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  • Atlanticare Financial Application Form 2015

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Charity Care Income Criteria and Required Information Valid Identification. Driver's License – Valid (unexpired) State/County ID. Social Security card. ... Proof of New Jersey Residency for Date(s) of Service. Utility bill for date of service. Valid (unexpired) driver's license with current address. ... Income Information.

NJ Charity Care is free or reduced charge care which is provided to patients who receive inpatient and outpatient services at acute care hospitals throughout the state of New Jersey. Charity Care is available only for emergent or medically necessary hospital care.

Charity Care is not health insurance; however subject to program eligibility, free or reduced charge care is available to patients, which can help cover the cost of hospital bills and reduce out-of-pocket patient expenses.

Please call 609-272-2500 to see if you qualify to have your patient liability reduced.

Citizenship is not technically required for patients to be counted towards a hospital's charity-care tab, as long as they can prove they live in New Jersey.

Get Covered NJ It's one less thing for you to worry about. You may qualify for financial help to lower the cost of your plan. In New Jersey, a family of four with an annual income of up to about $100,400 and an individual earning up to about $48,560 a year can qualify.

AtlantiCare is an integrated healthcare system based in Egg Harbor Township, New Jersey, whose more than 6,000 staff, providers and volunteers serve the community in more than 100 locations in Atlantic, Burlington, Camden, Cape May and Ocean counties of southern New Jersey.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232