• Caring Partners of Morris/Sussex, Inc.
    200 Valley Road Suite 406, Mount Arlington, NJ 07856
    Phone: 973-770-5505 Fax: 973-770-5557
    The website/browser asks for your location which is voluntary. Caring Partners uses location information only for the purposes of verification and quality assurance.
  • Screening for Medicaid Benefits Form

    Please complete this form in order to determine if the youth (you/your child(ren)) are eligible for NJ Medicaid and/or NJ FamilyCare benefits or that the youth enrolled in the CMO is eligible for Mental Health Only Medicaid (356000).
    • Caring Partners Staff Information  
    • Please choose your Care Manager's name in the drop down below and then their name will appear in the "Care Manager Name Confirmation" box. Please click the button to complete the fields below in this section. If the Care Manager's name is not listed for some reason, please choose "*Not listed or unknown". If there is an error, you can skip the rest of this section.

    • Screening for Medicaid Benefits Form  
    •  -  - Pick a Date
    •  -  - Pick a Date
  • This is not an application for Medicaid. Applying for Medicaid benefits requires additional information and documentation which will be gathered on the next visit if a Medicaid application is necessary.

    The CMO Medicaid Coordinator will contact you within a week of receipt of this form, if necessary, to discuss how to access Medicaid benefits for the youth if he/she has not already been found eligible.

  • If the youth enrolled in the CMO is already receiving Medicaid benefits, you do not need to answer any additional questions. However, we may request documents from you in the future to verify the youth's identity for Medicaid billing purposes. 

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