Healthcare options in NJ

We habitually tend to overlook and forget some of the most important things in life. It’s a natural occurrence, as the pace of modern times is somewhat merciless. Being financially stable, securing your job and providing for your family is more often than not all the way up there on the priority list. And, it’s only normal. Staying healthy, on the other hand, is something that slips our mind frequently. Having health insurance and taking care of ourselves should, without any excuse, be the number one priority on our list. Whether you have decided on moving to the U.S. or you’re just moving interstate, knowing your healthcare options in NJ could be a lifesaver!

Which is which

The U.S. is a country of many, many virtues. The healthcare system is not one of them. As a matter of fact, it’s quite puzzling for anyone coming from abroad and wanting to settle down. Finding your place and getting the needed care is an unnerving experience for most citizens, even natives. In order to explore your healthcare options in NJ, we first need to break down the facts about the entire country’s healthcare system.

A – Z

Maybe you’re moving your business to New Jersey. Maybe you fell in love, or you simply find it convenient as an NYC commuter.  Whatever the reason, getting acquainted with your options and figuring out beforehand “where you belong” on the healthcare spectrum is crucial. So, what are your options? Honestly, it depends on your income.

  • Government (federal, state and local) health care
  • Insurance through your employer
  • Out – of – pocket
checking for healthcare options in NJ
Check if you’re eligible for government-funded programs.

Healthcare options in NJ – Medicaid, and Medicare

The U.S. healthcare system is, what you could call, a hybrid. It’s funded both by the government in the public sector, but the majority is sustained through private insurance policies. Medicare and Medicaid reforms took place under Obama’s presidency, as to assure coverage to vulnerable groups. Alongside Medicaid and Medicare, there is CHIP (Children’s Health Insurance Program), Veterans Administration and other military care.

Medicare

Medicare is a national health insurance program, developed solely for seniors over 65 and younger people with disabilities. It gets a bit complicated afterward, as there are four different parts of the program. A, B, C, and D. If you are eligible, you get your basic coverage (the part A) for free. A is for hospital insurance; if it’s an emergency, it will have you covered. Part B is for medical insurance -it provides routine physicals and annual check-ups with your chosen doctor. Part C (also called “Medicare Advantage”), offers additional benefits – eye care, hearing, dental coverage, while part D includes prescription drug coverage. Everything except part A is optional and goes out of your pocket (deductibles).

Medicaid

Medicaid is federally and state funded, and the program differs depending on the state itself. It focuses on people with low income, as well as people with disabilities. The major difference is a financial one; citizens on Medicaid program pay little to nothing for medical services. The state of New Jersey has expanded the coverage as the part of the ACA (Affordable Care Act), so people with incomes under 138% of the federal poverty level may qualify. If you’re not eligible, you should consider purchasing cheap coverage through the New Jersey health insurance marketplace.

Insurance through your employer

Relocating to NJ for a job opportunity?  There is a chance of enjoying health benefits. But, is it that simple? No, not entirely. Just in 2015, only 56 percent of smaller companies actually provided their employees with health coverage, whereas statistically, 98 percent of large-r companies provided their employees with health benefits. To make things simple, whether you’ll have health coverage or not depends solely on your wage. If you are a low-wage employee, the chances are you will be forced into paying out – of – pocket for any medical office visits and services. Take that into consideration when relocating your home.

doctor checking blood pressure
Not all employers offer health benefits.

Paying out – of – pocket for your health insurance

If you’re not eligible for a government-funded program and you can’t seem to find an employer willing to provide health benefits, what are your next viable healthcare options in NJ? Finding the right insurance company and getting your money’s worth.

Know your health plans

It’s all about finding the right balance. Are you in good health? How old are you? The cheapest option always sounds appealing, but does it really pay off? Plans with lower premiums have higher deductibles. Not just deductibles. Co-pays and coinsurance too. It does sound confusing (because it truly is!), but it really means you will be the one handling the majority of your medical costs down the line. If you are prone to certain illnesses or already have health problems, the best option for you would be to pay extra, get higher premiums and lower cost sharing. If you are younger and overall health, you would want to go for low premiums and high cost-sharing plans.

Silver is the new gold

Silver plans are the best value for money plans. It balances cost-sharing and premiums just about right. It’s also the only plan with additional cost-sharing reduction possibility (if you have a low income, for example.). Having this particular trait, Silver plans are known for actually outshining Gold and Platinum plans, as you get more for less. If you are of exceptional health, you can opt for Bronze or Catastrophic plans, as they have high cost-sharing benefits, but on the other hand, extremely cheap premiums.

silver coin
Silver plans are considered to be a great option for those in need of occasional medical services.

Insurers

There are currently three insurers to choose from in New Jersey. (there were 5 in 2016)

  • Horizon Blue Cross Blue Shield of New Jersey
  • AmeriHealth of New Jersey
  • Oscar Health

Choose wisely

Yes, finding health care options in NJ and opting for one is a tedious task. Best case scenario, you’re a doctor moving your medical office to NJ. But, that’s just far-fetching. Eating healthy, exercising, reducing stress to a minimum (that’s a tricky one) – these are all great preventive measures and they should keep you in check. However, we can’t solely rely on our healthy daily routines. Take some time to consider all the options and choose the best one for you. And, remember, health first!

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