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New Jersey Health Insurance (NJ)


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Choose from the list below to learn more about specific health insurance providers in New Jersey. Read on to learn about health insurance regulations in your state. Or enter your zip code in the box to the right to request a health insurance quote.

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Health Insurance Providers in New Jersey (NJ)

Aetna
Guardian
Health Net
Horizon Blue Cross Blue Shield of New Jersey
Oxford Health Plans
UnitedHealthcare


Individual Health Insurance in New Jersey (NJ)

The rules for individual health policies in New Jersey are different than in most other states. Here, individual insurers are not allowed to turn you down for coverage because of a health problem. Enrollment for individual coverage is only in October of each year. HIPAA eligible residents are guaranteed the right to purchase individual health insurance. Your insurance cannot be cancelled due to your illness. New Jersey requires insurance companies offer two types of individual plans: comprehensive standardized policies and the Basic and Essential Plan, which has fewer benefits. You are encouraged to thoroughly compare benefits of both plans. In relation to pre-existing conditions, insurance companies are allowed to look back at your medical records for the last six months before coverage begins. If they determine there is a pre-existing condition, they can impose an exclusion period with a maximum of 12 months at the start of coverage. If you are HIPAA eligible, the companies cannot require this pre-existing exclusion. Insurance companies are not allowed to attach exclusion riders to policies for these conditions. Pregnancy is considered a pre-existing condition in New Jersey, but any complications from pregnancy will be covered. Most individual policies have costs that are based on community ratings.

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Group Health Insurance in New Jersey (NJ)

Group health insurance regulations in New Jersey provide that a qualified person cannot be refused or charged more for coverage because of a health problem. A new job or new HMO can require a waiting period until covering you with insurance. Some life changes that deal with children, family, marriage, and job loss can affect your opportunities for group health coverage. Group insurers are allowed to look back at your medical history for the last six months before coverage, assessing whether you have a pre-existing condition. If one exists, the company can apply an exclusion period for coverage at the beginning of your new group insurance; the length of the exclusion varies with your type of group coverage. If you have had continuous coverage of your pre-existing condition, with no lapses of over 63 days, you are entitled to creditable coverage. There are several state governments which removed some protections from their group’s insurance plan; contact your employer to determine if you are affected.


Small Business Health Insurance in New Jersey (NJ)

Small businesses with two to 50 employees cannot be refused small group insurance and it cannot be cancelled due to illness of the insured group. The premium costs are determined using the modified community rating. In New Jersey, insurance companies must offer standardized plans.

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Self-Employed Health Insurance in New Jersey (NJ)

Self-employed individuals in New Jersey are not allowed to purchase group health insurance. Because some people and businesses join business associations which offer group health insurance to its members, it is recommended you check with the New Jersey Department of Banking and Insurance for regulations.

New Jersey Department of Banking and Insurance
P.O. Box 325
Trenton, NJ 08625
(609) 292-5360
www.state.nj.us/dobi/index.shtml


New Jersey Programs (NJ)

New Jersey offers assistance to low income residents through Medicaid and New Jersey Family Care.

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