Getting help in New Jersey.

New Jersey has the strongest addiction treatment insurance law in the United States. Most people who live here have no idea it exists, and there is one catch that decides whether it applies to you at all.

Numbers that work right now

• ReachNJ, 1-844-732-2465. The state's 24/7 addiction helpline. New Jersey says it connects callers regardless of insurance or ability to pay, and that a live person answers within the first 30 seconds.
• IME Addictions Access Center, 1-844-276-2777. This is the one worth knowing. It is the state's actual clinical intake line for Medicaid and uninsured residents, run for the state by Rutgers, 24/7. It screens you and hands you off to a program, warm handoff where possible. ReachNJ is the front door. This is the engine behind it.
• NJ Connect for Recovery, 1-855-652-3737. Free and confidential support line, 8am to 8pm weekdays, 10am to 4pm weekends.
• 988 if you are in crisis right now.

Coverage

New Jersey's Medicaid program is called NJ FamilyCare. New Jersey expanded Medicaid in 2014, so eligibility is broader than a lot of people assume. Substance use treatment is covered. Enrollment is 1-800-701-0710. Substance use treatment providers can enroll you on the spot through presumptive eligibility, which means you do not always have to sort out coverage before you get in the door.

The thing almost nobody tells you

Before you rely on any of the protections below, ask your HR department one question: is our health plan fully insured, or self funded? Write the answer down.

Here is why it matters. State insurance laws only reach plans the state regulates. If your employer self funds its plan, which most large employers do, the plan is governed by federal ERISA law instead and the state rules simply do not apply to you. New York's own Department of Financial Services says it flatly: if your employer self funds, "New York protections don't apply."

Your insurance card will usually look identical either way, because a normal insurance company often administers the plan. The card does not tell you. HR does.

New Jersey's law, if you have a fully insured plan

In 2017 New Jersey passed what is still the most aggressive substance use coverage mandate in the country. If your plan is fully insured in New Jersey, or you are on the State Health Benefits Program or the School Employees' Health Benefits Program, it gives you:

• 180 days per plan year of in-network inpatient and outpatient substance use treatment with no prior authorization, when your own physician, psychologist or psychiatrist says it is medically necessary.
• The first 28 days of an inpatient stay each year with no review at all. Not prospective, not concurrent, not retrospective. Medical necessity is whatever your treating physician says it is. The insurer cannot start reviewing until day 29.
• Outpatient visits inside those 180 days with no concurrent or retrospective review.
• Substance use prescriptions with no prior authorization.
• Coverage continues through appeals. If they deny you, your stay stays covered until the day after every appeal is exhausted, even if you ultimately lose.

Read that again if you have ever been told a stay was being cut short. If you are on a fully insured New Jersey plan and someone tells you an insurer is reviewing your medical necessity on day nine of an inpatient stay, that is worth challenging.

Finding a program

• NJSAMS Treatment Directory at njsams.rutgers.edu, the state's searchable directory of licensed programs.
• Treatment ATLAS at treatmentatlas.org, built by the nonprofit Shatterproof with New Jersey Human Services. It compares programs on services, insurance accepted, and whether they actually use evidence based practices.
• Free naloxone, anonymously, at participating pharmacies through StopOverdoses.nj.gov, age 14 and up.

And then

All of that gets you in a door. What happens after is the part that decides how your life goes, and it is what we are here for. Message us and a real person who has been where you are will get back to you. We are not paid by anyone and we have nothing to sell.