Go to ER or call 911 immediately for: severe chest/abdominal pain, uncontrollable bleeding, difficulty breathing, sudden vision changes, suicidal thoughts.

Occurs when using out-of-network providers unknowingly. Avoid by: checking benefit design and reviewing out-of-network protection forms before non-emergency care.

3. Understanding Medical Bill Terms

Allowed Amount: Max insurer pays. Deductible: Annual amount you pay before benefits. Co-pay: Fixed fee per service. Co-insurance: % you pay after insurer pays.

Do not pay immediately. Compare Bill “Charge” with EOB “Billed Amount”. EOB “Your Responsibility” should match Bill Balance.

NJ FamilyCare (Medicaid) application assistance available. Eligible for Charity Care or sliding scale fees at FQHC/BVMI.

Maximum Out-of-Pocket: The cap on what you pay in a year. Once reached, insurer pays 100% of remaining costs.

Referral: Permission to see a specialist. Pre-authorization: Insurer approval before expensive procedures (MRI, surgery).

Online portal to check records (results, vaccines), manage appointments, message providers, and pay bills.

Yes. Access available to Charity Care or FQHC regardless of status. Confidentiality guaranteed.

Yes. Free screening for breast, cervical, colorectal, and prostate cancer for eligible individuals via NJCEED.

Yes. Connection to partner agencies like Esther Ha Foundation and Care Plus NJ for counseling and support.