A Guide to Health Insurance in New Jersey (NJ)

When getting New Jersey Health Insurance the goal is always going to be to get the best possible cover for the cheapest possible price.

However, how you go about doing that can vary, because there are always different ways of going about getting health insurance in New Jersey.

For many people the preferable option is to get health insurance cover through their employer.

This has a number of advantages over other methods, not least that employers tend to subsidize the cover, and hence most of the time you will pay less to get insured through your workplace policy then if you choose to get an Individual New Jersey Health Insurance Plan.

Secondly, for people with pre-existing conditions, often they will be able to get medical insurance through workplace group policies that they would not be able to get as an individual. This is because workplace policies generally do not require a medical, because they work on a ‘balancing’ principle that accepts that if there are enough members of a group policy that effectively the healthy members will balance out against the ones who have pre-existing conditions.

As long as the policy meets certain minimum requirements that the insurance companies lay down about minimum income that they receive from premiums, as compared to the amounts they pay out for health cover, then everyone continues to be accepted into the plan.

Additionally, when government bodies are drafting health legislation, such as the Affordable Care Act for example, it tends to make immediate improvements to the terms of group policies such as are offered by businesses, before it then implements the same terms on individual policies.

The reason for this is largely one of scale and ease of implementation, because changing the terms on a group policy immediately impacts on the health care arrangements of all the participants of that policy, and hence can very quickly see an improvement without having to dig into the minutiae of individual arrangements.

You can see this in action for example if you consider the Autism Insurance Law that was enacted in Missouri in 2010. It was legislated such that group policies throughout Missouri HAD to include cover for those diagnosed with autism spectrum disorder, whilst with individual policies it was simply set down that it had to be made available as an optional extra.

There are still good reasons for choosing Individual New Jersey Health Insurance Plans rather than group policies though. Group policies do not tend to be very flexible and so you are largely stuck with whatever the terms and conditions of the policy happen to be, without too much recourse to change them.

The same is not true with individual insurance in New Jersey, because if you have the money then you can pretty much have any add-ons that you can afford to pay for, and very much tailor the policy to suit your own needs.

This can be an advantage when you are generally healthy, have no pre-existing conditions, but want to sort out a policy that suits you specifically.

You will usually also find that the cost for generally healthy individuals remains good (at least in comparison to what all health insurance costs!) and so there is a good argument to be made for getting some Individual New Jersey Health Insurance Plan Quotes prior to finalizing any arrangements that you make for your insurance cover.

There are three programs that are specific to health insurance in New Jersey:

1/ Individual Health Coverage Program (IHC)

This is aimed at people with pre-existing conditions or those who are having problems finding private insurance, perhaps because they do not have access to insurance through an employer in New Jersey.

The range of options includes finding coverage from private suppliers for individuals, an adult and a child, two adults or a family.

2/ Small Employer Health Benefits Program (SEH)

This was started in 1994 and exists to help small employers find a similar standard of Group New Jersey Health Insurance Policies to those that large employers are able to access.

One interesting feature of this is that where-as COBRA offers cover for an additional 18 months after you have left an employer, SEH offers the right to continue coverage even when the employer is not subject to COBRA conditions.

3/ NJ Protect

This is a relatively recent addition to the New Jersey Statute book, being brought in in 2010 to tackle the estimated 15% of New Jersey residents who are uninsured.

Again, this was specifically aimed at those with pre-existing conditions who have been turned down for health insurance in New Jersey in order to assist them to buy an Individual New Jersey Health Insurance Plan for themselves and their family at a better rate, with better benefits than would otherwise be available.

It is worth getting some quotes for cover immediately and starting to see exactly where you stand with regard to getting an affordable New Jersey Health Insurance Plan for you and your family.


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