This is a reminder that effective January 1, 2017, AmeriHealth New
Jersey has exited the Medicare Advantage market in all 21 counties. AmeriHealth
New Jersey has been committed to providing Medicare beneficiaries with plans
that best meet their health care needs and budgets. However, after careful
review, we found it is necessary to prioritize our resources around our core
product lines to ensure future growth and profitability.
Non-renewal (termination of plan) letters were sent to all affected
beneficiaries with a list of available plans in their service area as well as
information on our how to apply for our Medicare Supplement product.
How this affects you
This change only affects the Individual and Group Medicare Advantage
business in New Jersey. It does not affect any
of our AmeriHealth New Jersey commercial or consumer business.
Please note the following:
- Claims for services that occurred prior to January 1, 2017, will be
adjudicated in accordance with the plan?s medical policy.
- Services provided on or after January 1, 2017, will
not be covered ? with the exception of care received at a
Prospective Payment System hospital; in which case, the Part A services would
be covered until the enrollee is discharged.
- Affected primary care physicians were sent a letter last month advising
them of members who are no longer on their panel as of January 1, 2017.
If you have questions regarding this discontinuation, please contact your
Provider Partnership Associate.