Members in AmeriHealth New Jersey HMO Plus and POS Plus plans do not need referrals to access care. Plus members can select a participating AmeriHealth New Jersey primary care physician (PCP) who can provide routine and preventive care services and assist members in finding physicians who can provide services such as laboratory, physical therapy, and radiology. With HMO Plus and POS Plus plans, members can visit any network PCP and pay the PCP copayment. Please remember that under the AIM Program, CT, MRI, PET scans, and nuclear cardiology services require precertification. In addition, effective June 1, 2012, echocardiography services will also require precertification.

POS Plus members receive the highest level of coverage by utilizing doctors and hospitals that participate in the AmeriHealth New Jersey network. When POS Plus members choose to visit providers who do not participate in the network, they are responsible for additional out-of-pocket costs.

Small Employer Health (SEH) and Large Group (51+) HMO Plus members must use in-network providers to access benefits.

Unlike a traditional HMO or POS plan, Plus members never need a referral to seek care. HMO Plus members may visit any AmeriHealth New Jersey participating provider directly without obtaining a referral from their PCP. ID cards for these members clearly state that no referrals are required.

If you have questions regarding AmeriHealth New Jersey HMO Plus or POS Plus products, please call Customer Service at 1-800-275-2583 or contact your Network Coordinator or Hospital/Ancillary Services Coordinator.

This is not a statement of benefits. Benefits may vary based on state requirements, Benefits Program (HMO, PPO, etc.), and/or employer group. HMO and PPO member coverage may be verified by calling Customer Service.