Medical
PLANS
Aetna Patriot V Plan
The Patriot V QPOS Plan offered by the Fund provides you with in-network (referred) services coordinated by your participating Primary Care Physician (PCP). The Plan offers participants the options of going directly to out-of-network (self-referred) providers or facilities without a referral.
When you self-refer, you will be subject to the applicable self-referred deductible and coinsurance benefits levels and maximums.
The Patriot V Plan covers routine Wellness and Preventive Care provided by your PCP.
You may also obtain pediatric dental services and gynecological exams from participating providers without a referral from your PCP. If you choose to access care without a referral, you must obtain authorization prior to receiving self-referred care for certain services. Failure to precertify may result in a reduction of benefits
*Links to external websites are provided for your convenience only. The North Jersey Municipal Employee Benefit Fund is not responsible or liable for the content, accuracy or privacy practices of linked sites, or for services described on those sites.
Networks
Medicare
DELTA DENTAL
Delta Dental Plaza
1639 Route 10
Parsippany, NJ 07054
Delta Dental's Benefits Connection is a free 24 hour service allowing subscribers and their dentists to obtain instant, detailed information about their specific Delta Dental benefits online.
Prescriptions
