NOTE: The guide below is designed to be printed, and so it is all on one Web page. You can jump to any section by clicking on one of the underlined links in the Table of Contents. In most Web browsers, you can also search the entire document for particular information by following these steps:
-
In the upper left corner of your screen, click on Edit.
-
Click Find, then enter the word or phrase you are looking for.
-
Click Find Next.
Table of Contents
- Preface
- Please note - a word of caution
- If you need a lawyer
- Acknowledgments
- How to get copies of this handbook
- Comments and suggestions
- Legal Services Programs
- You may be eligible for free or reduced-cost hospital care
- What is Charity Care?
- I need hospital care, but I do not have insurance, Medicaid, NJ FamilyCare, or enough money to pay for my care. What can I do?
- Do I have to be a citizen or a legal permanent resident to be eligible for Charity Care?
- What must my income be to qualify for free hospital care?
- What if my income is higher than these amounts?
- What does “annual” or “yearly” income mean? Is it the 12 months before I received the hospital services, my income for all of this year, or my income for all of last year?
- I was admitted to the hospital through the emergency room. Can I still get Charity Care?
- How is the family size determined?
- How will I have to prove my income?
- Is there a limit on how much money I can have in the bank or what valuables I can own?
- What are assets?
- Can I apply for Charity Care if I own my own house?
- Will the hospital ask me for identification when I apply?
- Do I have to be a New Jersey resident to get help from Charity Care?
- How do I prove that I am a New Jersey resident?
- Can I get Charity Care if I am a migrant worker and I do not intend to stay in New Jersey?
- What if my mother from New York gets sick while visiting me? Can she get free care also?
- Does Charity Care cover everything?
- Will the hospital check to see if I have any insurance, or if I am eligible for Medicaid?
- The hospital told me to apply for Medicaid, but I know I don’t qualify for it. What should I do?
- I have insurance, but it only covered part of my bill. Can I still ask for Charity Care?
- Is there a time limit for applying for Charity Care?
- How long do I have to wait to know if I am eligible for Charity Care?
- I was approved for Charity Care at my hospital two months ago, and now I have to go back to the hospital. Do I have to apply for Charity Care again?
- I have a bill that is more than a year old, but I did not ask for Charity Care because I did not know about it. Is there anything I can do now?
- I was turned down when I applied for Charity Care, but now my income is lower. Can I apply again?
- Do I have to stay in the hospital to get Charity Care?
- Do I have to go to certain hospitals to get Charity Care?
- Will I be sued if I don’t pay my hospital bill? What can I do if I get sued?
- Does Charity Care mean that I don’t need health insurance?
- Facts you should know about Charity Care
Preface
Legal Services of New Jersey (LSNJ) coordinates the statewide Legal Services system in New Jersey, providing free legal assistance to low-income people in civil matters. Part of Legal Services’ mission is to make people more aware of their legal rights. Awareness allows people to resolve some problems on their own, without the need for lawyers. Informed people also are able to make better use of lawyers when they are needed.
Table of Contents | Top of page
Please Note—a Word of Caution
The laws mentioned in this handbook were correct as of February 25, 2005, but laws frequently change. In particular, the income limits in Tables I and II change. You should always check to be sure that any law or principle mentioned in this handbook is current before relying on it. This handbook gives general information about the law and eligibility for the Charity Care program in New Jersey. It cannot provide specific advice about a particular legal problem that you may have, and it is not a substitute for seeing a lawyer when you need one. If you are in doubt about whether you need a lawyer, by all means talk to one.
Table of Contents | Top of page
If You Need a Lawyer
If you need the advice of a lawyer but you cannot afford one, you may be eligible for Legal Services. Contact the Legal Services program in your county.
You may also contact the toll-free statewide legal hotline, LSNJ-LAW™, at 1-888-LSNJ-LAW (1-888-576-5529). The hotline provides information, advice, and referral to low-income residents of New Jersey with civil legal problems.
If you have a low income and are not able to get the necessary medical care that you need, you may contact the Health Care Access Project at LSNJ. Call 1-888-LSNJ-LAW (1-888-576-5529) and ask for the Health Care Access Project.
If you do not qualify for Legal Services, contact your local lawyer referral service. You can get the telephone number for the lawyer referral service in your area by contacting your county bar association.
Table of Contents | Top of page
Acknowledgments
Gail Chester, deputy director of Middlesex County Legal Services, wrote the first edition of this handbook in 1990. This edition was revised by Linda Garibaldi, supervising attorney at LSNJ’s Health Care Access Project. Other LSNJ staff members who worked on this edition are Tom Makin, Leighton Holness, Charlotte Adams, Adona Oglivie, and Sue Perger.
Table of Contents | Top of page
How to Get Copies of this Handbook
This handbook is available free of charge to Legal Services clients and to other low-income people. Others may get copies from LSNJ for $6 each, which includes postage and handling.
Table of Contents | Top of page
Comments and Suggestions
We hope that this handbook will be helpful to you. Please let us know if you have any suggestions that we might use in future editions. We would also like to know about your experiences in applying for Charity Care. You may contact us at:
Legal Services of New Jersey
P.O. Box 1357
Edison, New Jersey 08818-1357
publications@lsnj.org
Melville D. Miller, Jr., President
Legal Services of New Jersey
Table of Contents | Top of page
Legal Services Programs
Visit Legal Services of New Jersey’s Web site to find out the address of your nearest Legal Services program. You can find a list of programs, addresses, and telephone numbers there.
You may also call Legal Services of New Jersey at (732) 572-9100 to find the address of your nearest Legal Services program.
Table of Contents | Top of page
You may be eligible for free or reduced-cost hospital care
New Jersey hospitals that provide general care are forbidden by law from turning away patients because the patients do not have health insurance or because they are not able to pay for their care.
There are many people in New Jersey who have some type of private health insurance to cover all of their hospital expenses, such as Medicaid or NJ FamilyCare. There are also some people who have Medicare or health insurance that covers a part of their medical costs when they cannot afford to pay the entire amount. But there are many people in New Jersey who have no insurance or health benefits and who cannot afford to pay for the medical care they need from hospitals. If you do not have coverage for your hospital bill, you may be eligible for Charity Care (Health Care for the Uninsured). This handbook will help you to understand Charity Care and help you get it if you are eligible.
Table of Contents | Top of page
What is Charity Care?
Charity Care is a state program for low-income people in New Jersey who do not have full health care coverage and who are not eligible for other programs like Medicaid and NJ FamilyCare. If you already have insurance that will pay for some of your hospital bill but not all of it, Charity Care may pay for the rest of the bill if you are eligible. Charity Care is available in every acute care hospital in New Jersey, and every hospital providing general care is required to tell you about Charity Care and help you apply for it.
The Charity Care program has rules that the hospitals must follow to decide which patients are eligible for free or reduced-cost care. The program also has rules about how patients can apply for Charity Care. This handbook is designed to help you understand how the program works and how the Charity Care program can help you. It also explains how to apply and how to know if you will be eligible.
If you might be eligible for Medicaid or NJ FamilyCare, you will be required to apply for those programs before seeking Charity Care. Also, if you have Medicare or health insurance, the Charity Care program will not pay for any amounts that are covered by those insurers .
Table of Contents | Top of page
I need hospital care but I do not have insurance, Medicaid, NJ FamilyCare, or enough money to pay for my care. What can I do?
You may apply for Charity Care. If you are eligible for this program, it will pay all or part of your hospital bill. You should apply for this program at the hospital where you receive the service, usually in the hospital’s business office. But please read the rest of this handbook before you apply.
The hospital must give you a written notice about Charity Care. If they do not give it to you when you first go for medical help, they have to send it to you with their first bill. If you were admitted to the hospital through the emergency room, the hospital must give you a written notice about Charity Care before you are discharged. There should also be signs posted in the hospital admissions area about Charity Care, written in English, Spanish, and any other language that is spoken by 10 percent or more of the hospital’s patients.
Ask for an application for Charity Care. You may have to go to the hospital’s business office to get the application. They will help you to fill out the application and tell you what information you need to give them. Be sure to make a copy of your completed application to keep in a safe place at home before you give it to the hospital.
Table of Contents | Top of page
Do I have to be a citizen or a legal permanent resident to be eligible for Charity Care?
No. You do not have to be a citizen or permanent resident or have any particular immigration status to be eligible for Charity Care. However, if you are in the United States on a student visa or a tourist visa, Charity Care will cover your hospital bills only if you are admitted for emergency care. (See below for more information about Charity Care for other non-New Jersey residents. )
Table of Contents | Top of page
What must my income be to qualify for free hospital care?
If your gross annual income (income before federal and state taxes are taken out) is lower than the amount shown in Table I, you may be eligible for free hospital care. Your gross income includes your earnings and all other money you or your family members receive, including non-taxable income like welfare or Social Security. Do not count income that your husband or wife gets if you are separated and your spouse does not share his or her income with you. (Keep in mind that even if you are below the income levels in Table I, the amount of assets you can own is limited. The exact limit is discussed below. )
The numbers in Tables I and II are based on New Jersey Department of Health and Senior Services standards. These amounts are increased every year because of the increase in the cost of living.
Table I. Income Requirement for Free Care
(Less than or equal to 200% of the federal poverty guidelines)
| Family Size |
Maximum Yearly Income |
| 1 |
$20,800 or less |
| 2 |
$28,000 or less |
| 3 |
$35,200 or less |
| 4 |
$42,400 or less |
| 5 |
$49,600 or less |
| 6 |
$56,800 or less |
| 7 |
$64,000 or less |
| 8 |
$71,200 or less |
Federal Poverty Guidelines 2008
(A pregnant woman is counted as 2 family members. For families with more than 8 members, add $7,200 for each additional family member.)
Table of Contents | Top of page
What if my income is higher than these amounts?
Even if your gross annual income is not below the amounts in Table I, you may still be eligible for reduced-cost care. Reduced-cost care means that you may only have to pay a part of your hospital bill, depending on your income. If your gross annual income is between the amounts for your family size in Table II you will only be charged 20 to 80 percent of your bill. (Remember that there is still a limit for the amount of assets you may have. )
Table II. Income Requirement for Reduced-Cost Care
(Patients pay between 20% and 80% of their bill if their income is between 200% and 300% of the federal poverty guidelines.)
| |
You Pay 20% of Your Bill |
You Pay 40% of Your Bill |
You Pay 60% of Your Bill |
You Pay 80% of Your Bill |
| Family Size |
>200% to
225% |
>225% to
250% |
>250% to
275% |
>275% to
300 % |
| 1 |
$20,801 to
$23,400 |
$23,401 to
$26,000 |
$26,001 to
$28,600 |
$28,601 to
$31,200 |
| 2 |
$28,001 to
$31,500 |
$31,501 to
$35,000 |
$35,001 to
$38,500 |
$38,501 to
$42,000 |
| 3 |
$35,201 to
$39,600 |
$39,601 to
$44,000 |
$44,001 to
$48,400 |
$48,401 to
$52,800 |
| 4 |
$42,401 to
$47,700 |
$47,701 to
$53,000 |
$53,001 to
$58,300 |
$58,301 to
$63,600 |
| 5 |
$49,601 to
$55,800 |
$55,801 to
$62,000 |
$62,001 to
$68,200 |
$68,201 to
$74,400 |
| 6 |
$56,801 to
$63,900 |
$63,901 to
$71,000 |
$71,001 to
$78,100 |
$78,101 to
$85,200 |
| 7 |
$64,001 to
$72,000 |
$72,001 to
$80,000 |
$80,001 to
$88,000 |
$88,001 to
$96,000 |
| 8 |
$71,201 to
$80,100 |
$80,101 to
$89,000 |
$89,001 to
$97,000 |
$97,901 to
$106,800 |
| For each additional person, add: |
$7,200 |
$8,100 |
$9,000 |
$10,800 |
Federal Poverty Guidelines - 2008
You may be eligible for extra help if you qualify for reduced-cost care as described in the income guidelines in Table II above. If your family’s medical expenses within a 12-month period (from January through December of one calendar year) are more than 30 percent of your annual gross income, you will only have to pay an amount equal to 30 percent of your income. The rest of the medical bill will be covered by Charity Care.
If your gross annual income is more than 300 percent of the poverty level (the last column of figures in Table II), you should expect to be charged for the entire bill. Remember that the income limits in Tables I and II increase every year because the government raises its income guidelines. Your hospital will have the most up-to-date figures. You also may contact the toll-free statewide legal hotline, LSNJ-LAW, at 1-888-LSNJ-LAW (1-888-576-5529).
Table of Contents | Top of page
What does “annual” or “yearly” income mean? Is it the 12 months before I received the hospital services, my income for all of this year, or my income for all of last year?
For Charity Care, your annual or yearly income means your gross income for the 12 months before your hospital service. If your income went up and down during the 12 months before, Charity Care lets you calculate your annual income using whichever one of three different time periods during which your income was the lowest. It is important for you to try to calculate your income each of these ways before you apply for Charity Care so that you will know how much help you should be eligible for. Then keep the documents together that show your income in these different ways so that you may give copies of them with your application.
You must include all types of income that you received in the 12 months before your hospital treatment. Here are some examples of income you may have received that you will have to show as part of your total income:
-
salary (gross wages before taxes);
-
public assistance (cash assistance);
-
Social Security benefits;
-
unemployment benefits and worker’s compensation;
-
veteran’s benefits;
-
alimony and child support;
-
pension payments;
-
insurance and annuity payments;
-
dividends and interest;
-
net rental and business income (after expenses); and
-
all other types of cash support and income, including scholarships, grants, and royalties.
Here are the three ways to figure out your yearly gross income for Charity Care:
-
Show your family’s actual gross income for the 12 months right before the hospital service. Get your pay stubs or ask your employer for a statement of the total money (before taxes) you were paid during those 12 months. If you were on unemployment, ask for a statement from the unemployment office. Get statements or documents from each source of income to show what you received.
12 MONTHS’ TOTAL = _______.
-
Use your family’s gross income for the three months immediately before your hospital service. Multiply that amount by 4.
3 MONTHS’ TOTAL = _______ x 4 = _______.
-
Use your family’s gross income for the one month before your hospital service. Multiply that amount by 12.
1 MONTH’S TOTAL = _______ x 12 = _______.
Figure out your family’s yearly gross income using each of these three ways. Remember, the hospital has to use the lowest of the three ways to decide if you are eligible for Charity Care. If you can, when you apply for Charity Care, take with you all of the documents that prove what your income was for each of these periods. If your income is below the amounts in Table I (and you do not have more assets than allowed ), you will get free care. If your income is higher than Table I but lower than Table II, you will have part of your bill paid for by Charity Care.
Table of Contents | Top of page
I was admitted to the hospital through the emergency room. Can I still get Charity Care?
Yes, no matter how you were admitted to the hospital, you will get free or reduced-cost care if you are eligible for Charity Care. But the way the hospital decides whether or not you are eligible for Charity Care is different if you were admitted to the hospital through the emergency room.
If you were admitted to the hospital through the emergency room, the hospital will try to find out if you have any health insurance or if you are eligible for Medicaid or NJ FamilyCare before you leave the hospital. The hospital will also help you to complete a form with information about where you live, where you work, whether you intend to stay in New Jersey, how much income you make each year, and how much money you may have in a bank account.
The hospital will ask you to sign this form and give permission for the hospital to contact any person or place that you listed on the form to confirm that the information you gave is true. The hospital will then check your address by phone or by a visit. The hospital will contact your employer to check your income. The hospital will also talk with your bank to verify your account balance. If your employer refuses to tell the hospital your income and/or the bank refuses to tell the hospital the amount you have in the bank, the hospital will accept the income estimate and the asset total you gave them. The hospital will assume that you are a family of one person and it will compare your income and assets (if you have any) with Table I and Table II to decide whether you are eligible for Charity Care. If you have a family, you should provide the hospital with proof of who is in your household so that the hospital will compare your income and assets with the highest limit possible allowed for you.
If you are admitted to the hospital through the emergency room and you cannot supply the hospital with the information they need before you are discharged, the hospital must make at least two tries to contact you by phone at your home to arrange to meet with you in person. If the hospital cannot contact you by phone, someone from the hospital may come to your home. If they cannot meet with you, someone from the hospital can speak with your neighbors to ask if you live there and where you work.
If you are approved for Charity Care after being admitted to the hospital through the emergency room, and you are transferred to another hospital, the second hospital may accept your Charity Care approval from the first hospital. However, if you are admitted to the hospital again or receive future medical services, the approval for Charity Care you get for one hospitalization will not cover the future bills. You will have to apply for Charity Care again.
Table of Contents | Top of page
How is the family size determined?
The hospital decides your family size. If you are an adult, your family size includes you, your spouse, any minor children you or your spouse support, and any adults for whom you are legally responsible. If the applicant is a minor (under 18 years old), the family size includes both parents (or a parent’s spouse), minor siblings, and any adults in the family for whom the parents are legally responsible. A pregnant woman counts as two family members. The hospital will not count a parent or spouse in your family size if that person has abandoned you. And the hospital will not count a spouse who does not support you if you are separated or divorced.
Table of Contents | Top of page
How will I have to prove my income?
If you have them, the best proofs of your income are the following documents:
-
federal or state income tax returns,
-
pay check stubs,
-
W-2 forms,
-
a letter from your employer on company letterhead stating your income, or
-
a statement of your income from any government agency that provides you benefits.
If you are receiving Social Security benefits, you must show your annual statement from the Social Security Administration or a copy of your Social Security check, or your bank statements from the three months before the hospital service that show the direct deposit of your check.
If you do not have any of these proofs of your income, the next best proof is a paycheck stub from immediately before your hospital service. If you do not have a paycheck stub, you may sign a paper attesting to what your income was for 12 months, three months, or one month before you received hospital service.
Table of Contents | Top of page
Is there a limit on how much money I can have in the bank or what valuables I can own?
Yes, there are limits on the amount of property you can own if you apply for Charity Care. As of the date of your hospital service, a single person is not allowed to have assets that are worth more than $7,500. A family is not allowed to have assets worth more than $15,000. But if you or your family have assets that are worth more than the asset limit on the date of the hospital service, you may “spend down” your assets by paying toward your medical expenses until you reach the asset limit for Charity Care. Then, depending upon your income, you will be eligible for free or reduced-cost care.
Table of Contents | Top of page
What are assets?
Assets are items that can be turned into cash. All your family’s assets are counted toward the asset limits explained above. Assets include such things as cash, savings and checking accounts, certificates of deposit, stocks and bonds, Individual Retirement Accounts (IRAs), trust funds, and equity in any real estate that is not the residence that you and your family live in.
Table of Contents | Top of page
Can I apply for Charity Care if I own a house?
Yes. The hospital will not count the house you live in, your car, or your furniture as assets. But the hospital will look at any real estate you own that is not your home. This could be rental property, a vacation home, a store, or property that you inherited but you do not live in. If the value of any of these assets is higher than the asset limit, you will not be eligible for Charity Care. You would either have to sell the property to pay some of your medical expenses (see about “spending down” assets ) or keep the property and owe the hospital bill. But owning the home in which you live will not affect your application for Charity Care.
Table of Contents | Top of page
Will the hospital ask me for identification when I apply?
Yes. The hospital will ask you for one of the following forms of identification when you apply for Charity Care: driver’s license, Social Security card, alien registry card, birth or baptismal certificate, pay stub, passport or visa, death certificate (if the person for whom you are applying is now deceased), employee identification, or, if you are homeless, a signed statement that you do not have any of the above identification.
The hospital will ask you for a document that has your name and address on it, such as: a driver’s license, a voter registration card, a union membership card, an insurance or welfare plan identification, a student identification card, a utility bill, a federal or state income tax form, or an unemployment benefits statement. If you do not have any of these documents, you can bring a piece of mail that was addressed and delivered to you or a signed statement from someone saying who you are and where you live; or you can sign a statement yourself simply giving your name and saying who you are, without giving any address if you do not have one.
The hospital is supposed to try to get the following information: name, mailing address, home telephone number, date of birth, and, if applicable, where you work and what kind of work you do, and your employer’s address and telephone number.
But if you think that the hospital is being unreasonable and demanding to see documents that have nothing to do with your eligibility for Charity Care, you can call the Department of Health and Senior Services at their toll-free number, 1-800-367-6543, and ask to speak to someone who represents the Health Care for the Uninsured Program (Charity Care). They will answer your questions and talk to the hospital if they believe the hospital is not acting correctly. Also, talk to a lawyer if you think you need to.
Table of Contents | Top of page
Do I have to be a New Jersey resident to get help from Charity Care?
Except in very limited situations, you have to be a resident of New Jersey to be eligible for Charity Care. You must have been living in New Jersey, with the intent to stay in New Jersey, since the date of the service. This means that you cannot be a resident of another state or country. (There are exceptions to this requirement. )
Table of Contents | Top of page
How do I prove that I am a New Jersey resident?
You may prove you are a resident of New Jersey by showing the hospital one or more documents that show your name and address in New Jersey. But even if you have no current address or have no documents that show your name and a current address in New Jersey, you can still prove that you are a resident of New Jersey and get Charity Care. All you have to do is sign a paper saying that you have been living in New Jersey since the date of your treatment, that you do not live in another state or country, and that you intend to stay in New Jersey.
If you have any of the following documents, they may be used to show your residency: driver’s license, voter registration card, union membership card, insurance or welfare identification card, student identification card, a utility bill, a federal or state income tax form, or an unemployment benefits statement. If you are homeless, you may sign a paper saying that you are homeless. There are also other documents that you can provide to show that you are a New Jersey resident.
Your documents must also show a date so that the hospital can reasonably decide that you have lived in New Jersey since the date of your treatment, that you do not live in another state or country, and that you intend to stay in New Jersey.
Table of Contents | Top of page
Can I get Charity Care if I am a migrant worker and I do not intend to stay in New Jersey?
Yes. If you are within the income and assets limits, you can satisfy the residency requirement by showing that you were residing in New Jersey when you received the medical service.
Table of Contents | Top of page
What if my mother from New York gets sick while visiting me? Can she get free care, too?
People who live in another state or another country are generally not eligible for Charity Care. But a person who has a serious medical emergency that needs immediate attention may apply for Charity Care. The medical emergency has to be so serious that delaying treatment would cause a serious risk to life or health.
New Jersey hospitals cannot turn away anyone who needs emergency treatment. It does not matter where they live or whether or not they have insurance.
Table of Contents | Top of page
Does Charity Care cover everything?
Charity Care covers hospital care, but there is some question about exactly what “hospital care” includes. For example, hospital care may not include the services of a doctor not employed directly by the hospital. However, doctors often will not charge a Charity Care patient. If you have been approved by Charity Care and still receive a bill for medical services, you should talk to a lawyer.
Table of Contents | Top of page
Will the hospital check to see if I have any insurance, or if I am eligible for Medicaid?
Yes. The hospital must check to see if you have any health insurance coverage. If you do have health insurance, you may still be eligible for Charity Care to pay the medical bills your insurance will not cover. However, you must do everything necessary to collect your health insurance benefits before you can get Charity Care. If you fail to get necessary referrals, pre-approvals, or authorizations, or fail to give your insurance information to the hospital, you will not get Charity Care.
The hospital also must decide if you are eligible for any other medical assistance program before they can approve you for Charity Care. If the hospital thinks that you may be eligible for Medicaid or NJ FamilyCare, the hospital will require you to apply for these programs before applying for Charity Care. Medicaid and NJ FamilyCare are programs that pay for medically necessary services, in or out of a hospital, for low-income people who are eligible for the program. Medicaid will also pay your unpaid medical bills for three months before your Medicaid application if you were eligible for Medicaid during those three months. If you do not apply for Medicaid within three months of your hospital service, Charity Care may bill you for that service.
But if you apply to Medicaid or any other medical assistance program, and the hospital has not received a response from that program within seven months of your application, the hospital must pay your hospital bills if you are eligible for Charity Care.
The hospital cannot bill you for the services you received if the hospital has not given you, within three months of the date of your service, the written information about how to apply for Charity Care and other medical assistance programs.
Table of Contents | Top of page
The hospital told me to apply for Medicaid, but I know I don’t qualify for it. What should I do?
If the hospital requires you to apply for Medicaid before applying for Charity Care, you should do so even if you think you are not eligible for Medicaid. The hospital will give you the address of the place to apply for Medicaid, which is usually your local county Board of Social Services. If Medicaid rejects you, get a written denial and take it to the hospital to apply for Charity Care again.
If the only reason you do not qualify for Medicaid is that you are an undocumented alien or you are in the U.S. temporarily (for example, if you are here as a student, a tourist, or a worker), and you need emergency care at a hospital, you are eligible for Emergency Medical Services for Aliens. Your medical condition must be so severe that it puts your heath at serious risk if you do not get immediate treatment. Labor and delivery is considered an emergency and will be paid for by Emergency Medical Services.
Table of Contents | Top of page
I have insurance, but it only covered part of my bill. Can I still ask for Charity Care?
Yes. If you think your insurance only covers part of your bill, apply for Charity Care right away. If you have Medicare, you should also apply to Charity Care because it may pay for your co-payment. If you are eligible for Charity Care, it may pay for the medical charges that Medicare or your health insurance does not cover.
Table of Contents | Top of page
Is there a time limit for applying for Charity Care?
Yes, if you do not apply on time, you could lose your right to Charity Care. You may apply for Charity Care within 30 days before your scheduled procedure or up to one year after the date of your service. The hospital can decide to give you Charity Care more than a year after your treatment, but it does not have to. Therefore, you should apply for Charity Care as soon as possible and make sure that your application includes all of the information the hospital needs. If the hospital says that you have not given enough information with your application, you must give them the information they require within a year of your hospital service.
Table of Contents | Top of page
How long do I have to wait to know if I am eligible for Charity Care?
Once your application is complete, the hospital must decide if you are eligible for Charity Care as soon as possible, but not later than 10 working days after you file. If your application is not complete, the hospital must notify you that they need more information within 10 days after you give them your application. You have to give them the information within a year of the date of your service.
When you are granted Charity Care, the hospital will give you a letter telling you what charges will be covered and for how long. If you are denied Charity Care, the hospital must tell you why you have been denied. There is no right to appeal this denial. But if you were denied Charity Care and you think you should be eligible, you should contact the Department of Health and Senior Services, Health Care for the Uninsured (Charity Care), at the toll-free number, 1-800-367-6543, or write to them at:
Health Care for the Uninsured Program
State of New Jersey
Department of Health and Senior Services (DHSS)
P.O. Box 360
Trenton, New Jersey 08625
Save copies of your letters and any mail that you get from Charity Care for at least six years in case a question comes up later about your eligibility for Charity Care.
Table of Contents | Top of page
I was approved for Charity Care at my hospital two months ago, and now I have to go back to the hospital. Do I have to apply for Charity Care again?
If your income and assets have not changed, you should still be eligible for Charity Care. But if you are now going to another hospital, you must take your Charity Care approval to the second hospital. The second hospital will usually approve your application for Charity Care based on the approval you received from the first hospital. However, if you were granted Charity Care more than a year ago, the hospital will require you to apply again for Charity Care so that they may make a new decision about your eligibility.
Table of Contents | Top of page |
