questions or concerns regarding the Charity Care program, you can contact the Department of Health staff at the Office of Hospital Finance & Charity Care.

What services are covered by Charity Care?

Charity Care in New Jersey is a free or reduced-charge service for patients who require inpatient and outpatient services at acute care hospitals. It is only available for emergent or medically necessary hospital care. Charity Care is means-tested, and patients must meet income and asset criteria to be eligible. For instance, a patient's household gross income must be at or below 300% of the federal poverty guidelines. Individual assets cannot exceed $7,500, and family assets cannot be more than $15,000.

Charity Care does not cover all services. For example, physician fees, anesthesiology fees, radiology interpretation, and outpatient prescriptions are separate from hospital charges and may not be eligible for reduction.

In New Brunswick, there are two types of publicly funded home care services: the Extra-Mural Program and home support services. The Extra-Mural Program provides home health services under acute, palliative, chronic, rehabilitative, and supportive care. The home support services are delivered under the Long-Term Care Program or the Disability Support Program to clients in need of personal care.

The New Brunswick Medicare plan is the provincial plan for all New Brunswick residents. It provides coverage for most basic healthcare services. The plan covers emergency hospital visits, emergency physician services at New Brunswick rates, and services with prior approval. New Brunswick Medicare does not cover routine dental services, such as cleanings, fillings, and extractions. However, it does cover some surgical dental procedures when medically required and rendered in a hospital.

What to do if you can't afford hospital payments

If you're facing unaffordable hospital payments, there are several steps you can take to reduce your debt and manage your payments. Here's a guide on what to do:

Check for Errors

Start by reviewing your medical bills for any errors or inaccuracies. Request an itemized statement from your healthcare provider and compare it with your insurance coverage. Look for duplicate charges, services you didn't receive, or charges that your insurance should have covered. You can also compare the charges with those of other providers in your area to identify any discrepancies. If you find any errors or have concerns, contact the billing department and request corrections.

Understand Your Bill

Ensure that you actually owe the bill and that there is no confusion with another patient. Check if the charges reflect the services you received and if your insurance coverage has been accurately applied. Understand your insurance policy and any applicable laws, such as the No Surprises Act (NSA), which protects you from certain out-of-network charges for emergency services.

Appeal to Your Insurance Company

If you have insurance, contact your insurance company to discuss coverage options. Ask what steps need to be taken for your treatment to be covered. You may need to provide additional documentation or notes from your doctor to support your claim. If necessary, file an official appeal and consider seeking assistance from organisations like the Patient Advocate Foundation, which can guide you through the process.

Negotiate Your Bill

If you still owe a portion of the bill, negotiate with your healthcare provider to reduce the charges to an amount you can afford. Many hospitals offer financial assistance programs or charity care, especially for low-income patients. You can also request an interest-free repayment plan or a zero-interest payment plan. If you can afford to pay a percentage of the bill immediately, you may be able to negotiate a discount.

Seek Outside Assistance

Explore options for financial assistance from external organisations. If you have a specific illness, disease-based organisations may be able to help cover part of your bills. Community-based nonprofits, churches, or charities may also be able to provide financial support or assistance with other expenses, such as housing or transportation, which can free up funds for your medical bills.

Prevent Future Issues

Take steps to prevent facing similar issues in the future. Choose a comprehensive healthcare plan that suits your needs and includes the doctors and hospitals you want to visit. During open enrollment, evaluate your options carefully. If possible, opt for in-network providers to avoid unexpected charges.

Remember, it's important to be proactive and address your medical debt as soon as possible. Ignoring the situation can lead to late fees, interest charges, and negative impacts on your credit score. By following these steps, you can reduce your financial burden and manage your hospital payments more effectively.

How to report fraud in the Charity Care Program

To report fraud in the Charity Care Program in New Brunswick, you can use the following steps:

• Recognize the signs of fraud: Be aware of common red flags that may indicate fraudulent activity, such as suspicious calls, texts, emails, or door-to-door scams. Keep in mind that fraudsters can be very convincing and may use persuasive tactics.
• Document the fraud: Keep accurate notes about how and when the suspected fraud occurred. Record the facts and gather all relevant documents and information related to your report.
• Report the fraud immediately: Do not delay in reporting any suspected fraud or abuse. You can submit an anonymous or signed report to the New Jersey Department of Health. You can contact them by calling 1-866-588-5696 (Monday through Friday, 9 am to 5 pm), or by emailing [email protected]. Provide as much detailed information as possible about the identity and circumstances of the individuals and hospitals involved in the suspected fraud.
• Protect yourself: If you are a victim of fraud, take steps to protect yourself from further harm. This may include changing passwords, securing your personal information, and seeking advice from financial professionals or law enforcement.
• Follow up: If you desire a reply or further action on your report, be sure to include your contact information, such as your name, email address, phone number, and/or postal address. You can also follow up with the Department of Health to inquire about the status of your report.
• Seek support: Reporting fraud can be emotionally challenging. Consider seeking support from friends, family, or counseling services to help you through this difficult time. Remember, you are not alone, and it is important to take care of your well-being.

Remember, fraud can have serious consequences and impact the valuable funds, infrastructure, and reputation of organizations and individuals. By reporting suspected fraud in the Charity Care Program, you are playing a crucial role in protecting the public and ensuring that those in need receive the assistance they deserve.

Frequently asked questions