Overview

All women presenting for prenatal services should be asked for the insurance information. If she does not have commercially available insurance, the NJ FamilyCare/Medicaid Member Verification System (MVS – on line [EMVS] ) should be checked. If the woman does not have any evidence of any type of coverage, she should be sent, while on site, to the presumptive eligibility (PE) worker on site (at a hospital or an FQHC).The Presumptive Eligibility Worker would then complete a PE application and provide the woman with the “Important Information Letter” and a copy of documents which most likely would be requested later by the County Board of Social Services in order to establish full Medicaid eligibility.If there is no presumptive eligibility worker on site, any provider may distribute a copy of the NJ Medicaid/Family Care Application (or the web site address; http://www.njfamilycare.com).In the meantime, there is a program, being piloted in Salem County, that allows outstation worker to access the County file, in real time, process the information, and verify that she examined whatever paperwork is required; this relieves the woman from going to the County Board of Social Services, the application is filled out, on the spot, and an HMO selection is made at the time of application.