Frequently asked questions

Do you have a mobile app?

Make the most of your AmeriHealth New Jersey health plan with the AHNJ On the Go app. It gives you easy access to your health care coverage 24/7, wherever you are.

You can use the AHNJ app to:

  • Access benefit information
  • View, share, or order a new ID card
  • Find a doctor or hospital
  • Change your primary care physician
  • Estimate your out-of-pocket costs for medical procedures
  • See your most recent claims
  • Find or price a prescription drug
  • ...and much more

Learn more and find out how to download the app to your iPhone or Android device.

How do I order an ID card?

To order an ID card, log in to our member site at amerihealthnj.com. Once you are logged in, click on the Order New link beneath your ID card. Once the ID Cards page displays, do the following:

  • Ensure the check mark is next to your name. If you are the account holder and have a dependent(s) listed on your account, you can select the name(s) of your dependent(s).
  • Verify your mailing address on where the card will be sent. You can change this address to have your ID card go to an alternate address. Note that this will not change your mailing address that we have on file.

Your new ID card should be mailed to you within 7 – 10 business days. If you need a copy of your ID card before your new one arrives, you have the option to:

  • Print a temporary ID card by using the Print feature on the ID card page.
  • Show your ID card on your smart phone by downloading our application from the Apple App Store or the Google Play Store for Android.
  • Have your ID card sent to your provider, pharmacy, or a family member via email or fax. Just select the Send button, enter the email address or fax number, and click Send.

Can I download a temporary ID card?

When you enroll in health coverage with AmeriHealth New Jersey, your new ID card should be mailed to you within 7 – 10 business days. If you need a copy of your ID card before your new one arrives, you have the option to:

  • Print a temporary ID card by using the Print feature on the ID card page.
  • Show your ID card on your smart phone by downloading our application from the Apple App Store or the Google Play Store for Android.
  • Have your ID card sent to your provider, pharmacy, or a family member via email or fax. Just select the Send button, enter the email address or fax number, and click Send.

What is the status of my claim?

You can view the status of your claims on amerihealthnj.com under the Claims and Spending tab. The standard timeframe for a claim to process is 4 – 6 weeks once received by the health plan. To access your claims, click the Claims and Spending tab. Then click My Claims Overview.

To verify the status of your claim, look at the “ Status” column. Your claim can show one of the following:

  • Paid or Approved — your claim has been processed and payment submitted to the provider
  • Pending — means that your claim has been received but processing has not been finalized
  • Denied — means your claim has been processed but not approves for payment
  • In Process — which means your claim has been received and is being processed

What is an appeal and grievance?

An appeal is a request for your health insurer or plan to review a decision or a grievance again.
A grievance is a complaint that you communicate to your health insurer or plan. If you are not satisfied with the outcome of a claim or process of the insurance plan, you can contact Customer Service at the number on the back of your ID card.

You can submit an appeal in writing. If you, or someone on your behalf, wish to file an appeal, you can mail it to:

AmeriHealth New Jersey Provider Claim Appeals Unit
259 Prospect Plains Road
Building M
Cranbury, NJ 08512
Fax: 609-662-2610

To know your rights on how or when you can file an appeal, review the Member Services: How to Raise Questions or Concerns section of your Explanation of Benefits for the claim in question.

Where can I find my plan details?

You can find your plan information at amerihealthnj.com. Upon logging into your account, you can find plan information by selecting Coverage and Benefits under the Benefits tab at the top of the Home page, or by selecting the plan information you wish to view under My Benefits in the middle of the Home page.

Member portal

What is the Embrace Well-being Action Plan?

Centrally located on the Embrace Well-being homepage and updated every day, the Action Plan is a daily to-do list configured for your personal and private profile. It includes engaging content such as articles, recipes and videos along with activities, tasks, reminder and rewards communications for programs.

To access the Action Plan, click the Embrace Well-being link on the left menu under the Health & Well-being tab.

What is Embrace Well-being?

Embrace Well-being is our holistic wellness program featuring discounts, and a variety of member resources that can help you on your journey to well-being in a way that’s fun and rewarding. Every AmeriHealth New Jersey plan features access to Embrace Well-being. As a member, you’ll benefit from tools to help you get well and resources to help you stay well.

Learn more about Embrace Well-being and log in at amerihealthnj.com to complete your Well-being Profile and get started.

How does the Embrace Well-Being Rewards program work?

The Embrace Well-being Rewards program lets eligible members earn Well-being dollars that can be redeemed for e-gift cards.

Begin the process by completing your Well-being Profile. When you’re ready, you can start earning Well-being dollars by completing healthy activities. There are 13 ways to earn!

To learn more about the Embrace Well-being Rewards healthy activities and find out how much you can earn, go to the Embrace Well-being Rewards page. And remember, you must complete your Well-being Profile, before you complete and submit your healthy activities.

Learn more about Embrace Well-being and log in at amerihealthnj.com to complete your Well-being Profile and get started.

Note: Only members enrolled in group plans have access to the Embrace Well-being Rewards program. If you are eligible, you can navigate here by selecting the Earn Rewards option within the Health & Well-Being tab on the Home page.

What procedures are covered?

To learn more about what procedures are covered, visit amerihealthnj.com. Upon logging into your account, you can find coverage information by selecting Coverage and Benefits under the Benefits tab at the top of the page or selecting the plan information you wish to view under My Benefits in the middle of the Home page (below).

The Care Cost Estimator provides members with estimated out-of-pocket costs for health care services. This feature allows members to retrieve cost data for inpatient, out-patient, and diagnostic services among the physicians and hospitals in our network.

This tool is available for all commercial products. To access the Care Cost Estimator, log into the member portal at amerihealthnj.com and access the Care Cost Estimator tool at the top of the homepage under Search for Doctors and Hospitals, or by clicking on the My Care tab and clicking Estimate Cost of Care located on the left menu.

Is there a way to estimate costs for care?

You can with the Care Cost Estimator tool.

The Care Cost Estimator provides members with estimated out-of-pocket costs for health care services. This feature allows members to retrieve cost data for inpatient, out-patient, and diagnostic services among the physicians and hospitals in our network. This tool is available for all commercial products. To access the Care Cost Estimator, log into the member portal at amerihealthnj.com and access the Care Cost Estimator tool at the top of the homepage under Search for Doctors and Hospitals, or by clicking on the My Care tab and clicking Estimate Cost of Care located on the left menu.

What do I do if my ID card was stolen?

If your ID card was stolen, please contact Customer Service to report the issue.

Customer Service:

  • For coverage through an employer or union: 888-YOUR-AH1 (888-968-7241) (TTY: 711)
  • For coverage through Medicare: 1-866-406-5967 (TTY/TDD: 711)

If you need a replacement ID card you can print a temporary ID card for yourself and anyone covered on your policy. Log in at amerihealthnj.com and click the View/Share ID Card link from the Home page, then click Print (located above the ID card).

It usually takes 7 – 10 business days to receive your replacement card.

What do I do if I’ve lost or did not receive my ID card?

If you have not received your ID card, you can order a new card or print a temporary ID card.

To order a new ID card:

  • Log in at amerihealthnj.com and click on the “Order New” link under your ID Card from the Home page.
  • Select the member(s) you are ordering for and verify the address which the card is being sent to.
  • Once satisfied, select Order.

It usually takes 7 – 10 business days to receive your replacement card. If you need your card before it arrives, you can print a temporary ID card or send a copy to your doctor right from amerihealthnj.com.

To print a temporary ID card:

  • Visit amerihealthnj.com and click on the View/Share my ID Card link from the homepage.
  • Click the Print button located above the ID card image.

How can I set up automatic recurring payments to pay my monthly premium?

Before you get started, you’ll want to have your bank account number and bank routing number ready — these numbers are printed on your personal check.

Note: You cannot set up a recurring payment when a new invoice is available. If you have a bill that’s waiting for payment, you will need to first do a one-time payment.

  • Visit our member site at amerihealthnj.com and log in to your account. If you haven’t set one up, it takes just a minute to do so.
  • On the member portal homepage, click Manage Account in the Pay my Bill section on the top left of your home page.
  • First, add a payment method by clicking Add Payment Method under Payment Methods. Payments, and choose Payment Method List.
  • Once complete, add the recurring payment by clicking the Add button under Recurring Payment. You can schedule a payment up to ten days before the payment due date. Recurring payment arrangements need to be added separately for each billing account you may have.

What information is on my ID card?

Before you get started, you’ll want to have your bank account number and bank routing number ready — these numbers are printed on your personal check.

Note: You cannot set up a recurring payment when a new invoice is available. If you have a bill that’s waiting for payment, you will need to first do a one-time payment.

  • Your member ID card contains important information your doctor and other health care providers need to file claims on your behalf.
  • Your ID card will show your name, member ID number, basic medical copay or deductible information (if applicable), plan name (for example, Regional Preferred or Local Value) and out-of-pocket maximum. If you have an HMO plan, your ID card will also display the name of your primary care physician and their phone number. Your ID card may also include your pharmacy information, if you have prescription coverage along with your medical.
  • To view your ID card, Visit amerihealthnj.com and click on your ID Card from the homepage.

If I get COBRA after I lose coverage through a job, can I still apply for a Special Enrollment Period?

Yes, you can apply for special enrollment period if your COBRA benefits expire. Expiration of your COBRA benefits is a qualifying life event. You can also apply for an individual and family plan at amerihealthnj.com instead. If you think you may qualify for a subsidy to help lower your monthly insurance premiums, you will need to apply through getcovered.nj.gov.

Who do I contact with billing questions?

For information on making a payment or setting up a recurring payment:

  • Visit our member site at amerihealthnj.com and log in to your account. If you haven’t set one up, it takes just a minute to do so.
  • On the member portal homepage, click Manage Account in the Pay my Bill section on the top left of your home page.
  • First, add a payment method by clicking Add Payment Method under Payment Methods. Payments, and choose Payment Method List.
  • Once complete, add the recurring payment by clicking the Add button under Recurring Payment. You can schedule a payment up to ten days before the payment due date. Recurring payment arrangements need to be added separately for each billing account you may have.

For questions about your premium bill, or how to make a payment, contact the Customer Billing Center at 1-800-313-9168 (TTY: 711). Representatives are available Monday – Friday, 8 a.m. – 6 p.m. (EST).

Is my current doctor in-network?

When you search for a doctor, you will need to select the plan network. You will then be able to see which doctors are in- and out-of-network for that plan.

Search for a doctor.

How can I find a doctor or hospital?

The Find a Doctor tool allows you to search for doctors and hospitals within the AmeriHealth New Jersey network.