Making Sense of Your Individual Health Options

Finding health insurance for yourself and your family can be a daunting process. In New Jersey, there are quite a few different carriers, insurance plans, and other special programs through the state.

Here is a resource list for those looking for coverage or reviewing their options.

1) COBRA and NJ Continuation

If you were covered by employer based insurance, you will have the option to continue the same coverage for up to 18 months.

2) Are you under age 31?

Dependent to 26 and Dependent to 31

Option 1: Dependent to 26 coverage. As part of the Affordable Care Act, adult dependents may stay on their parents plan until age 26. There is no longer the requirement of being a full time college student.

Option 2: Dependent to 31 coverage. Over age dependents may remain "tethered" to their parents plan at a reduced rate until age 31. If the parents' employer based coverage is $500 per month for example, the overage dependent may pay $360. Each insurance carrier has a different discount so it's best to check first.

3) Individual Health Insurance

Individual Health Insurance is available in New Jersey on a guaranteed issued basis so anyone that signs up must be accepted. The premiums are based solely on your age, sex and location in the state.

There are quite a few different plans and insurance carriers, but my top choices would be as follows:

Tier 1:Horizon Direct Access Plan C 100/70

Tier 2:Horizon Direct Access Plan A/50

Tier 2:Amerihealth PPO

Tier 3: Horizon HMO Coinsurance

Tier 4: Horizon EPO Plus

*You may also want to look at other plans but these are the best for people in the South Jersey area, in my opinion.

4) Been without coverage for more than 6 months and have a pre-existing condition?

You are in luck! Another provision of the Affordable Care Act was the addition of special, pre-existing condition plans. All plans in NJ are guaranteed issue but this particular option will waive any pre-existing exclusions from day 1. You also benefit by getting a premium discount.

You can read more about the program here. New Jersey Protect

5) New Jersey Family Care

This program is for children under age 18 and certain low income adults. It will provide insurance for significatnly lower premiums than can be found elsewhere if you meet the requirements.

Read more at New Jersey Family Care and Horizon BCBS Family Care

6) New Jersey Medicaid

Medicaid provides health insurance to parents/caretakers and dependent children, pregnant women, and people who are aged, blind or disabled. These programs pay for hospital services, doctor visits, prescriptions, nursing home care and other healthcare needs, depending on what program a person is eligible for.

Read more here at the Department of Human Services

If you or someone you know are looking to get coverage, please read through the list and evaluate all of your different options. If you are looking for more information on health insurance or other New Jersey Insurance please drop me a note.