Medicaid plans › New Jersey
New Jersey Medicaid Managed-Care Plans for Providers
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
NJ FamilyCare is run by the New Jersey Division of Medical Assistance and Health Services. 1,555,225 people were enrolled in its 5 managed-care plans in 2024. To see their patients, a provider enrolls with NJ FamilyCare through NJMMIS (Gainwell), then applies to each plan separately.
| Plan | Members (2024) | Share | Parent |
|---|---|---|---|
| Horizon NJ Health | 879,632 | 56.6% | In-state |
| UnitedHealthcare Community Plan | 313,807 | 20.2% | UnitedHealth Group |
| Wellpoint | 180,181 | 11.6% | Elevance Health |
| Aetna Better Health NJ | 100,624 | 6.5% | CVS Health |
| Fidelis Care/Wellcare | 80,981 | 5.2% | Centene |
How Joining Works in New Jersey
First the state: NJ FamilyCare enrollment through NJMMIS (Gainwell), which gives you the Medicaid ID every plan asks for. Then the plans: each takes its own participation request and credentials you from your CAQH ProView (DataSpring) profile. 4 parent companies run plans here, and plans owned by the same company still contract state by state.
How to Join Each New Jersey Plan
UnitedHealthcare Community Plan (UnitedHealth Group): UnitedHealthcare Community Plans use UnitedHealthcare's provider onboarding: a participation request on the UnitedHealthcare provider site, credentialing from your CAQH ProView (DataSpring) profile, then a state-specific Community Plan agreement.
Wellpoint (Elevance Health): Elevance Health plans take participation requests through the plan's provider site for that state, most of them now inside Availity Essentials, and credential from your CAQH ProView (DataSpring) profile. Each state is its own contract.
Aetna Better Health NJ (CVS Health): Aetna Better Health plans each have a state-specific "Join our network" request on aetnabetterhealth.com. They are separate from Aetna's commercial network, so an Aetna commercial contract does not carry over.
Fidelis Care/Wellcare (Centene): Centene runs this plan alongside its Ambetter and Wellcare products. Each Centene plan takes its own contract request on the plan's provider website, credentials from your CAQH ProView (DataSpring) profile, and will not load a provider without the state Medicaid ID.
Horizon NJ Health: This plan is run in-state rather than by a national carrier, so participation requests go to the plan's own provider relations or contracting team, listed on its provider website.
Also in New Jersey: Medicare, NJ FamilyCare and commercial credentialing.
Questions
Which New Jersey Medicaid plan is the largest?
Horizon NJ Health, with 879,632 members in 2024, 56.6% of the 1,555,225 people enrolled in New Jersey's Medicaid managed-care plans.
Do I have to join every New Jersey Medicaid plan?
No. Each plan is a separate contract. Practices usually start with the two or three largest plans in their county, then add others as patients ask for them. All of them require NJ FamilyCare enrollment first.
Membership from KFF, Medicaid MCO Enrollment by Plan and Parent Firm, 2024. Plans change when the state rebids its contracts; we confirm the current list on every file.