Getting Health Insurance in New Jersey (NJ)

[walkinwood]

Hello,

I have a few questions about getting private health insurance in NJ. I would like to ER sometime in 2008 & want to plan /budget for my health-insurance.

I have seen the options on eHealthinsurance.com. Are there more options out there besides Oxford and Horizon BC/BS? Where can I find a list?

I'd also like to hear from NJ residents on this board.
What plan are you using, how much does it cost, family size & are you happy with coverage?

I am glad we are guaranteed health insurance in NJ, but the costs are high! Any tips to save costs while still being covered?

Thank you.
ww

 

[mykidslovedogs]

Here is info. on New Jersey Individual Health Insurance options:

http://www.state.nj.us/dobi/ihcrates.htm

 

[perinova]

The previous link summarizes our situation in NJ.... Bleak.
Let me know what you decide.
Self-employed at this time, plus 10yo DS, and DW. We decided to be uninsured for the moment.

Our choices:
We might decide to
- stay uninsured,
- move,
- take a job,
- pay the $12000+/yr premium ($10k deductible)

None of the choices seem reasonable unfortunately. So for the moment we are keeping things as is since my S-corp has a local contract.

Note that in NJ there is no short term insurance allowed and no catastrophic insurance either. We are also facing high homeownership cost.

Moving comes to mind. Let me know what you decide....

 

[mykidslovedogs]

The previous link summarizes our situation in NJ.... Bleak.

Ahhhh, but isn't guaranteed issue and community rating wonderful? Hey - Colorado is a nice place to live!

 

[kramer]

I just got approved for health insurance coverage today in California. After I saw this thread, I ran the numbers for New Jersey. It looks like I would pay 4 to 5 times more for similar coverage in New Jersey. And there is very little competition, considering the high population of New Jersey.

Kramer

 

[mykidslovedogs]

I just got approved for health insurance coverage today in California. After I saw this thread, I ran the numbers for New Jersey. It looks like I would pay 4 to 5 times more for similar coverage in New Jersey. And there is very little competition, considering the high population of New Jersey.

Kramer

That's what "guaranteed issue" and "community rating" regulation does to a market. It drives out most of the competition, leaving prohibitive rates for everyone. The intentions are good; i.e....legislators are trying to make it easier for uninsurables to get insured, but in the process, they make it so that only the very elite can get coverage.

Conclusion: Equality isn't always the best solution. Sometimes, you have to have a little bit of inequality to get the best result for the MAJORITY of people!

 

[perinova]

I just got approved for health insurance coverage today in California. After I saw this thread, I ran the numbers for New Jersey. It looks like I would pay 4 to 5 times more for similar coverage in New Jersey. And there is very little competition, considering the high population of New Jersey.

Kramer

I had done exactly the same comparison. California seem to have much more affordable health care and plenty of competition.

By curiosity which top insurers in CA did you consider? Which one did you elect?

 

[mykidslovedogs]

I had done exactly the same comparison. California seem to have much more affordable health care and plenty of competition.

By curiosity which top insurers in CA did you consider? Which one did you elect?

He went with Aetna!

 

[kramer]

Perinova, my journey is documented in this thread:

http://early-retirement.org/forums/index.php?topic=13377.0

California has indirect taxes, too. For instance, egregious zoning decisions and building laws here unnecessarily increase the cost of housing much higher than it would be otherwise. These are the sorts of things that one must consider for an ER location.

Kramer

 

[Tommy]

New Jersey health insurance premiums cannot be considered high if someone is greater than a standard risk.
Its the healthy individuals that pay more than most other states.

The HMO's offered even though they are expensive are generally less than a Hippa plan in a non guarantee issue state.

 

[perinova]

The HMO's offered even though they are expensive are generally less than a Hippa plan in a non guarantee issue state.

You must be joking... AM I missing some data

Yes in NJ all pay a high risk premium even the standard or low risk individuals.

 

[walkinwood]

Moving comes to mind. Let me know what you decide....

We've thought of moving because of the high property taxes, health insurance, state & sales tax. But our friends are here, and that's making the decision very difficult. For now, we plan to stay put.

We don't have children, but are still looking at close to around $10K a year.

Anyone know if NJ insurance premiums can come from HSA accounts? If so, I need to research HSA.

 

[REWahoo]

Anyone know if NJ insurance premiums can come from HSA accounts? If so, I need to research HSA.

If your question is can HSA savings account monies be used to pay health insurance premiums, the answer is no...until after age 65.

This is a great overview of HSA's, including the new rules that went into effect Jan 1:

http://www.treas.gov/offices/public-affairs/hsa/pdf/all-about-HSAs_040507.pdf

 

[perinova]

I think two carriers provide HSAs in NJ. One of them being CIGNA. I don't recall the 2nd one.
It is possible though that those HSAs are only provided to businesses with more than 50 employees.

 

[Tommy]

You must be joking... AM I missing some data

Yes in NJ all pay a high risk premium even the standard or low risk individuals.

The Oxford premiums per the NJ Dept. of Insurance can be had from $563. upward for 1 person.

Look at the high risk pool rates amongst other states. They range more than that.
Hippa rates are also about the same as high risk pools.
Usually $800 upward for 1 person.

If you don't meet the criteria for standard risk it's easily $800 or more in most states.
And when your over 60 more than that.

 

[mykidslovedogs]

The Oxford premiums per the NJ Dept. of Insurance can be had from $563. upward for 1 person.

Look at the high risk pool rates amongst other states. They range more than that.
Hippa rates are also about the same as high risk pools.
Usually $800 upward for 1 person.

If you don't meet the criteria for standard risk it's easily $800 or more in most states.
And when your over 60 more than that.

I think there is something wrong with the kind of system NJ has....NJ makes insurance unaffordable for the healthiest individuals (approx 85%) of the population, many of which fall into the 19-35 yr old category who for the most part don't have the income yet to support such high premiums....all so we can guarantee insurance to the other 15% of the population, most of who are older and have had a chance to save all of their lives and could potentially afford the extra couple of hundred dollars for their additional risk?

To me, there's something wrong with the mentality of screwing things up for the majority of people so a smaller number of people can have an advantage. What is the thought process here?...Do they think healthy people don't need health insurance anyway because they are healthy? People want to be able to protect their assets. That's what health insurance all about. IMO, I think it is more unfair to make it practically impossible for the majority of people to afford insurance.

Many of you talk about being tied to work because of illness, and how terrible that is....OK, that's maybe what, less than 15% of the population of people? NJ makes it nearly impossible for 50% or more of the population to get health insurance outside of work by imposing guaranteed issue and community rating laws on health insurance carriers, resulting in premium rates that are prohibitive for practically everyone!

Tell me, how is that better?

 

[perinova]

The NJ system started from a good idea gone bad. They intended to build something affordable and fair for everyone and screwed up since they didn't think of all the consequences. They also might have been heavily lobbied by someindustry ; this I don't know.

I wish they would have taken notice of the problem and make changes.

 

[brewer12345]

I wish they would have taken notice of the problem and make changes.

I wish that too. They figured out how to fix the auto insurance market in the state, so maybe they could fix the health insurance market. But there are a lot fewer consumers buying their own health insuramce than auto, so I am not holding my breath.

 

[Tommy]

I think there is something wrong with the kind of system NJ has....NJ makes insurance unaffordable for the healthiest individuals (approx 85%) of the population, many of which fall into the 19-35 yr old category who for the most part don't have the income yet to support such high premiums....all so we can guarantee insurance to the other 15% of the population, most of who are older and have had a chance to save all of their lives and could potentially afford the extra couple of hundred dollars for their additional risk?

To me, there's something wrong with the mentality of screwing things up for the majority of people so a smaller number of people can have an advantage. What is the thought process here?...Do they think healthy people don't need health insurance anyway because they are healthy? People want to be able to protect their assets. That's what health insurance all about. IMO, I think it is more unfair to make it practically impossible for the majority of people to afford insurance.

Many of you talk about being tied to work because of illness, and how terrible that is....OK, that's maybe what, less than 15% of the population of people? NJ makes it nearly impossible for 50% or more of the population to get health insurance outside of work by imposing guaranteed issue and community rating laws on health insurance carriers, resulting in premium rates that are prohibitive for practically everyone!

Tell me, how is that better?

It is a hard situation in NJ for many who have to pay the high premiums. I do think most individuals are on some type of group plans. Reasons being NJ is a money state alot have good jobs. They work in Manhattan for good firms, there are unions for blue collar workers with good benefits, state and county jobs offer pensions and benefits.

What does surprise me is there is not a NJ plan for low income workers, In NY they is Healthy New York for those who earn less than $2100 a month or so. They can buy insurance for $200 a month. Jersey has some plans for kids but not adults as far as I know.

 

[perinova]

What does surprise me is there is not a NJ plan for low income workers, In NY they is Healthy New York for those who earn less than $2100 a month or so. They can buy insurance for $200 a month. Jersey has some plans for kids but not adults as far as I know.

Tommy
Look at this site. The low income health insurance is now available to children for income levels up to 350% of poverty level. Parents can be included if income doesn;t exceed 115% of poverty level (really low!!!)
tohttp://www.njfamilycare.org/
Unfortunately this solution is for income level too low for us.

 

[Tommy]

Tommy
Look at this site. The low income health insurance is now available to children for income levels up to 350% of poverty level. Parents can be included if income doesn;t exceed 115% of poverty level (really low!!!)
tohttp://www.njfamilycare.org/
Unfortunately this solution is for income level too low for us.

Yes the plan is designed for the poor

 

[walkinwood]

How does insurance in states without community ratings work?

Once you get a private health insurance policy, are you guaranteed renewals at the same or similar rate?

Or can they bump up premiums or drop you if you get seriously sick?

Regards,
ww

 

[firewhen]

Walkinwood,

We are almost identical to you--same age, state, time to ER--I almost feel when reading your posts they could be mine, except we have children.

I'm not an expert, but I think health insurance in the other states is like car or homeowners insurance, you can be nonrenewed at the sole discretion of the insurer. Some here have suggested moving to another state while you are healthy for the low rates, and coming back to NY or NJ if you get sick for the guaranteed coverage, although planning one's life and domicile around insurance seems such a shame.

NY also has guaranteed insurance and they have some relatively less expensive plans that I have found on ehealthinsurance. PA also has low rates. This would allow you to live relatively close to friends.

Is there any way you can stay on your company's plan, even if you pay the full cost?

 

[kramer]

No, an insurance company cannot just drop you or raise rates only for you. They must identically raise rates on the whole pool of people in the same insurance plan (although this can vary by certain factors like sex, geography, etc., depends on state law). Otherwise, insurance would be mostly useless. This is why short term insurance is much cheaper than regular insurance, because short term insurance does not obligate the insurer to renew for any member of the pool at the end of the time period (in my age bracket, short term insurance is around 40% cheaper than regular insurance for this reason).

In addition to being governed by specific insurance law, many (all?) states have oversight commissions for insurance rates.

When you get into trouble is when an insurance company starts playing games with particular pools, in effect just giving up the business by raising rates above health care inflation for a particular plan over time that was losing money -- it is hard to tell how often this really happens. This was one reason that I didn't want to get a boutique plan, but a very common plan offered by a reputable, growing company that hopefully a large number of other people enroll in, as well.

Kramer

 

[mykidslovedogs]

What Kramer said is correct. Insurance carriers cannot drop you or raise your rates individually just because of your personal claims. A lot of people are mistaken about this fact, and you see it all over the boards - people complaining that they personally had their rates raised because of claims, in an effort of the insurance company to personally single them out and force the coverage to be so expensive that the person can no longer afford it.

This is NOT the case. Insurance companies can only raise your rates or cancel your coverage if they do it for the entire large population of other people in your "group" (typically, this is a huge group of people, all who became effective around the same time period as you did, who also live in a similar geographic are as you.)

I often see people complaining that insurance companies purposely try to raise the rates of these groups of people in hopes that the healthier risk will drop out of the group, making it so the insurance company can drive the unhealthy's rates high enough to make it unaffordable for them to keep the coverage. To me, this sounds like a consipiracy theory that I doubt really happens.

In my experience, most carriers renewal rates are similar to new business rates WITH THE EXCEPTION OF ASSURANT HEALTH. Assurant health tends to take rate increases more often (approx. every 9 months), and their renewal rates are almost always higher than new business rates for everyone.