NJ Health Insurance - recommendations please
I have a great broker if you wish to explore. PM me and I will provide info.
When I was shopping a couple years ago, there were no individual plans in NJ that offered out-of-state coverage. I would be surprised if that has changed.
kthnry said:
When I was shopping a couple years ago, there were no individual plans in NJ that offered out-of-state coverage. I would be surprised if that has changed.
Many of the Health Republic of NJ plans have oos coverage. Within NJ they use the Qualcare network. Out of state they use the MultiPlan network. Even Sloan Kettering is covered. One of my children who goes to college oos has used it at an urgent care center in her state.
shoshannah said:
kthnry said:
When I was shopping a couple years ago, there were no individual plans in NJ that offered out-of-state coverage. I would be surprised if that has changed.
Many of the Health Republic of NJ plans have oos coverage. Within NJ they use the Qualcare network. Out of state they use the MultiPlan network. Even Sloan Kettering is covered. One of my children who goes to college oos has used it at an urgent care center in her state.
Are those individual plans or group plans? There are plenty of group plans that offer oos coverage.
kthnry said:
shoshannah said:
kthnry said:
When I was shopping a couple years ago, there were no individual plans in NJ that offered out-of-state coverage. I would be surprised if that has changed.
Many of the Health Republic of NJ plans have oos coverage. Within NJ they use the Qualcare network. Out of state they use the MultiPlan network. Even Sloan Kettering is covered. One of my children who goes to college oos has used it at an urgent care center in her state.
Are those individual plans or group plans? There are plenty of group plans that offer oos coverage.
It's a plan for our family, not part of a business. I guess that's an individual plan?
Cool. I'm glad that's changed. It's dumb to not allow NJ residents to go to NY docs.
kthnry said:
Cool. I'm glad that's changed. It's dumb to not allow NJ residents to go to NY docs.
Other than the price, I am very happy with our plan.
Just discovered this option for health insurance for those of us who are self employed. Plans are reasonable, and offer a lot of flexibility.
If you are self employed, this company acts as a payroll service and as a PEO allows individuals who are self employed to access healthcare and other typical employee benefits. It may not work for everyone, but can work for many.
I've had Amerihealth platinum and horizon bcbs gold, both purchased off healthcare.gov. Amerihealth had a national rider, which in theory allowed me to go to NYC docs. In actuallity I only ever found one that took it. Amerihealth as an insurance company was terrible to deal with, but in the end they did cover almost everything we submitted(it took a lot of work for a few out of network docs at summit who attended my wife during our second kids delivery). Bcbs has been wonderful, but no NYC docs unless it's an emergency. I will probably stay with them. One thing I will say is healthcare.gov is great for shopping around, but unless you qualify for a subsidy you are much better off buying the plan directly from the insurance company. They are basically a glitchy unreliable middleman between you and the insurance company, where any changes have to go through them. My insurance policies have been cancelled 4 times because of beurocratic idiocy and horrible customer service agents. When my son was born they terminated my old policy but somehow never started the new one with the baby on it. That was fun! It eventually all worked out but it was a nightmare.
When I came off COBRA I got Horizon BC/BS Omnia Silver plan. I did a ton of research and I'm a person who really uses her healthcare insurance. I knew I needed surgery and that fell right between end of COBRA/beginning of new insurance company (thank you, ACA, for allowing pre-existing conditions). So less than one month into my Horizon policy, I underwent surgery; had to go back and have another surgery 4 months later. Physical therapy, home healthcare, rehab, TCU. Other than a $500/day hospital co-pay (for 2 surgeries = $3,000), they paid for everything. And, again, thank you ACA, I pay close to $600/month less than I paid for COBRA insurance. I do not qualify for any subsidies.
The cons are: their website and customer service sucks. I came from United HealthCare where I could find any and all things related to my claims. With Horizon, there is scant information about claims made against my policy. When you call to ask about them, the "English is not my first language" people just don't understand what you're asking for, and therefore cannot assist you. I find I get better results asking my questions online on their website.
Good luck!
I'm glad to hear that because the Horizon Omnia Silver was the one we selected!
mumstheword said:
When I came off COBRA I got Horizon BC/BS Omnia Silver plan. I did a ton of research and I'm a person who really uses her healthcare insurance. I knew I needed surgery and that fell right between end of COBRA/beginning of new insurance company (thank you, ACA, for allowing pre-existing conditions). So less than one month into my Horizon policy, I underwent surgery; had to go back and have another surgery 4 months later. Physical therapy, home healthcare, rehab, TCU. Other than a $500/day hospital co-pay (for 2 surgeries = $3,000), they paid for everything. And, again, thank you ACA, I pay close to $600/month less than I paid for COBRA insurance. I do not qualify for any subsidies.
The cons are: their website and customer service sucks. I came from United HealthCare where I could find any and all things related to my claims. With Horizon, there is scant information about claims made against my policy. When you call to ask about them, the "English is not my first language" people just don't understand what you're asking for, and therefore cannot assist you. I find I get better results asking my questions online on their website.
Good luck!
After a ton of research and input from 2 insurance people, we went with Horizon BC/BS Omnia Silver. It's also the plan my psychiatrist was pointed to if that means anything 
We are husband and wife self-employed. After extensive research and comparison we chose Omnia Silver last year and will be renewing it this year. I'm also considering adding their dental coverage this year (2017).
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Mrs. Lanky & I are both self employed. We are looking for recommendations for NJ-based health plans / providers. Extra credit for coverage out of state (for when we travel for work, however I'm not certain such a plan exists except for ER coverage), low deductibles and low co-pays.
Thank you in advance!