Other Important Resources
When making health care decisions, consider other sources of information.
Checking on Quality
The State of New Jersey, through the Department of Health and Senior Services, monitors the quality of care and services provided by HMOs and POS plans. The Department investigates consumer complaints and conducts in-depth reviews of each plan. Plans are also required to obtain a quality audit by an independent review organization every three years. For more information, contact the Department's Office of Managed Care at (888) 393-1062.
The National Committee for Quality Assurance (NCQA) is a non-profit organization committed to assessing, reporting on and improving the quality of care provided by the nation's health plans. To find out if your health plan is NCQA accredited, call (888) 275-7585 or visit www.ncqa.org.
Individual and Small Employer Coverage
The New Jersey Department of Banking and Insurance publishes Buyer's Guides for individual and small employer coverage. You may obtain a copy of the Buyer's Guide for individuals at (800) 838-0935 and for small employers at (800) 263-5912. The Buyer's Guides and additional information about health coverage options are also available at the Department of Banking and Insurance's Web site: www.njdobi.org.
Larger employers often assume financial responsibility for their health benefits instead of buying insurance. Employers may contract with outside organizations, including insurance companies, to administer their self-insured health benefits. Employees should ask if their health benefits programs are self-insured. For complaints about self-insured plans, contact the U.S. Department of Labor at (202) 219-8233.
For information on Medicare coverage options or complaints, call the New Jersey Department of Health and Senior Services, Division of Senior Affairs at (800) 792-8820. You can also call Medicare at (800) 633-4227 or visit www.medicare.gov.
For information on Medicaid health plan options, quality information and complaints, call the New Jersey Department of Human Services at (800)356-1561 or visit www.state.nj.us/humanservices.
Take Care of Kids and Families
If you know someone who is not covered by health insurance, please call (800) 701-0710 or visit www.njkidcare.org for information on New Jersey KidCare and FamilyCare. Call today to learn about the State's new affordable health insurance programs for children and adults.
For information on New Jersey physicians, including disciplinary actions, call the New Jersey State Board of Medical Examiners at (609) 826-7100 or visit www.state.nj.us/lps/ca/bme/docdir.htm.