NJ FamilyCare Detox & Rehab: How to Get In

What NJ FamilyCare covers

• Medical detox, ambulatory and inpatient (ASAM withdrawal management levels)
• Residential treatment at ASAM levels 3.1, 3.5, and 3.7
• Partial hospitalization, intensive outpatient, and standard outpatient
• Buprenorphine, methadone, and naltrexone; prior authorization for opioid use disorder medication was dropped on April 1, 2019, though brand-name and injectable forms may still need approval
• Certified peer recovery specialist support
• Non-emergency medical transportation to treatment, booked through the state's broker

Adults enrolled in Plan A or the Alternative Benefit Plan owe no cost-sharing for any of it. Plan C exempts substance use disorder treatment from cost-sharing, and Plan D charges copays for some services, so confirm which plan you are in. For most adult members, that changes the math for families who have been told that treatment is out of reach.

The five managed care plans

Most NJ FamilyCare members are enrolled in one of five managed care organizations: Horizon NJ Health, Aetna Better Health of New Jersey, Wellpoint (formerly Amerigroup), UnitedHealthcare Community Plan, and Fidelis Care (formerly WellCare). All five must cover the same substance use benefits, and all five contract with the state's licensed programs, but their networks are not identical and their care managers are not equally responsive. If your plan has no in-network program for a service it covers, the plan is responsible for finding one, and pushing on that point works. Members can also switch plans during open enrollment or for cause.

Your NJ FamilyCare plan now handles outpatient treatment

Since January 1, 2025, your NJ FamilyCare plan manages most outpatient behavioral health care itself, including substance use counseling, intensive outpatient, partial care and ambulatory (outpatient) detox. Before that, those services were billed to the state directly and the plan was not involved. That makes the plan’s member services line a real door into treatment. These are the numbers each plan publishes for its New Jersey Medicaid members (TTY 711 for all). They are plan contacts, not emergency lines: for a medical emergency or overdose, call 911; for a suicide or mental health crisis, call or text 988.

Every plan will also assign a care manager if you ask, and the care manager can help find a program, including one the plan does not pay for directly.

The split: your plan for outpatient, the IME for residential

The state is moving behavioral health into the health plans in phases, and the residential phase has been pushed to January 2027. Until then, approval is split. Care the plans do not manage yet is paid by the state directly, which Medicaid calls fee-for-service. For most members (Plan A, the Alternative Benefit Plan, and Plans B, C and D), it works like this:

Members enrolled through the Division of Developmental Disabilities, Managed Long Term Services and Supports (MLTSS), or a fully integrated dual-eligible plan (FIDE SNP, a plan for people with both Medicare and Medicaid) are the exception: their health plan covers residential detox, residential treatment and opioid treatment too, so they start with the plan. If you are not sure which group you are in, the plan can tell you in one call.

In practice, your program does the authorization paperwork, not you. What you control is the first call: the plan for outpatient care, the IME for a residential bed. If you call the wrong one, ask for help anyway: your plan’s care manager can help you find a fee-for-service residential program. If your plan cannot sort out a behavioral health problem, the state’s behavioral health integration team takes member calls at 609-281-8028.

Where to start the call

For a NJ FamilyCare member or an uninsured resident who needs residential detox or residential treatment, the number is the state’s IME Addictions Access Center, 1-844-276-2777, open 24/7. It is the entity that assesses you, authorizes residential detox and rehab for most members, and refers you to a Medicaid or state-funded program. For outpatient care, including outpatient detox, call your health plan. ReachNJ (1-844-732-2465) is the general statewide referral line. Periscope Behavioral Health at (888) 313-3583 is our publisher’s admissions call center; a care navigator there can help you confirm coverage and find a licensed program, but only the IME can award a state-funded slot. If you are not sure which plan you have, or whether you are enrolled at all, start with the IME.

Getting enrolled fast

Adults with income up to 138 percent of the federal poverty level qualify if they meet the program's citizenship and immigration rules, which tightened for some non-citizens on October 1, 2026. Apply at njfamilycare.org, by phone at 1-800-701-0710, or at any county Board of Social Services. Approval normally takes weeks, but treatment does not have to wait for it. Hospitals and licensed treatment programs that the state has approved for it can grant presumptive eligibility, short-term coverage that starts while the full application is processed. Ask the program whether it can. Starting January 1, 2027, some adults ages 19 to 64 on the Alternative Benefit Plan must work, volunteer, or attend school to keep coverage, and must renew every six months. The state lists who is exempt; anyone in treatment for a substance use disorder should ask whether an exemption applies.

How placement works in practice

Detox first if you need it. A program or the IME assesses you against ASAM criteria, decides the level, and helps find a bed. Detox beds for Medicaid members exist across the state but concentrate in hospital systems and the larger nonprofit programs; in rural counties, placement often means traveling to Camden, Atlantic, or Middlesex County. From detox, the step to residential or PHP should be arranged before discharge, and the program is expected to do it. If you leave detox with nothing scheduled, call the IME yourself at 1-844-276-2777.

Medication

NJ FamilyCare covers buprenorphine, methadone, and naltrexone. On April 1, 2019, it stopped requiring prior authorization for opioid use disorder medication; prescribers interviewed in 2021 and 2022 said brand-name and injectable forms, and some dose increases, could still need approval. Methadone at opioid treatment programs is covered without a daily copay. Any prescriber can write buprenorphine, and NJ FamilyCare covers the visit whether it is a community health center, a hospital clinic, or telehealth. Our MAT guide covers same-week starts.

Transportation and peer support

Members can book rides to treatment through the state's non-emergency medical transportation broker, usually with a few days' notice. It is imperfect and worth using anyway, because transportation is the reason a great many people miss IOP. Certified peer recovery specialists are a covered benefit, and hospital emergency departments across the state have peers on site through the Opioid Overdose Recovery Program. Ask for one.

Common problems

"No beds" usually means no beds in that plan's network at that moment, not none in the state; call the IME at 1-844-276-2777. "You're not eligible" from a program's front desk often means they did not check presumptive eligibility; ask them to. A missed renewal form is a common way people lose coverage mid-treatment, and from 2027 some adults must renew every six months; watch for the renewal notice and return it. If you are between coverage, the IME's state-funded slots still exist.

Where to go

Our location guides name the programs that serve Medicaid populations in each region. The Hammonton medical detox will publish its NJ FamilyCare participation when it opens.

Plans covered on this page

• Horizon NJ Health
• Aetna Better Health
• Wellpoint
• UnitedHealthcare Community Plan
• Fidelis Care

This page is educational. Benefits and prior-authorization rules change; always verify with your plan’s member services line above.