We Have Recently Updated Our Visitation Policies

Participating Healthcare Plans

CareWell Health Medical Center accepts major health insurance and managed care plans. For specific information on co-payments or for coverage information regarding a specific procedure, please consult the insurance carrier or your employer’s human resources representatives.

The following is a list of the plans with which CareWell Health Medical Center is currently a participating hospital provider:

Aetna Better Health Medicaid HMO In Network
Aetna Commercial and Medicare In Network
Amerigroup/Wellpoint Medicaid and Medicare (DNSP) In Network
Horizon BCBS Commercial and Medicare In Network
Horizon NJ Health Medicaid HMO and Medicare (DSNP) In Network
MagnaCare Commercial and Workers Compensation In Network
Medicaid FFS Medicaid In Network
Medicare Medicare In Network
United Healthgroup Commercial and Medicare In Network
United Health Community Plan Medicaid HMO
Wellcare Medicare and Medicaid (DSNP) In Network

Out of Network Information

On June 1, 2018 Governor Murphy signed the “Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act” (“OON”)

It is the law that hospitals provide patients with multiple notices when they contact the hospital to schedule an appointment.

The following information is for individuals with a fully insured, New Jersey-issued plan, a State Health Benefits Plan, a School Employees’ Health Benefits Plan or members of self-funded insurance plans.

Disclosure Prior To Scheduling Covered Services: Click Here Disclosures 

Disclosures are not required for emergent or urgent services.

The following types of plans are not part of the OON “Out-of-Network Consumer Protection:

  • Medicaid
  • Medicare
  • Medicare Advantage
  • Accident Only Plans
  • Disability Plans
  • Long-Term Care Plans
  • Tricare
  • Workers’ Compensation
  • Auto Medical Insurance
  • Personal Injury Protection (PIP)
  • Dental Insurance
  • Hospital Confinement Indemnity

CareWell Health Hospital Commercial health insurance plans:

  • Aetna Better Health
  • Horizons BC HMO/PPO/Indemnity
  • Qualcare Commercial HMO/POS/PPO
  • United Healthcare All Payer/Oxford

Prior to receiving services, please contact your insurance company to confirm the potential out-of-pocket costs designated by your insurance plan and to ensure that the individual healthcare services are covered and/ or authorized.

CareWell Health Medical Center participates with major health care plans, please be aware that physicians are NOT employees of the CareWell Health Medical Center and may or may not participating with the same health insurance plans. Please check with your referring physicians to ensure the plans the physician participates with.

Please be advised that these healthcare professional(s)’ costs are not included in the hospital’s charges. All physicians’ charges are separate from any bills from CareWell Health Medical Center.

Employed Physicians and Physicians Groups

The following is a list of the physicians or physician groups that are employed by CareWell Health Medical Center. On the physicians that are employed by the hospital you may still receive a separate bill for their services if and when they administer their own billing.

Physicians and Physicians Groups with Whom We Contract

CareWell Health Medical Center contracts with hospital-based physician groups which provide services to our patients e.g., anesthesiology, pathology and radiology. Contact your insurance company to verify that the independent providers / group are in network with your insurance carrier. The costs for the hospital based physician groups are billed separately from the hospital. The facility charges do not include the healthcare professionals cost therefore, they will bill you separately.

Click here to see a list of the physicians and physician groups that are contracted with CareWell Health Medical Center.

  • NAPA (North American Partners in Anesthesia)
  • P.O. Box 65
  • Glenhead, NY 11545 Telephone (888) 240-1793
  • UPA (University Physicians Associates)
  • 220 Davidson Avenue
  • Somerset, N.J 08873 telephone (973) 972-1150

Please speak to your ordering physician to ensure he/ she is in network or out of network with your health insurance plan. In addition, ensure that other physician’s that may be involved in your care are in network or out of network.

The physicians bill separately. So, you may receive more than one bill for your healthcare services.

If a physician is in network, you should never be charged more than your in-network copayment, coinsurance or deductible.

Please notify your health insurance plan and the Department of Banking and Insurance/Department of Health if an in-network provider charges more than your in-network co-pay, coinsurance or deductible.

 

In-network Disclosures

  • Since CareWell Health Medical Center in network, you will not pay more than your in-network copayment, coinsurance or deductible for the hospital’s services.
  • If and when CareWell Health Medical Center network status changes with your health insurance plan prior to your scheduled visit, you will be notified.

Out-of-network Disclosures

  • Since CareWell Health Medical Center is out of network, you may pay more than your in-network co-payment, coinsurance or deductible for the services received or performed at this facility.
  • You may be responsible for any difference between what your insurance company pays CareWell Health Medical Center for the service and what CareWell Health Medical Center charges.
  • If you wish to receive services at CareWell Health Medical Center, first please contact your insurance company to determine if you have an out-of-network benefit option. If you do, you should ask what your potential out-of-pocket costs may be and double-check that your services will be covered. If you do not have an out-of-network benefit option, you will be responsible for all charges.

Self-funded Plans that did not opt-in Disclosures

  • You have a health insurance plan that is self-funded.
  • Self-funded insurance plans are not required to follow the “Out of Network” law.
  • We must advise you that any services you receive at CareWell Health Medical Center may be out-of-network with your health insurance plan.
  • Because of this, you may pay more than your co-payment, coinsurance or deductible for services received or performed at this facility.
  • You may also have to pay the balance above any amount that your insurance plan paid for the services.
  • If you wish to receive services at CareWell Health Medical Center, please contact your insurance plan to find out if you have an out-of-network benefit option. If you do have an out-of-network benefit option, you should inquire about your potential out-of-pocket costs and double-check that the healthcare services will be covered. If you do not have an out-of-network benefit option, you will be responsible for all charges.

If you have any questions about insurance or out-of-network benefits, please contact us between 8 a.m. and 5 p.m. at 973-266-8400 and dial 3 for Admitting.