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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.
Do you need help navigating the system? Are you seeking assistance with Medicaid, Medicare, Social Security, or another healthcare-related issue? We are here to help.
Include as much information as possible when completing the form below. You will be contacted by a staff person as soon as possible.