Can You Recommend an ACA Health Insurance Plan for Central New Jersey?

[nico08]

I may be losing health insurance with my employer soon. I am 44 and live in central New Jersey. Can you recommend an ACA health plan of insurance that you use in New Jersey and that you are satisfied with? About how much do you spend for the premiums and other costs for it? My health condition and health care needs would be that which is typical for a 44 year old man. Thanks for your advice.

[pb4uski]

Have you checked out healthsherpa.com?

[nico08]

Quote:

Originally Posted by pb4uski Have you checked out healthsherpa.com?

Hi pb4uski:

Thank you for the website. I called the local doctor office that I use, and they accept Horizon Blue Cross Blue Shield so I am going to probably choose a Horizon BCBS HMO like Silver plan.

[2B]

Your best option is probably COBRA if available. Most employers are required to offer it for 18 months after termination of employment.

If you don't have any chronic medical conditions, you will probably be better off with a bronze plan. You still get the "free" physical. A few PPO priced doctor visits during the year versus the silver copay would probably not make the silver plan work out as the best option unless you are getting a large subsidy.

[MichaelB]

Before making any decision, first check to see if you are eligible for premium assistance. Healthsherpa will help assess that , so will the KFF calculator here Subsidy Calculator | The Henry J. Kaiser Family Foundation. Healthsherpa will list all the exchange available plans in your zip code and quote you prices.

If you require specific doctors in your plan you may need to check the insurers website. Most of the major carriers have directory lookups on their websites. They also have different tiers of coverage, however, so not every plan has the same providers. You need to check the specific plan.

[nico08]

Quote:

Originally Posted by 2B Your best option is probably COBRA if available. Most employers are required to offer it for 18 months after termination of employment. If you don't have any chronic medical conditions, you will probably be better off with a bronze plan. You still get the "free" physical. A few PPO priced doctor visits during the year versus the silver copay would probably not make the silver plan work out as the best option unless you are getting a large subsidy.

Hi 2B:

But isn't the cost for COBRA plan coverage typically very high?

[rbmrtn]

Quote:

Originally Posted by nico08 Hi 2B: But isn't the cost for COBRA plan coverage typically very high?

It can be . It's essentially the full cost for your employer group plan. They can add an administrative fee, which I think was limited to 2%.

[2B]

Quote:

Originally Posted by nico08 Hi 2B: But isn't the cost for COBRA plan coverage typically very high?

COBRA is high but for me it's cheaper than the available ACA compliant plans. The cost of insurance goes up as you age but COBRA is level for all ex-employees. If I was 30, a private plan would certainly be cheaper but not for someone over 60.

[nico08]

Quote:

Originally Posted by rbmrtn It can be . It's essentially the full cost for your employer group plan. They can add an administrative fee, which I think was limited to 2%.

Hi 2B:

I just contacted the employer, and I was surprised to learn that the COBRA monthly cost isn't tremendously higher than a Silver ACA HMO plan. So, at least in the short term, I probably will go with COBRA until I find the best deal under the ACA plans. And the employer extends dental coverage at an additional fee too.

[2B]

Quote:

Originally Posted by nico08 Hi 2B: I just contacted the employer, and I was surprised to learn that the COBRA monthly cost isn't tremendously higher than a Silver ACA HMO plan. So, at least in the short term, I probably will go with COBRA until I find the best deal under the ACA plans. And the employer extends dental coverage at an additional fee too.

Good. You can still switch at any open enrollment period for the ACA policies and also become eligible when your COBRA expires even if it isn't during the open enrollment period.

[pb4uski]

When I retired at the beginning of 2012 my COBRA was 50% more than what I could buy for individual HDHI. Now, the monthly premium for our catastrophic plan is less than half what our COBRA was at the beginning of 2012.

If you're 44, in good health and qualify for a catastrophic plan I suggest you consider one. While the benefits are a bit less than a bronze HDHI plan, in our case the premiums are a lot less (38% less than the bronze plan). You could qualify for cat coverage if your 2013 plan was cancelled (probably not applicable in your case) or if the annual cost of the lowest cost bronze plan exceeds 8% of your income (modified AGI).

Cat coverage works for us because it gets us access to negotiated rates with providers and protection against the financial loss of a severe health event. In our case, the provider network is the same as bronze plans, but that is something to check on.