NJ MEDICAID MARKET
New Jersey
monitoring
No current verified market signal.
Last verified: unavailable
Last verified: unavailable · no state-specific item
No current verified signal
Precapture is monitoring this market. No state-specific public intelligence item is currently published.
Plans in this market
Parent, plan, and program come from the plan graph. Enrollment and share use the latest CMS reported count. Operations counts are CMS MCPAR. A dollar amount is not on this page.
Plans in this market 95
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| not reported | AtlantiCare Life Connection | not reported | 0 (2017) | 0.0% calculated | not reported |
| not reported | Beacon of LIFE | not reported | 181 (2021) | 15.9% calculated | not reported |
| not reported | Beacon of Life | not reported | 115 (2022) | 10.0% calculated | not reported |
| not reported | AtlantiCare Life | not reported | 92 (2022) | 8.0% calculated | not reported |
| not reported | Atlanticare LIFE | not reported | 94 (2020) | 8.2% calculated | not reported |
show all 95
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| not reported | Atlanticare LIFE Connection | not reported | 163 (2024) | 12.2% calculated | not reported |
| not reported | Beacon of LIFE | not reported | 72 (2017) | 7.4% calculated | not reported |
| not reported | Horizon NJ Health | not reported | 821,758 (2018) | 53.7% calculated | not reported |
| not reported | Beacon of LIFE | not reported | 419 (2024) | 31.3% calculated | not reported |
| CVS/Aetna | Aetna Assure Premier Plus | not reported | 2,056 (2022) | 2.7% calculated | not reported |
| CVS/Aetna | Aetna Assure Premier Plus | not reported | 6,752 (2024) | 8.0% calculated | not reported |
| CVS/Aetna | Aetna Assure Premier Plus (HMO SNP) | not reported | 900 (2021) | 1.4% calculated | not reported |
| CVS/Aetna | Aetna Better Health NJ | not reported | 34,632 (2017) | 2.3% calculated | not reported |
| CVS/Aetna | Aetna Better Health NJ | not reported | 93,872 (2024) | 6.4% calculated | 28 sanctions, 4,177 appeals resolved |
| not reported | Capital Health LIFE | not reported | 218 (2024) | 16.3% calculated | not reported |
| Centene | WellCare Liberty | not reported | 7,486 (2022) | 10.0% calculated | not reported |
| Centene | WellCare Liberty (HMO SNP) | not reported | 2,697 (2018) | 7.1% calculated | not reported |
| Centene | WellCare Liberty D-SNP | not reported | 1,359 (2017) | 5.1% calculated | not reported |
| Centene | WellCare of New Jersey | not reported | 63,437 (2018) | 4.1% calculated | not reported |
| Centene | WellCare of New Jersey | not reported | 82,086 (2020) | 5.4% calculated | not reported |
| Centene | WellCare of New Jersey | not reported | 98,945 (2022) | 5.1% calculated | not reported |
| Centene | Wellcare Dual Liberty | not reported | 6,525 (2024) | 7.8% calculated | not reported |
| Centene | Wellcare Liberty (HMO D-SNP) | not reported | 6,329 (2021) | 9.9% calculated | not reported |
| Centene | Wellcare Liberty (HMO SNP) | not reported | 3,836 (2019) | 8.1% calculated | not reported |
| Centene | Wellcare of New Jersey | not reported | 74,456 (2024) | 5.1% calculated | 12 sanctions, 1,590 appeals resolved |
| Elevance | Amerigroup New Jersey | not reported | 179,997 (2017) | 11.7% calculated | not reported |
| Elevance | Amerigroup New Jersey Inc | not reported | 165,413 (2018) | 10.8% calculated | not reported |
| Elevance | Amerigroup New Jersey Inc | not reported | 218,039 (2021) | 12.4% calculated | not reported |
| Elevance | Amerigroup New Jersey, Inc. | not reported | 167,805 (2024) | 11.4% calculated | 20 sanctions, 2,579 appeals resolved |
| Elevance | Amerivantage | not reported | 15,597 (2022) | 20.8% calculated | not reported |
| Elevance | Amerivantage Dual Coordination | not reported | 15,665 (2023) | 17.3% calculated | not reported |
| Elevance | Amerivantage Dual Coordination (HMO D-SNP) Amerivantage Dual Secure (HMO POS) | not reported | 10,126 (2020) | 18.9% calculated | not reported |
| Elevance | Amerivantage Dual Coordination (HMO D-SNP) Amerivantage Dual Secure (HMO POS) | not reported | 12,335 (2021) | 19.4% calculated | not reported |
| Elevance | Amerivantage Dual Coordination (HMO SNP) | not reported | 9,221 (2018) | 24.4% calculated | not reported |
| Elevance | Amerivantage Dual Coordination (HMO SNP) | not reported | 9,011 (2019) | 19.1% calculated | not reported |
| Elevance | Amerivantage Dual Cooridination | not reported | 8,667 (2017) | 32.6% calculated | not reported |
| Elevance | Wellpoint Full Dual Advantage | not reported | 12,376 (2024) | 14.7% calculated | not reported |
| Horizon Blue Cross Blue Shield of New Jersey | Horizon NJ Health | not reported | 860,036 (2024) | 58.5% calculated | 22 sanctions, 13,801 appeals resolved |
| not reported | Horizon NJ Totalcare | not reported | 17,926 (2022) | 23.9% calculated | not reported |
| not reported | Horizon NJ Health | not reported | 818,099 (2017) | 53.4% calculated | not reported |
| not reported | Horizon NJ TotalCare | not reported | 19,596 (2024) | 23.3% calculated | not reported |
| not reported | Horizon NJ TotalCare (HMO D-SNP) | not reported | 16,093 (2021) | 25.3% calculated | not reported |
| not reported | Horizon NJ TotalCare (HMO SNP) | not reported | 11,241 (2019) | 23.9% calculated | not reported |
| not reported | Inspira LIFE | not reported | 245 (2017) | 25.2% calculated | not reported |
| not reported | Inspira LIFE | not reported | 268 (2020) | 23.5% calculated | not reported |
| not reported | Inspira LIFE | not reported | 274 (2021) | 24.1% calculated | not reported |
| not reported | Inspira LIFE - Vineland | not reported | 272 (2024) | 20.3% calculated | not reported |
| not reported | Inspira LIFE - Williamstown | not reported | 0 (2024) | 0.0% calculated | not reported |
| not reported | Inspira Life | not reported | 268 (2022) | 23.3% calculated | not reported |
| not reported | LIFE at Lourdes | not reported | 218 (2017) | 22.4% calculated | not reported |
| not reported | Lutheran Senior LIFE of Jersey City | not reported | 128 (2017) | 13.2% calculated | not reported |
| not reported | Lutheran Senior LIFE at Jersey City | not reported | 95 (2024) | 7.1% calculated | not reported |
| not reported | Lutheran Senior Life | not reported | 120 (2022) | 10.4% calculated | not reported |
| not reported | UnitedHealthcare Dual Complete NJ-Y001 | not reported | 38,743 (2024) | 46.1% calculated | not reported |
| not reported | UnitedHealthcare Dual Complete ONE | not reported | 43,114 (2023) | 47.6% calculated | not reported |
| not reported | Logisticare | not reported | 1,555,703 (2017) | 100.0% calculated | not reported |
| not reported | Logisticare | not reported | 1,561,266 (2018) | 100.0% calculated | not reported |
| not reported | LIFE St. Francis | not reported | 286 (2021) | 25.1% calculated | not reported |
| not reported | Life St. Francis | not reported | 342 (2022) | 29.7% calculated | not reported |
| not reported | Logisticare | not reported | 1,486,074 (2019) | 100.0% calculated | not reported |
| not reported | ModivCare | not reported | 1,499,339 (2022) | 100.0% calculated | not reported |
| not reported | Modivcare | not reported | 1,556,565 (2024) | 100.0% calculated | not reported |
| not reported | LIFE St. Francis | not reported | 309 (2017) | 31.8% calculated | not reported |
| not reported | Trinity Health LIFE New Jersey | not reported | 173 (2024) | 12.9% calculated | not reported |
| UnitedHealth | UHC Dual Complete | not reported | 31,803 (2022) | 42.5% calculated | not reported |
| UnitedHealth | United Healthcare Community Plan | not reported | 383,031 (2022) | 19.7% calculated | not reported |
| UnitedHealth | UnitedHealthcare Community Plan | not reported | 439,722 (2017) | 28.7% calculated | not reported |
| UnitedHealth | UnitedHealthcare Community Plan | not reported | 275,064 (2024) | 18.7% calculated | 20 sanctions, 9,454 appeals resolved |
| UnitedHealth | UnitedHealthcare Dual Complete ONE | not reported | 13,101 (2017) | 49.3% calculated | not reported |
| UnitedHealth | UnitedHealthcare Dual Complete ONE (HMO SNP) | not reported | 19,158 (2018) | 50.6% calculated | not reported |
| UnitedHealth | UnitedHealthcare Dual Complete ONE ONE (HMO D-SNP) | not reported | 24,356 (2020) | 45.5% calculated | not reported |
| UnitedHealth | UnitedHealthcare Dual Complete ONE (HMO D-SNP) | not reported | 28,007 (2021) | 44.0% calculated | not reported |
| UnitedHealth | UnitedHealthcare Dual Complete ONE (HMO SNP) | not reported | 22,993 (2019) | 48.8% calculated | not reported |
| not reported | Trinity Health LIFE NJ | not reported | 181 (2021) | 15.9% calculated | not reported |
| not reported | Trinity Health Life New Jersey | not reported | 215 (2022) | 18.7% calculated | not reported |
| not reported | Aetna Better Health NJ | not reported | 25,920 (2016) | 1.7% calculated | not reported |
| not reported | Amerigroup New Jersey | not reported | 189,014 (2016) | 12.1% calculated | not reported |
| not reported | Amerivantage Dual Coordination | not reported | 7,965 (2016) | 0.5% calculated | not reported |
| not reported | Atlanticare LIFE | not reported | 44 (2018) | 4.1% calculated | not reported |
| not reported | Beacon of LIFE | not reported | 40 (2016) | 4.3% calculated | not reported |
| not reported | Beacon of LIFE | not reported | 106 (2018) | 9.9% calculated | not reported |
| not reported | Horizon NJ Health | not reported | 820,123 (2016) | 52.7% calculated | not reported |
| not reported | Inspira LIFE | not reported | 225 (2016) | 24.2% calculated | not reported |
| not reported | Inspira LIFE | not reported | 268 (2018) | 25.1% calculated | not reported |
| not reported | LIFE (Living Independently For Elders) St. Francis | not reported | 310 (2016) | 33.3% calculated | not reported |
| not reported | LIFE St. Francis | not reported | 317 (2018) | 29.7% calculated | not reported |
| not reported | LIFE at Lourdes | not reported | 229 (2016) | 24.6% calculated | not reported |
| not reported | LIFE at Lourdes | not reported | 199 (2018) | 18.7% calculated | not reported |
| not reported | Logisticare | not reported | 1,556,150 (2016) | 100.0% calculated | not reported |
| not reported | Lutheran Senior LIFE | not reported | 127 (2016) | 13.6% calculated | not reported |
| not reported | Lutheran Senior Life | not reported | 133 (2018) | 12.5% calculated | not reported |
| not reported | UnitedHealthcare Community Plan | not reported | 447,928 (2016) | 28.8% calculated | not reported |
| not reported | UnitedHealthcare Dual Complete ONE | not reported | 7,879 (2016) | 0.5% calculated | not reported |
| not reported | WellCare Liberty D-SNP | not reported | 206 (2016) | 0.0% calculated | not reported |
| not reported | WellCare of New Jersey | not reported | 57,115 (2016) | 3.7% calculated | not reported |
CMS reported enrollment
CMS reporting years in this file run from 2016 through 2024. Retrieved 2026-11-01. The latest reporting year is 2024, which is behind the retrieval date. Enrollment figures are the CMS cell for that reporting year. Share is calculated from CMS reported total enrollment for that state, program, and year. Precapture does not combine rows. A year missing from a trend was not reported. A plan and region with more than one CMS row in a year has no trend and no year-over-year change. The dataset says a reported 0 may not truly represent 0 when a state suppressed a small count. CMS reported.
FIDE SNP (Comprehensive MCO + MLTSS)
FIDE SNP (Comprehensive MCO + MLTSS) 32
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Aetna Assure Premier Plus (HMO SNP) | Aetna Better Health, Inc. | CVS/Aetna | Bergen, Camden, Essex, Hudson, Mercer, Middlesex, Monmouth, Ocean, Passaic and Union counties | not reported | not reported | not reported | not reported | 2021: 900 |
| Aetna Assure Premier Plus | Aetna Better Health , Inc./CVS | CVS/Aetna | Statewide | not reported | not reported | not reported | not reported | 2022: 2,056 |
| Aetna Assure Premier Plus | Aetna Better Health, Inc. | CVS/Aetna | All NJ Counties | CMS reported 6,752 (2024) | 8.0% | +2,443 (+56.7%) | +3.3 pts | 2023: 4,309; 2024: 6,752 |
| Amerivantage Dual Coordination (HMO D-SNP) Amerivantage Dual Secure (HMO POS) | Amerigroup New Jersey, Inc (Anthem) | Elevance | Atlantic, Bergen, Burlington, Camden, Cumberland, Cape May, Essex, Gloucester, Hudson, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Salem, Somerset, Sussex, and Union Counties | not reported | not reported | not reported | not reported | 2020: 10,126 |
| Amerivantage Dual Coordination (HMO D-SNP) Amerivantage Dual Secure (HMO POS) | Amerigroup New Jersey, Inc. (Anthem) | Elevance | Atlantic, Bergen, Burlington, Camden, Cumberland, Cape May, Essex, Gloucester, Hudson, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Salem, Somerset, Sussex, and Union counties | not reported | not reported | not reported | not reported | 2021: 12,335 |
show all 32
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Amerivantage Dual Coordination (HMO SNP) | Amerigroup New Jersey, Inc (Anthem) | Elevance | Bergen, Burlington, Camden, Hudson, Middlesex, Monmouth, Ocean, Passaic, Somerset, Union Counties | not reported | not reported | not reported | not reported | 2019: 9,011 |
| Amerivantage Dual Coordination (HMO SNP) | Amerigroup, Inc. | Elevance | Atlantic, Bergen, Burlington, Camden, Cumberland, Essex, Gloucester, Hudson, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Somerset, and Union Counties | not reported | not reported | not reported | not reported | 2018: 9,221 |
| Amerivantage Dual Coordination | Amerigroup New Jersey, Inc./Anthem | Elevance | All NJ Counties except Hunterdon and Warren | not reported | not reported | not reported | not reported | 2023: 15,665 |
| Amerivantage Dual Cooridination | Anthem | Elevance | Atlantic, Bergen, Burlington, Cumberland, Essex, Gloucester, Hudson, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Somerset and Union Counties | not reported | not reported | not reported | not reported | 2017: 8,667 |
| Amerivantage | Amerigroup New Jersey, Inc./Anthem | Elevance | All New Jersey counties except Hunterdon and Warren | not reported | not reported | not reported | not reported | 2022: 15,597 |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare of New Jersey, Inc. | Horizon Healthcare of New Jersey, Inc. | Statewide | not reported | not reported | not reported | not reported | 2020: 13,827; 2021: 16,093 |
| Horizon NJ TotalCare (HMO SNP) | Horizon Healthcare of New Jersey, Inc. | Horizon Healthcare of New Jersey, Inc. | Atlantic, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Monmouth, Morris, Passaic, Salem, Somerset, Sussex, Union, and Warren Counties | not reported | not reported | not reported | not reported | 2018: 6,781 |
| Horizon NJ TotalCare (HMO SNP) | Horizon Healthcare of New Jersey, Inc. | Horizon Healthcare of New Jersey, Inc. | Statewide | not reported | not reported | not reported | not reported | 2019: 11,241 |
| Horizon NJ TotalCare | Horizon Healthcare of New Jersey, Inc. | Horizon Healthcare of New Jersey, Inc. | All NJ Counties | CMS reported 19,596 (2024) | 23.3% | -546 (-2.7%) | +1.1 pts | 2023: 20,142; 2024: 19,596 |
| Horizon NJ TotalCare | Horizon Healthcare of New Jersey, Inc. | Horizon Healthcare of New Jersey, Inc. | Atlantic, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Monmouth, Morris, Passaic, Salem, Somerset, Sussex, Union, Warren counties | not reported | not reported | not reported | not reported | 2017: 3,438 |
| Horizon NJ Totalcare | Horizon Healthcare of NJ | Horizon Healthcare of NJ | Statewide | not reported | not reported | not reported | not reported | 2022: 17,926 |
| UHC Dual Complete | United Healthcare | UnitedHealth | All NJ counties except Cape May | not reported | not reported | not reported | not reported | 2022: 31,803 |
| UnitedHealthcare Dual Complete NJ-Y001 | Oxford Health Plans (NJ), Inc. | Oxford Health Plans (NJ), Inc. | All NJ Counties except Cape May | CMS reported 38,743 (2024) | 46.1% | not reported | not reported | 2024: 38,743 |
| UnitedHealthcare Dual Complete ONE (HMO SNP) | UnitedHealthcare | UnitedHealth | Atlantic, Bergen, Burlington, Camden, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Salem, Somerset, Sussex, and Union Counties | not reported | not reported | not reported | not reported | 2018: 19,158 |
| UnitedHealthcare Dual Complete ONE ONE (HMO D-SNP) | UnitedHealthcare Community Plan | UnitedHealth | Atlantic, Bergen, Burlington, Camden, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Salem, Somerset, Sussex, Union, and Warren Counties | not reported | not reported | not reported | not reported | 2020: 24,356 |
| UnitedHealthcare Dual Complete ONE (HMO D-SNP) | UnitedHealthcare Community Plan | UnitedHealth | Atlantic, Bergen, Burlington, Camden, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Salem, Somerset, Sussex, Union, Warren counties | not reported | not reported | not reported | not reported | 2021: 28,007 |
| UnitedHealthcare Dual Complete ONE (HMO SNP) | UnitedHealthcare Community Plan | UnitedHealth | Atlantic, Bergen, Burlington, Camden, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Salem, Somerset, Sussex, Union Counties | not reported | not reported | not reported | not reported | 2019: 22,993 |
| UnitedHealthcare Dual Complete ONE | Oxford Health Plans (NJ), Inc. | Oxford Health Plans (NJ), Inc. | All NJ Counties except Cape May | not reported | not reported | not reported | not reported | 2023: 43,114 |
| UnitedHealthcare Dual Complete ONE | UnitedHealthCare | UnitedHealth | Atlantic, Bergen, Burlington, Camden, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Somerset, Union counties | not reported | not reported | not reported | not reported | 2017: 13,101 |
| WellCare Liberty (HMO SNP) | WellCare | Centene | Bergen, Essex, Hudson, Middlesex, Morris, Passaic, Somerset, and Union Counties | not reported | not reported | not reported | not reported | 2018: 2,697 |
| WellCare Liberty D-SNP | WellCare | Centene | Bergen, Essex, Hudson, Middlesex, Morris, Passaic, Somerset, and Union counties | not reported | not reported | not reported | not reported | 2017: 1,359 |
| WellCare Liberty | WellCare Health Plans, Inc. | Centene | All NJ counties except for Hunterdon | not reported | not reported | not reported | not reported | 2022: 7,486 |
| Wellcare Dual Liberty | Wellcare Health Plans of New Jersey, Inc. | Centene | All NJ Counties except for Hunterdon | CMS reported 6,525 (2024) | 7.8% | -853 (-11.6%) | -0.4 pts | 2023: 7,378; 2024: 6,525 |
| Wellcare Liberty (HMO D-SNP) | WellCare Health Plans, Inc. | Centene | Atlantic, Bergen, Burlington, Camden, Cumberland, Essex, Hudson, Gloucester, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Somerset, and Union counties | not reported | not reported | not reported | not reported | 2021: 6,329 |
| Wellcare Liberty (HMO D-SNP) | WellCare Health Plans, Inc. | Centene | Atlantic, Bergen, Burlington, Camden, Essex, Hudson, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Somerset, and Union Counties | not reported | not reported | not reported | not reported | 2020: 5,239 |
| Wellcare Liberty (HMO SNP) | WellCare Health Plans, Inc. | Centene | Atlantic, Bergen, Camden, Essex, Hudson, Mercer, Middlesex, Morris, Passaic, Somerset, Union Counties | not reported | not reported | not reported | not reported | 2019: 3,836 |
| Wellpoint Full Dual Advantage | Wellpoint New Jersey, Inc. | Elevance | All New Jersey Counties except Hunterdon and Warren | CMS reported 12,376 (2024) | 14.7% | not reported | not reported | 2024: 12,376 |
NJ FamilyCare (Comprehensive MCO + MLTSS)
NJ FamilyCare (Comprehensive MCO + MLTSS) 14
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Aetna Better Health NJ | Aetna | CVS/Aetna | Atlantic, Bergen, Burlington, Camden, Cumberland, Essex, Gloucester, Hudson, Mercer, Middlesex, Morris, Passaic, Salem, Somerset, Sussex, Union counties | not reported | not reported | not reported | not reported | 2017: 34,632 |
| Aetna Better Health NJ | CVS Health | CVS/Aetna | Statewide | not reported | not reported | not reported | not reported | 2021: 110,717 |
| Aetna Better Health NJ | not reported | unmatched | Bergen, Camden, Essex, Hudson, Middlesex, Passaic, Somerset, Union | not reported | not reported | not reported | not reported | 2016: 25,920 |
| Amerigroup New Jersey Inc | Anthem | Elevance | Statewide | not reported | not reported | not reported | not reported | 2021: 218,039 |
| Amerigroup New Jersey | Anthem | Elevance | Statewide except Salem county | not reported | not reported | not reported | not reported | 2017: 179,997 |
show all 14
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Amerigroup New Jersey | not reported | unmatched | Statewide except Salem County | not reported | not reported | not reported | not reported | 2016: 189,014 |
| Amerivantage Dual Coordination | not reported | unmatched | Atlantic, Bergen, Burlington, Cumberland, Essex, Gloucester, Hudson, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Somerset and Union Counties | not reported | not reported | not reported | not reported | 2016: 7,965 |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Horizon Blue Cross Blue Shield of New Jersey | Statewide | not reported | not reported | not reported | not reported | 2016: 820,123; 2017: 818,099; 2021: 998,203 |
| UnitedHealthcare Community Plan | UnitedHealthcare | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2016: 447,928; 2017: 439,722; 2021: 335,219 |
| UnitedHealthcare Dual Complete ONE | not reported | unmatched | Atlantic, Bergen, Burlington, Essex, Hudson, Mercer, Monmouth, Morris, Ocean, Union counties | not reported | not reported | not reported | not reported | 2016: 7,879 |
| WellCare Liberty D-SNP | not reported | unmatched | Bergen, Essex, Hudson, Middlesex, Morris, Passaic, Somerset, and Union counties | not reported | not reported | not reported | not reported | 2016: 206 |
| WellCare of New Jersey | WellCare Health Plans, Inc. | Centene | All counties except Hunterdon | not reported | not reported | not reported | not reported | 2021: 94,053 |
| WellCare of New Jersey | WellCare | Centene | Bergen, Essex, Hudson, Mercer, Middlesex, Morris, Passaic, Somerset, Sussex and Union counties | not reported | not reported | not reported | not reported | 2017: 60,408 |
| WellCare of New Jersey | not reported | unmatched | Bergen, Essex, Hudson, Mercer, Middlesex, Morris, Passaic, Somerset, Sussex and Union Counties | not reported | not reported | not reported | not reported | 2016: 57,115 |
NJFamilyCare (Comprehensive MCO + MLTSS)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Aetna Better Health NJ | CVS Health | CVS/Aetna | Statewide | not reported | not reported | not reported | not reported | 2018: 48,256; 2019: 59,073; 2020: 86,756 |
| Amerigroup New Jersey Inc | Anthem | Elevance | Statewide | not reported | not reported | not reported | not reported | 2018: 165,413; 2019: 165,835; 2020: 189,876 |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Horizon Blue Cross Blue Shield of New Jersey | Statewide | not reported | not reported | not reported | not reported | 2018: 821,758; 2019: 777,236; 2020: 848,638 |
| UnitedHealthcare Community Plan | UnitedHealthcare | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2018: 431,556; 2019: 381,662; 2020: 326,892 |
| WellCare of New Jersey | WellCare Health Plans Inc. | Centene | All counties except Hunterdon | not reported | not reported | not reported | not reported | 2018: 63,437; 2019: 67,300; 2020: 82,086 |
New Jersey Family Care (Comprehensive MCO + MLTSS)
New Jersey Family Care (Comprehensive MCO + MLTSS) 10
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Aetna Better Health NJ | CVS Health | CVS/Aetna | All NJ Counties | CMS reported 93,872 (2024) | 6.4% | -39,220 (-29.5%) | -0.3 pts | 2023: 133,092; 2024: 93,872 |
| Aetna Better Health NJ | CVS Health | CVS/Aetna | Statewide | not reported | not reported | not reported | not reported | 2022: 125,263 |
| Amerigroup New Jersey, Inc. | Anthem | Elevance | All NJ Counties | CMS reported 167,805 (2024) | 11.4% | -64,207 (-27.7%) | -0.3 pts | 2023: 232,012; 2024: 167,805 |
| Amerigroup New Jersey, Inc. | Anthem | Elevance | Statewide | not reported | not reported | not reported | not reported | 2022: 243,127 |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Horizon Blue Cross Blue Shield of New Jersey | All NJ Counties | CMS reported 860,036 (2024) | 58.5% | -288,682 (-25.1%) | +0.4 pts | 2023: 1,148,718; 2024: 860,036 |
show all 10
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Horizon Blue Cross Blue Shield of New Jersey | Statewide | not reported | not reported | not reported | not reported | 2022: 1,092,830 |
| United Healthcare Community Plan | UnitedHealthcare | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2022: 383,031 |
| UnitedHealthcare Community Plan | UnitedHealthcare | UnitedHealth | All NJ Counties | CMS reported 275,064 (2024) | 18.7% | -86,296 (-23.9%) | +0.4 pts | 2023: 361,360; 2024: 275,064 |
| WellCare of New Jersey | WellCare Health Plans, Inc. | Centene | Statewide | not reported | not reported | not reported | not reported | 2022: 98,945 |
| Wellcare of New Jersey | Wellcare Health Plans, Inc. | Centene | All NJ Counties | CMS reported 74,456 (2024) | 5.1% | -28,962 (-28.0%) | -0.2 pts | 2023: 103,418; 2024: 74,456 |
Non- Emergency Medical Transportation (Non-Emergency Medical Transportation)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| ModivCare | The Providence Service Corp. | The Providence Service Corp. | Statewide | not reported | not reported | not reported | not reported | 2020: 1,587,896 |
Non-Emergency Medical Transporation (Non-Emergency Medical Transportation)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Logisticare | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 1,556,150 |
Non-Emergency Medical Transportation (NEMT)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| ModivCare | The Providence Service Corp. | The Providence Service Corp. | Statewide | not reported | not reported | not reported | not reported | 2022: 1,499,339 |
| Modivcare | The Providence Service Corp. | The Providence Service Corp. | All NJ Counties | CMS reported 1,556,565 (2024) | 100.0% | -513,932 (-24.8%) | 0.0 pts | 2023: 2,070,497; 2024: 1,556,565 |
Non-Emergency Medical Transportation (Non-Emergency Medical Transportation)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Logisticare | The Providence Service Corp. | The Providence Service Corp. | Statewide | not reported | not reported | not reported | not reported | 2017: 1,555,703; 2018: 1,561,266; 2019: 1,486,074 |
| ModivCare | The Providence Service Corp. | The Providence Service Corp. | Statewide | not reported | not reported | not reported | not reported | 2021: 1,820,183 |
PACE (PACE)
PACE (PACE) 7
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Atlanticare LIFE Connection | Atlantic Health System | Atlantic Health System | Atlantic and Cape May Counties | CMS reported 163 (2024) | 12.2% | +27 (+19.9%) | +1.6 pts | 2023: 136; 2024: 163 |
| Beacon of LIFE | BoldAge PACE, NJ | BoldAge PACE, NJ | Monmouth County, Ocean County, and select zip codes in Burlington County | CMS reported 419 (2024) | 31.3% | +75 (+21.8%) | +4.6 pts | 2023: 344; 2024: 419 |
| Capital Health LIFE | Capital Health | Capital Health | Mercer County and select zip codes in Burlington County | CMS reported 218 (2024) | 16.3% | -22 (-9.2%) | -2.4 pts | 2023: 240; 2024: 218 |
| Inspira LIFE - Vineland | Inspira Health Network LIFE, Inc. | Inspira Health Network LIFE, Inc. | Cumberland, Gloucester, and Salem Counties | CMS reported 272 (2024) | 20.3% | -21 (-7.2%) | -2.4 pts | 2023: 293; 2024: 272 |
| Inspira LIFE - Williamstown | Inspira Health Network LIFE, Inc. | Inspira Health Network LIFE, Inc. | Cumberland, Gloucester, and Salem Counties | CMS reported 0 (2024) | 0.0% | 0 | 0.0 pts | 2023: 0; 2024: 0 |
show all 7
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Lutheran Senior LIFE at Jersey City | Lutheran Social Ministries of NJ | Lutheran Social Ministries of NJ | Hudson County | CMS reported 95 (2024) | 7.1% | -10 (-9.5%) | -1.1 pts | 2023: 105; 2024: 95 |
| Trinity Health LIFE New Jersey | Trinity Health PACE | Trinity Health PACE | Camden County and select zip codes in Burlington County | CMS reported 173 (2024) | 12.9% | +2 (+1.2%) | -0.4 pts | 2023: 171; 2024: 173 |
PACE (Program of All-inclusive Care for the Elderly (PACE))
PACE (Program of All-inclusive Care for the Elderly (PACE)) 25
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| AtlantiCare Life Connection | A member of Geisinger | A member of Geisinger | Atlantic and Cape May County | not reported | not reported | not reported | not reported | 2017: 0 |
| AtlantiCare Life | AtlantiCare, a member of Geisinger Commonwealth School of Medicine | AtlantiCare, a member of Geisinger Commonwealth School of Medicine | Atlantic and Cape May counties | not reported | not reported | not reported | not reported | 2021: 92 |
| Atlanticare LIFE | AtlantiCare, a member of Geisinger Commonwealth School of Medicine | AtlantiCare, a member of Geisinger Commonwealth School of Medicine | Atlantic and Cape May Counties | not reported | not reported | not reported | not reported | 2018: 44; 2019: 92; 2020: 94 |
| Beacon of LIFE | AcuteCare Health System | AcuteCare Health System | Monmouth County | not reported | not reported | not reported | not reported | 2017: 72; 2018: 106; 2019: 115; 2020: 138 |
| Beacon of LIFE | AcuteCare Health System | AcuteCare Health System | Monmouth county | not reported | not reported | not reported | not reported | 2021: 181 |
show all 25
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Beacon of LIFE | not reported | unmatched | 07701, 07702, 07703, 07704. 07709, 07710, 07711, 07715, 07716, 07718, 07721, 07722, 07723, 07724, 07726, 07728, 07730, 07732, 07733, 07734, 07735, 07737, 07738, 07739, 07740, 07746, 07747, 07748, 07750, 07751, 07752, 07755, 07756, 07757, 07758, 07760, 07763, 07764, 07765, 07799, 08501, 08510, 08514, 08526, 08535, 08555, 08720 | not reported | not reported | not reported | not reported | 2016: 40 |
| Inspira LIFE | Inspira Health Network LIFE Inc. | Inspira Health Network LIFE, Inc. | 08028, 08062, 08071, 08094, 08098, 08302, 08311, 08312, 08314, 08316, 08318, 08321, 08322, 08323, 08324, 08327, 08328, 08329, 08332, 08343, 08344, 08345, 08348, 08349, 08352, 08353, 08360, 08361, 08362 | not reported | not reported | not reported | not reported | 2016: 225; 2017: 245; 2020: 268 |
| Inspira LIFE | Inspira Health Network LIFE Inc. | Inspira Health Network LIFE, Inc. | Portions of Cumberland, Gloucester and Salem Counties, specifically, residents of zip codes: 08028, 08062, 08071, 08094, 08098, 08302, 08311, 08312, 08314, 08316, 08318, 08321, 08322, 08323, 08324, 08327, 08328, 08329, 08332, 08343, 08344, 08345, 08348, 08349, 08352, 08353, 08360, 08361, 08362 | not reported | not reported | not reported | not reported | 2018: 268; 2019: 268 |
| Inspira LIFE | Inspira Health Network LIFE, Inc. | Inspira Health Network LIFE, Inc. | Portions of Cumberland, Gloucester and Salem counties, specifically, residents of zip codes: 08028, 08062, 08071, 08094, 08098, 08302, 08311, 08312, 08314, 08316, 08318, 08321, 08322, 08323, 08324, 08327, 08328, 08329, 08332, 08343, 08344, 08345, 08348, 08349, 08352, 08353, 08360, 08361, 08362 | not reported | not reported | not reported | not reported | 2021: 274 |
| LIFE (Living Independently For Elders) St. Francis | not reported | unmatched | 08015, 08016, 08022, 08060, 08068, 08505, 08512, 08515, 08518, 08520, 08525, 08530, 08534, 08540, 08541, 08542, 08543, 08544, 08550, 08554, 08560, 08561, 08601, 08602, 08603, 08604, 08605, 08606, 08607, 08608, 08609, 08610, 08611, 08618, 08619, 08620, 08625, 08628, 08629, 08638, 08645, 08646, 08647, 08648, 08650, 08666, 08690, 08691, 08695 | not reported | not reported | not reported | not reported | 2016: 310 |
| LIFE St. Francis | PACE | unmatched | Mercer County and those who reside in Burlington County with one of the following zip codes: 08015, 08016, 08022, 08060, 08068, 08505, 08515, 08518, 08554 | not reported | not reported | not reported | not reported | 2018: 317 |
| LIFE St. Francis | St. Francis Medical Center, Member of Trinity Health | St. Francis Medical Center, Member of Trinity Health | 08015, 08016, 08022, 08060, 08068, 08505, 08515, 08518, 08554 | not reported | not reported | not reported | not reported | 2020: 316 |
| LIFE St. Francis | St. Francis Medical Center, Member of Trinity Health | St. Francis Medical Center, Member of Trinity Health | All of Mercer County and those who reside in Burlington County with one of the following zip codes: 08015, 08016, 08022, 08060, 08068, 08505, 08515, 08518, 08554 | not reported | not reported | not reported | not reported | 2019: 342 |
| LIFE St. Francis | St. Francis Medical Center, Member of Trinity Health | St. Francis Medical Center, Member of Trinity Health | All of Mercer county and those who reside in Burlington county with one of the following zip codes: 08015, 08016, 08022, 08060, 08068, 08505, 08515, 08518, 08554 | not reported | not reported | not reported | not reported | 2021: 286 |
| LIFE St. Francis | Trinity Health | Trinity Health | 08015, 08016, 08022, 08060, 08068, 08505, 08512, 08515, 08518, 08520, 08525, 08530, 08534, 08540, 08541, 08542, 08543, 08544, 08550, 08554, 08560, 08561, 08601, 08602, 08603, 08604, 08605, 08606, 08607, 08608, 08609, 08610, 08611, 08618, 08619, 08620, 08625, 08628, 08629, 08638, 08645, 08646, 08647, 08648, 08650, 08666, 08690, 08691, 08695 | not reported | not reported | not reported | not reported | 2017: 309 |
| LIFE at Lourdes | Lourdes Health System | Lourdes Health System | 08002, 08003, 08004, 08007, 08009, 08012, 08021, 08026, 08029, 08030, 08031, 08033, 08034, 08035, 08043, 08045, 08049, 08059, 08078, 08081, 08083, 08084, 08091, 08095, 08099, 08101, 08102, 08103, 08104, 08105, 08106, 08107, 08108, 08109, 08110 | not reported | not reported | not reported | not reported | 2016: 229; 2017: 218 |
| LIFE at Lourdes | PACE | unmatched | Most of Camden County, some of Burlington County, and zip codes: 08002, 08003, 08004, 08007, 08009, 08012, 08021, 08026, 08029, 08030, 08031, 08033, 08034, 08035, 08043, 08045, 08049, 08052, 08059, 08065, 08076, 08077, 08078, 08081, 08083, 08084, 08091, 08095, 08099, 08101, 08102, 08103, 08104, 08105, 08106, 08107, 08108, 08109, 08110 | not reported | not reported | not reported | not reported | 2018: 199 |
| Lutheran Senior LIFE of Jersey City | Lutheran Social Ministers of NJ | Lutheran Social Ministers of NJ | 07002, 07030, 07047, 07086, 07087, 07093, 07094, 07302, 07304, 07305, 07306, 07307, 07310, 07311 | not reported | not reported | not reported | not reported | 2017: 128 |
| Lutheran Senior LIFE | not reported | unmatched | 07002, 07030, 07047, 07086, 07087, 07093, 07094, 07302, 07304, 07305, 07306, 07307, 07310, 07311 | not reported | not reported | not reported | not reported | 2016: 127 |
| Lutheran Senior Life | Lutheran Social Ministries of NJ | Lutheran Social Ministries of NJ | 07002, 07030, 07047, 07086, 07087, 07093, 07094, 07302, 07304, 07305, 07306, 07307, 07310, 07311 | not reported | not reported | not reported | not reported | 2020: 123 |
| Lutheran Senior Life | Lutheran Social Ministries of NJ | Lutheran Social Ministries of NJ | Most of Hudson County, including residents of zip codes: 07002, 07030, 07047, 07086, 07087, 07093, 07094, 07302, 07304, 07305, 07306, 07307, 07310, 07311 | not reported | not reported | not reported | not reported | 2018: 133; 2019: 120 |
| Lutheran Senior Life | Lutheran Social Ministries of NJ | Lutheran Social Ministries of NJ | Most of Hudson county, including residents of zip codes: 07002, 07030, 07047, 07086, 07087, 07093, 07094, 07302, 07304, 07305, 07306, 07307, 07310, 07311 | not reported | not reported | not reported | not reported | 2021: 124 |
| Trinity Health LIFE NJ | Virtua Health System | Virtua Health System | 08002, 08003, 08004, 08007, 08009, 08012, 08021, 08026, 08029, 08030, 08031, 08033, 08034, 08035, 08043, 08045, 08049, 08052, 08059, 08065, 08076, 08077, 08078, 08081, 08083, 08084, 08091, 08095, 08099, 08101, 08102, 08103, 08104, 08105, 08106, 08107, 08108, 08109, 08110 | not reported | not reported | not reported | not reported | 2020: 201 |
| Trinity Health LIFE NJ | Virtua Health System | Virtua Health System | Most of Camden county, some of Burlington county. Zip codes: 08002, 08003, 08004, 08007, 08009, 08012, 08021, 08026, 08029, 08030, 08031, 08033, 08034, 08035, 08043, 08045, 08049, 08052, 08059, 08065, 08076, 08077, 08078, 08081, 08083, 08084, 08091, 08095, 08099, 08101, 08102, 08103, 08104, 08105, 08106, 08107, 08108, 08109, 08110 | not reported | not reported | not reported | not reported | 2019: 215 |
| Trinity Health LIFE NJ | Virtua Health System | Virtua Health System | Most of Camden county, some of Burlington county. Zip codes: 08002, 08003, 08004, 08007, 08009, 08012, 08021, 08026, 08029, 08030, 08031, 08033, 08034, 08035, 08043, 08045, 08049, 08052, 08059, 08065, 08076, 08077, 08078, 08081, 08083, 08084, 08091, 08095, 08099, 08101, 08102, 08103, 08104, 08105, 08106, 08107, 08108, 08109, 08110 | not reported | not reported | not reported | not reported | 2021: 181 |
Program of All-Inclusive Care for the Elderly (PACE)
Program of All-Inclusive Care for the Elderly (PACE) 6
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| AtlantiCare Life | AtlantiCare, a member of Geisinger Commonwealth School of Medicine | AtlantiCare, a member of Geisinger Commonwealth School of Medicine | Atlantic and Cape May Counties | not reported | not reported | not reported | not reported | 2022: 92 |
| Beacon of Life | AcuteCare Health System | AcuteCare Health System | Monmouth County | not reported | not reported | not reported | not reported | 2022: 115 |
| Inspira Life | Inspira Health Network LIFE, Inc. | Inspira Health Network LIFE, Inc. | Cumberland, Gloucester, and Salem Counties | not reported | not reported | not reported | not reported | 2022: 268 |
| Life St. Francis | St. Francis Medical Center, Member of Trinity Health | St. Francis Medical Center, Member of Trinity Health | Mercer County and select zip codes of Burlington County | not reported | not reported | not reported | not reported | 2022: 342 |
| Lutheran Senior Life | Lutheran Social Ministries of NJ | Lutheran Social Ministries of NJ | Hudson County | not reported | not reported | not reported | not reported | 2022: 120 |
show all 6
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Trinity Health Life New Jersey | Virtua Health System | Virtua Health System | Camden County and select zip codes of Burlington County | not reported | not reported | not reported | not reported | 2022: 215 |
Plan operations (CMS MCPAR)
Counts, rates, dates, and status are the CMS MCPAR cells for that plan, program, and reporting year. The appeal rate is calculated from CMS reported appeals resolved in favor of the enrollee divided by CMS reported appeals resolved. It is not a CMS-published rate. A plan links when the name matches one enrollment plan in that same state and program. Unmatched is shown and is not guessed. A sanction amount is not on this page. Retrieved 2026-11-02. CMS MCPAR.
National plan operations · Federal compliance deadlines
Appeals, grievances, and enrollment share (2024)
Appeals, grievances, and enrollment share (2024) 10
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| Aetna Better Health of New Jersey | CVS/Aetna | New Jersey FamilyCare Core Medicaid Acute Care 12/27/2024 | 2,588 | 650 | 25.1% calculated | 1,504 | 5.9% | 6.2% |
| Fidelis Care | unmatched | New Jersey FamilyCare Core Medicaid Acute Care 12/27/2024 | 1,501 | 734 | 48.9% calculated | 197 | 4.2% | 4.4% |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | New Jersey FamilyCare Core Medicaid Acute Care 12/27/2024 | 4,990 | 1,095 | 21.9% calculated | 4,416 | 53.3% | 55.7% |
| UnitedHealthcare Community Plan | UnitedHealth | New Jersey FamilyCare Core Medicaid Acute Care 12/27/2024 | 4,450 | 1,212 | 27.2% calculated | 976 | 18.2% | 19.1% |
| Wellpoint | Elevance | New Jersey FamilyCare Core Medicaid Acute Care 12/27/2024 | 1,787 | 414 | 23.2% calculated | 1,187 | 10.9% | 11.4% |
show all 10
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| Aetna Better Health of New Jersey | CVS/Aetna | New Jersey FamilyCare MLTSS 12/27/2024 | 142 | 27 | 19.0% calculated | 150 | 0.3% | 0.3% |
| Fidelis Care | unmatched | New Jersey FamilyCare MLTSS 12/27/2024 | 310 | 149 | 48.1% calculated | 39 | 0.6% | 0.7% |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | New Jersey FamilyCare MLTSS 12/27/2024 | 360 | 47 | 13.1% calculated | 347 | 1.1% | 1.1% |
| UnitedHealthcare Community Plan | UnitedHealth | New Jersey FamilyCare MLTSS 12/27/2024 | 314 | 46 | 14.6% calculated | 66 | 0.6% | 0.7% |
| Wellpoint | Elevance | New Jersey FamilyCare MLTSS 12/27/2024 | 135 | 29 | 21.5% calculated | 129 | 0.5% | 0.5% |
Sanctions (2024)
Sanctions (2024) 52
| Plan | Parent | Topic | Date | Corrective action plan | Remediation status |
|---|---|---|---|---|---|
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement (N/A) | 2022-01-20 | Yes | Remediation in progress |
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement | 2023-11-16 | Yes | Yes, remediated |
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement | 2023-12-01 | No | Yes, remediated |
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement | 2024-04-19 | Yes | Remediation in progress |
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement | 2024-02-14 | Yes | Yes, remediated |
show all 52
| Plan | Parent | Topic | Date | Corrective action plan | Remediation status |
|---|---|---|---|---|---|
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement | 2022-09-01 | Yes | Remediation in progress |
| Fidelis Care | unmatched | Performance improvement | 2023-11-16 | Yes | Yes, remediated |
| Fidelis Care | unmatched | Performance improvement | 2023-12-01 | No | Yes, remediated |
| Fidelis Care | unmatched | Performance improvement | 2024-04-19 | Yes | Remediation in progress |
| Fidelis Care | unmatched | Performance improvement (N/A) | 2022-05-09 | Yes | Remediation in progress |
| Fidelis Care | unmatched | Performance improvement | 2024-02-14 | Yes | Yes, remediated |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Performance improvement | 2022-12-01 | Yes | Yes, remediated |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Performance improvement | 2023-11-16 | Yes | Yes, remediated |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Reporting | 2024-10-01 | No | Remediation in progress |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Performance improvement | 2023-12-01 | No | Yes, remediated |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Performance improvement | 2024-04-19 | Yes | Remediation in progress |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Performance improvement | 2024-02-14 | Yes | Yes, remediated |
| UnitedHealthcare Community Plan | UnitedHealth | Performance improvement | 2023-11-16 | Yes | Yes, remediated |
| UnitedHealthcare Community Plan | UnitedHealth | Performance improvement (N/A) | 2023-12-01 | No | Yes, remediated |
| UnitedHealthcare Community Plan | UnitedHealth | Performance improvement | 2024-04-19 | Yes | Remediation in progress |
| UnitedHealthcare Community Plan | UnitedHealth | Performance improvement | 2024-02-14 | Yes | Yes, remediated |
| Wellpoint | Elevance | Performance improvement | 2023-11-16 | Yes | Yes, remediated |
| Wellpoint | Elevance | Performance improvement | 2023-12-01 | No | Yes, remediated |
| Wellpoint | Elevance | Performance improvement (N/A) | 2022-01-18 | Yes | Remediation in progress |
| Wellpoint | Elevance | Performance improvement | 2024-04-19 | Yes | Remediation in progress |
| Wellpoint | Elevance | Performance improvement | 2024-02-14 | Yes | Yes, remediated |
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement (N/A) | 2022-01-20 | Yes | Remediation in progress |
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement | 2023-11-16 | Yes | Yes, remediated |
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement | 2023-12-01 | No | Yes, remediated |
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement | 2024-04-19 | Yes | Remediation in progress |
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement | 2024-02-14 | Yes | Yes, remediated |
| Aetna Better Health of New Jersey | CVS/Aetna | Performance improvement | 2022-09-01 | Yes | Remediation in progress |
| Fidelis Care | unmatched | Performance improvement | 2023-11-16 | Yes | Yes, remediated |
| Fidelis Care | unmatched | Performance improvement | 2023-12-01 | No | Yes, remediated |
| Fidelis Care | unmatched | Performance improvement | 2024-04-19 | Yes | Remediation in progress |
| Fidelis Care | unmatched | Performance improvement (N/A) | 2022-05-09 | Yes | Remediation in progress |
| Fidelis Care | unmatched | Performance improvement | 2024-02-14 | Yes | Yes, remediated |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Performance improvement | 2022-12-01 | Yes | Yes, remediated |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Performance improvement | 2023-11-16 | Yes | Yes, remediated |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Reporting | 2024-10-01 | No | Remediation in progress |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Performance improvement | 2023-12-01 | No | Yes, remediated |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Performance improvement | 2024-04-19 | Yes | Remediation in progress |
| Horizon NJ Health | Horizon Blue Cross Blue Shield of New Jersey | Performance improvement | 2024-02-14 | Yes | Yes, remediated |
| UnitedHealthcare Community Plan | UnitedHealth | Performance improvement | 2023-11-16 | Yes | Yes, remediated |
| UnitedHealthcare Community Plan | UnitedHealth | Performance improvement | 2023-12-01 | No | Yes, remediated |
| UnitedHealthcare Community Plan | UnitedHealth | Performance improvement | 2024-04-19 | Yes | Remediation in progress |
| UnitedHealthcare Community Plan | UnitedHealth | Performance improvement | 2024-02-14 | Yes | Yes, remediated |
| Wellpoint | Elevance | Performance improvement | 2023-11-16 | Yes | Yes, remediated |
| Wellpoint | Elevance | Performance improvement | 2023-12-01 | No | Yes, remediated |
| Wellpoint | Elevance | Performance improvement (N/A) | 2022-01-18 | Yes | Remediation in progress |
| Wellpoint | Elevance | Performance improvement | 2024-04-19 | Yes | Remediation in progress |
| Wellpoint | Elevance | Performance improvement | 2024-02-14 | Yes | Yes, remediated |
Award history
not published by state. No official award, score, or protest was retrieved for this state on 2026-11-03. Award history
Early procurement signals
No official early-procurement document has been retrieved for this state. This is not a finding that no signal exists. Early signals
Contract amendments
No official Medicaid managed-care contract amendment has been retrieved for this state. This is not a finding that no amendment exists. Contract amendments
Medicaid policy
Indiana rows are official policy instruments. Other states show only Federal Register notices of hearings on SPA disapprovals, which are a narrow slice and not waiver or SPA coverage.
Federal Register notices of hearings on SPA disapprovals are read from the Federal Register JSON API. That covers no approved SPAs, waivers, or section 1115 demonstrations.
Coverage not_collected.
No official Medicaid managed-care policy instrument has been retrieved for this state. This is not a finding that no waiver, state plan amendment, or rule exists. Medicaid policy
Federal Register SPA disapproval hearing notices (2015 or later): 0
Plan financials
No official Medicaid plan financial filing has been retrieved for this state. This is not a finding that no filing exists, and it is not a zero. Plan financials. Coverage: not_collected.
Federal compliance deadlines
Cited federal Medicaid managed care deadlines, with the Federal Register citation, the effective date, the compliance date, and the plan obligation.