All PlansAdministrativeMedium impact
Newsletter Vol. 35, No.13
New Jersey Medicaid·NJ·Pharmacy
Effective date
Dec 1, 2025
We identified it
Jun 20, 2026
Summary
New Jersey's ADDP/HIPP program now covers medical copayments, deductibles, and out-of-pocket costs for HIV patients at 500% or below poverty line. Providers must bill patient's primary insurance first, then submit remaining patient costs to American Exchange for direct reimbursement instead of charging patients.
Action Required
Immediately: For patients enrolled in NJ ADDP/HIPP program - (1) Bill primary insurance first as usual, (2) Submit invoices for patient copays/deductibles to American Exchange at https://americanexchange.com/clients/new-jersey-upload/ with detailed breakdown including service date, description, provider name, billed amount, insurance adjustment, plan payment, and copay amount, (3) Do not charge patients directly for outpatient services, (4) Call 1-800-353-3232 to verify patient eligibility. Applies to outpatient services only.