Affordable Health Insurance in New Jersey
Affordable Health Insurance in New Jersey

Obtaining coverage through an affordable health insurance in New Jersey may seem intimidating, because the state enforces several laws and provisions that are different from those of other states. However, this does not discard the fact that it is crucial to become properly insured, so as to gain financial protection and better access to health services. This is particularly applicable during instances wherein you might not have ample financial resources to cover your medical needs.

Understanding Group and Individual Coverage Regulations

The following are some of the basic regulations for the available coverage options you have in New Jersey. For more information and further clarification regarding your coverage choices, you should consult the New Jersey Department of Banking and Insurance.  Family and student health insurance may either be obtained under group or individual coverage.

A .Group Coverage

1.  Due to the non-discrimination provision, your eligibility for an employer-sponsored group plan cannot be based on your health status. Health status pertains to your medical history, condition, and your genetic information. There are other valid reasons for an employer to refuse or impose restrictions on your coverage, such as having a part-time status as an employee.

2. Unlike in other states, New Jersey does not require employers to contribute to monthly costs or premiums.
3. Your family may obtain coverage if the plan extends coverage to dependents. The New Jersey law also states that your newborns and adopted newborns are automatically covered under your fully insured group plan, for 31 days. Furthermore, if you signed up for a fully insured employer-sponsored plan, then your domestic partner is also automatically covered and considered an eligible dependent.
4. However, if you are currently working for a non-federal public employer based in the state, you may not be subject to all regulations and protections that are generally applied to those insured under group plans.
5. Many universities and colleges in the state require students to be properly covered by student health insurance. As such, if you’re a student, check with your school if it offers a group plan. School-sponsored plans provide students with affordable health insurance in New Jersey.

B. Individual Coverage

1. Unlike in many states, individual health insurance companies cannot refuse to sell you an individual policy due to your health status. 

2. However, to qualify, you must be a New Jersey resident for 6 months. If you just arrived within the state, you should intend to stay for at least 6 months.

3. On a general note, you are also qualified to purchase a policy all year-round if you are not presently covered by, or eligible for, other coverage; but there are certain exceptions to this.

4. It is also required of individual private insurers to offer policies that are comprehensive and standardized. Comprehensive coverage includes maternity care, checkups and immunizations, prescription drugs, and hospital and physician care. However, individual insurers must also offer a non-comprehensive standardized policy called the Basic and Essential Plan. Because certain key benefits will not be covered, you should read policy details carefully before deciding to purchase this type.

5. Excluding premiums of the Basic and Essential plan, community rating is imposed on individual policies. This means that insurers cannot vary premium costs based on age, health status, location, and occupation grounds. However, premiums will vary based on the size of your family and the type of plan. As such, obtain affordable health insurance in New Jersey even through individual policies.

6. If you find the group plan that provides family coverage, or the group plan offered by your school too limited: You may purchase family and student health insurance from individual health insurers.
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Affordable Health Insurance in New Jersey