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 recently sent to affected
beneficiaries. The letter included a list
of available plans in the beneficiary?s 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.
- 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.