Friday, July 7, 2023

Nemours Children's Hospital in Dupont Drops NJ family Care Patients

First it was CHOP, now Nemours childrens hospital in Dupont, Delaware will no longer accept patients who have Insurance covered by NJ family care begning August 1, 2023.

This means Lakewood  area children who are covered with NJ Family care, either with Amerigroup, Horizon, Wellcare will have to find another children's hospital to go to for procedures. Local doctors are planning to work with Children’s Hospital at Hackensack University Medical Cener in North Jersey or other  networks. In case of  a serious emergency  patients may still go to Philadelphia to CHOP. 

This may be a negotiation attempt at getting more money from the state, but for now they are dropping Jersey care patients.

Official statement:

Effective August 1, 2023, Nemours Children’s will not be working with any New Jersey Medicaid health plan. This means that we will not be able to see patients who have insurance with Horizon NJ Health, WellCare NJ FamilyCare or Amerigroup Community Care.

If your child has an emergency, they can still come to the emergency room at Nemours Children's Hospital, Delaware. As always, in an emergency you should call 911 or go to the nearest emergency room.

Here are some common questions and answers.

1.  After Aug. 1, 2023, can I take my child to Nemours Children’s Hospital, Delaware if they need emergency care?

Yes. If your child is having a medical emergency, call 911 or go to the nearest emergency room, including Nemours Children’s Hospital, Delaware. This change in your child’s health insurance will NOT affect your child’s ability to get emergency care from Nemours Children’s or a Nemours Children’s provider at our hospital or any partner hospital.

2.  My child is getting treatment from a Nemours Children’s specialist. What happens after Aug. 1, 2023?

If your child is in the middle of an ongoing course of treatment, call your health plan to ensure they will continue to receive care through Nov. 30, 2023.

If your child is receiving the type of care shown below, the date of their coverage with Nemours Children’s will be extended as follows:

Post-operation — Jan. 31, 2024

Cancer treatment — July 31, 2024

Psychiatric treatment — July 31, 2024

Treatments or services not mentioned may be considered for extension on a case-by-case basis. Contact your health plan for information.

3.  Can I still make an appointment for my child to see a Nemours Children’s provider before Aug. 1, 2023?

Yes, Nemours Children’s will do our best to schedule new appointments for patients with Horizon NJ Health, WellCare NJ FamilyCare or Amerigroup Community Care before Aug. 1, 2023. We will not be scheduling any new patients after that date.

4.  What if my child already has an appointment to see a Nemours Children’s provider after Aug. 1, 2023?

If your child is a new Nemours Children’s patient, we will contact you try to reschedule your appointment for before Aug. 1, 2023. If we are unable to move your appointment, it will be canceled, and you will need to find a new in-network provider with your health plan.

If your child is in an active course of treatment as described in question 2, your appointment will take place as scheduled.

5.  My child has a surgery/procedure scheduled on or after Aug. 1, 2023. Will that be canceled?

We’ll try to reschedule. If we are unable to reschedule, we will contact your health plan to determine your continuity of care plan.

6.  My child has other health insurance in addition to Horizon NJ Health/WellCare NJ FamilyCare/Amerigroup Community Care. Can I still go to Nemours Children’s?

If your child has another health insurance plan, it may cover care delivered by Nemours Children’s. To find out, go to Nemours.org/insurance or contact the insurance plan directly.

7.  Can I switch my child’s care to a doctor who is not at Nemours Children’s?

Yes. You can visit your health plan’s website or contact your health plan directly through Member Services and asking for a list of in-network providers.

Member Services hotlines:

Horizon NJ Health

(800) 682-9090

WellCare NJ FamilyCare

(888) 453-2534

Amerigroup Community Care

8800) 600-4441

The New Jersey Medicaid hotline

(800) 356-1561

Call the New Jersey Medicaid hotline if you have trouble reaching your health plan or if you have concerns about moving your child’s care to a new provider: (800) 356-1561

8. How can I transfer my child's medical record to a new provider?

Once you choose a new provider, we can send your child’s medical record to them for free. You will need a Release of Information form, which you can obtain by calling (866) 956-7299 (press 1 to request copies of medical records) or online at Nemours.org/MedicalRecord.

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