New Jersey Health Insurance
Are you looking for New Jersey health insurance? We are here to provide you with reliable New Jersey health insurance quotes. Start by entering your zip code above and learn about health insurance plans available in your community.
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Facts and Figures
-
Place in State
Health Report Card 42nd - Insured 7,302,520
- Uninsured 1,286,300
-
Insurance
Carriers 8 -
Number of
Primary Care Physicians 19600 -
Number of
Hospitals 74 -
Average Cost of
Health Insurance* $1033
Breakdown of Insureds
- Employer-sponsored health insurance 70%
- Private plans 4%
- Medicaid 12%
- Medicare 14%
Insurance Carriers
- Aetna Health
- Americhoice of New Jersey
- AmeriHealth
- Connecticut General Life Insurance
- Health Net
- Horizon Healthcare
- Oxford Health
- UnitedHealthCare
New Jersey Health Insurance Laws and Regulations
New Jersey health insurance plans are required to be sold with a guaranteed renewability clause. This allows customers to renew their coverage as much as they want to provided they keep up with their monthly premiums and do not violate their contracts. Policyholders are also protected from termination of coverage due to health problems. New Jersey health insurance plans can exclude coverage for a pre-existing condition for up to 12 months. This means that costs associated with the pre-existing condition will not be covered by the insurer. This problem can be avoided by staying with your health insurance plan over the months before moving to a different policy. Health insurers in the state are allowed to deny coverage to new applicants based on factors like age, gender, health, and other related factors. Also, the cost of health insurance cannot be based on such factors. A New Jersey resident has the option of purchasing a Blue Cross Blue Shield policy if his or her application is ultimately denied. Small businesses (with 2 to 50 employees) in the state are qualified to purchase group health insurance policies. These policies should be similar or comparable to the same group plans available to other small businesses in the state. There may be requirements necessary to maintain a group health plan such as having a minimum number of participants and minimum employer contribution. Group plans can be cancelled if these and other requirements are not met. Small group health insurance cannot be terminated based on a group member’s health condition. However, New Jersey health insurance quotes for group coverage can vary according to the risk factors of its members. Self-employed individuals cannot purchase group plans. However, they can choose an individual plan instead. A portion of the premium payment for this type of plan can be deducted from the plan holder’s tax liability
Heath Care Reform
With the new health care law, children under the age of 26 can choose to stay under their parent’s New Jersey health insurance as long as they are not offered an employer-based health insurance. This provision enabled 2.5 million young adults to have insurance nationwide. In New Jersey, 68,816 young adults have insurance coverage through this provision as of June 2011.
The new health care law allowed 132,831 Medicare policyholders in New Jersey to receive a $250 rebate check to help with prescription drug costs when they fell into the Medicare gap in 2010. In 2011, 125,968 Medicare plan holders were given a 50% discount on brand-name prescription drugs covered by their plans when they hit the donut hole. An average of $756 per person or a total of $95,200,406 was saved in New Jersey.
Previously uninsured individuals without health coverage because of a pre-existing condition can now apply for a Pre-Existing Condition Insurance Plan. This plan is available to U.S. citizens or legal residents with a pre-existing condition and have been uninsured for at least 6 months. In 2011, 794 individuals in New Jersey have benefited from this new law.
When looking at New Jersey health insurance quotes, applicants are assured that at least 80 percent of the price will go directly to health care services and other related improvements. A rebate or premium discount shall be provided if the minimum is not met. The 2,438,000 private policyholders in New Jersey will get greater value for their premium payments because of this 80/20 rule.
Preventive care services like immunizations, colonoscopies, mammograms, or annual wellness doctor visits must be included in all New Jersey health insurance with no deductibles or co-pays. In 2011, 985,987 Medicare subscribers and 1,694,000 individuals with private policies received such services in New Jersey.
Under the new law, insurance companies are no longer allowed to impose an annual dollar limit — a cap on the yearly spending for your benefits, or a lifetime dollar limit — a lifetime cap for spending for your covered benefits. This law frees chronically ill individuals like cancer patients from worrying about getting further treatment because of such limitations. In 2011, 3,274,000 New Jersey residents have benefited from this law.
If insurance companies want to raise their premium rates by ten percent or more, they are required by federal law to publicly announce and justify their actions. To guard against such unreasonable increases, the state of New Jersey received a total of $5.1 million.
All fifty states receive increases in funding for community health centers under the Affordable Care Act. This will help construct new health centers, provide medical services to more patients, improve preventive and primary health care services, and fund infrastructure projects. In New Jersey, 127 community health centers received a total of $31.4 million to fund these improvements.
In 2010, the Affordable Care Act created the Prevention and Public Health Fund. This new fund was created for wellness promotion, disease prevention, and protection against public health emergencies. New Jersey has already received a total of $20.6 million to support its policies, programs, and communities to help its residents lead healthier lives.
State Government Insurance Programs Offered
Individual Health Coverage (IHC) Program wwww.state.nj.us (Search: Individual Health Coverage)
800-838-0935
The Individual Health Coverage (IHC) Program provides health coverage for individuals (and their families) who have no access to government or employer sponsored health care program. The program offers services through various private carriers. Services covered include hospital care, office visits, lab and X-ray services, prenatal and maternity care, immunizations, well-child care, mental and substance abuse services, mammography, Pap smears, prostate exams, and prescription drugs. Individuals may undergo a twelve-month waiting period. Eligibility: 1. Must be a New Jersey resident for at least 6 months. 2. Must be ineligible for coverage under Medicare, or any group, government, or church plan. 3. HIPAA-eligible individuals may qualify without satisfying residency requirements.
Medicaid www.state.nj.us/ humanservices/dmahs/clients/ medicaid/
800-356-1561
609-588-2600
Medicaid is a state and federal government-sponsored program which offers health coverage for residents who cannot afford to pay for medical care on their own. Services offered include physician services, laboratory tests and x-rays, early and periodic screening, diagnostic and treatment services, inpatient and outpatient hospital treatment, home health care, assistance with family planning and any necessary supplies, nurse-midwife services, and nursing facilities for people over 21. Eligibility: 1. Must be a U.S. citizen or qualified resident living in New Jersey. 2. Must not exceed income limits: Pregnant women and infants aged less than 12 months: 185% of the FPL. Parents and caretakers living with children aged 1 to 18 years: 200% of the FPL. Aged, blind, or disabled: 100% of the FPL, with assets not exceeding $4,000 for singles and $6,000 for couples. Medically-needy: $367 monthly income with assets not exceeding $4,000 for singles. $434 monthly income with assets not exceeding $6,000 for couples.
NJ Family Care Program www.njfamilycare.org
800-701-0710
FamilyCare of New Jersey provides affordable health coverage for qualified children and low-income parents. Services include physician services, inpatient and outpatient hospital services, laboratory services, preventive health care, prescription drugs, emergency medical care, mental health services and many more. Eligibility: 1. Must be a U.S citizen or qualified resident living in New Jersey. 2. Must not have health coverage. 3. Children must be under 19 and must not exceed income of 350% FPL. 4. Parents or guardians and their under-19 children must not exceed income of 133% of the FPL.
Medicare www.medicare.gov
800-633-4227
Medicare provides health coverage to eligible seniors or those with qualified disability. Coverage has four parts: Part A: provides inpatient care in hospitals and rehabilitative centers. Part B: provides doctor and some preventive services and outpatient care. Part C: provides Medicare benefits through Medicare Advantage. Part D: provides prescription drug coverage. Eligibility: 1. Must be a U.S. citizen or permanent U.S. resident. 2. Must be 65 years or older, with you or your spouse having worked in a Medicare-covered employment for at least ten years; or have a qualified disability or end-stage renal disease, regardless of age.
VA Medical Benefits Package www.va.gov
877-222-8387
The Veteran Affairs (VA) Medical Benefits Package offers a complete range of preventive inpatient and outpatient health care services for eligible veterans. Members can access services from any of VA centers all over the country. Services include preventive and preventive care; and inpatient and outpatient services. Eligibility: 1. Applicants must have veteran status.
NJ Protect Federal program run by the state of New Jersey www.PCIP.gov www.state.nj.us (Search: NJ Protect)
888-551-2130
NJ Protect is a federal program which offers health coverage to uninsured residents with a qualified pre-existing condition. Coverage includes a wide range of benefits including hospital care, primary care, specialty care, and prescription drugs. Eligibility: 1. Must be a U.S. citizen or legal resident living in New Jersey. 2. Must be uninsured for at least six months. 3. Must have a qualified pre-existing health condition.
Women-Infant- Children (WIC) www.state.nj.us/health/fhs/wic
866-446-5942
609-292-9560
Women-Infant-Children is funded by the federal government and offers nutrition program for women, infants, and children. Benefits include health screening, medical history, body measurement, nutrition assessment and education, breast feeding support and education, hemoglobin check, and vouchers for food supplements. Eligibility: 1. Must be a resident of New Jersey. 2. Must have nutritional or medical risk. 3. Must be pregnant or postpartum women and children not more than 5 years. 4. Must not exceed income limits of 185% of the FPL.