This is a reminder that effective January 1, 2017,
AmeriHealth New Jersey will exit 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 affected
beneficiaries that included a list of available plans in the
beneficiary?s service area as well as information on 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.
- Later this year, primary care physicians will receive a letter advising
them of members who will no longer be on their panel as of January 1, 2017.
If you have questions regarding this discontinuation, please contact your
Provider Partnership Associate.