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Family members and staff may use this form when a person with IDD is having difficulty qualifying for NJ FamilyCare/Medicaid.
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Family members and staff may use this form if an individual is currently enrolled in a Medicaid MCO and having difficulty obtaining a medical, dental, or behavioral health service that should be covered. This form can also be used if the MCO has reduced the approved number of hours for a service, such as personal care assistance or private duty nursing.
Are you someone who needs help navigating the system? Do you need assistance with Medicaid, Medicare, Social Security, or another healthcare-related issue? The Arc of New Jersey is here to help.
Include as much information as possible when submitting the form below. Following submission, you will be contacted as soon as possible.