New Jersey is the fourth smallest state in the United States and is located in the Northeastern region of the country. It is also the most densely populated state in the country, with over 8.8 million residents. Similarly, like any large population, access to health insurance is a vital issue. In this article, we will be discussing the various health insurance companies operating in New Jersey, the types of insurance plans they offer, the benefits and drawbacks of each plan, and how to choose the best plan for your needs.
The Major Health Insurance Companies in NJ
There are a handful of major health insurance companies operating in New Jersey. These include:
Company |
Plan Types |
|---|---|
Aetna |
HMO, PPO, POS, EPO |
AmeriHealth |
HMO, POS, PPO |
Cigna |
HMO, EPO, PPO |
Horizon Blue Cross Blue Shield |
HMO, EPO, PPO |
Oxford Health Plans |
HMO, EPO, POS |
Aetna
Aetna is a nationwide health insurance provider that offers four different types of health insurance plans in NJ: HMO, PPO, POS, and EPO.
HMO plans are the most restrictive but often the most affordable. With an HMO plan, you are typically required to select a primary care physician who will be your main point of contact for all your health care needs. Additionally, you must receive a referral from your primary care physician before seeing a specialist.
PPO plans offer more flexibility but are also more expensive. With a PPO plan, you can see any doctor or specialist you choose without needing a referral. However, if you choose to see a doctor outside of the PPO network, the cost will be higher.
POS plans are a combination of HMO and PPO plans. With a POS plan, you must select a primary care physician and receive a referral before seeing a specialist. However, if you choose to go outside of the network, the cost will be higher but not as high as a PPO plan.
EPO plans are similar to PPO plans in that you can see any doctor or specialist you choose without needing a referral. However, EPO plans typically have a smaller network of providers and are often more affordable than PPO plans.
AmeriHealth
AmeriHealth is a local health insurance provider that offers three different types of health insurance plans in NJ: HMO, POS, and PPO.
HMO plans are the most restrictive but often the most affordable. With an HMO plan, you are typically required to select a primary care physician who will be your main point of contact for all your health care needs. Additionally, you must receive a referral from your primary care physician before seeing a specialist.
POS plans are a combination of HMO and PPO plans. With a POS plan, you must select a primary care physician and receive a referral before seeing a specialist. However, if you choose to go outside of the network, the cost will be higher but not as high as a PPO plan.
PPO plans offer more flexibility but are also more expensive. With a PPO plan, you can see any doctor or specialist you choose without needing a referral. However, if you choose to see a doctor outside of the PPO network, the cost will be higher.
Cigna
Cigna is a nationwide health insurance provider that offers three different types of health insurance plans in NJ: HMO, EPO, and PPO.
HMO plans are the most restrictive but often the most affordable. With an HMO plan, you are typically required to select a primary care physician who will be your main point of contact for all your health care needs. Additionally, you must receive a referral from your primary care physician before seeing a specialist.
EPO plans are similar to PPO plans in that you can see any doctor or specialist you choose without needing a referral. However, EPO plans typically have a smaller network of providers and are often more affordable than PPO plans.
PPO plans offer more flexibility but are also more expensive. With a PPO plan, you can see any doctor or specialist you choose without needing a referral. However, if you choose to see a doctor outside of the PPO network, the cost will be higher.
Horizon Blue Cross Blue Shield
Horizon Blue Cross Blue Shield is a regional health insurance provider that offers three different types of health insurance plans in NJ: HMO, EPO, and PPO.
HMO plans are the most restrictive but often the most affordable. With an HMO plan, you are typically required to select a primary care physician who will be your main point of contact for all your health care needs. Additionally, you must receive a referral from your primary care physician before seeing a specialist.
EPO plans are similar to PPO plans in that you can see any doctor or specialist you choose without needing a referral. However, EPO plans typically have a smaller network of providers and are often more affordable than PPO plans.
PPO plans offer more flexibility but are also more expensive. With a PPO plan, you can see any doctor or specialist you choose without needing a referral. However, if you choose to see a doctor outside of the PPO network, the cost will be higher.
Oxford Health Plans
Oxford Health Plans is a local health insurance provider that offers three different types of health insurance plans in NJ: HMO, EPO, and POS.
HMO plans are the most restrictive but often the most affordable. With an HMO plan, you are typically required to select a primary care physician who will be your main point of contact for all your health care needs. Additionally, you must receive a referral from your primary care physician before seeing a specialist.
EPO plans are similar to PPO plans in that you can see any doctor or specialist you choose without needing a referral. However, EPO plans typically have a smaller network of providers and are often more affordable than PPO plans.
POS plans are a combination of HMO and PPO plans. With a POS plan, you must select a primary care physician and receive a referral before seeing a specialist. However, if you choose to go outside of the network, the cost will be higher but not as high as a PPO plan.
Frequently Asked Questions (FAQ)
What is the Affordable Care Act (ACA)?
The Affordable Care Act (ACA) is a federal law that requires most U.S. citizens to have health insurance or pay a fine. The ACA also established the Health Insurance Marketplace, which is an online marketplace where individuals can compare and purchase health insurance plans.
How do I enroll in a health insurance plan?
You can enroll in a health insurance plan during the open enrollment period, which typically takes place from November 1 through December 15 each year. You can also enroll in a plan if you have experienced a qualifying life event, such as getting married, having a baby, or losing your job.
A premium is the amount of money you pay to maintain your health insurance coverage. Premiums can vary depending on the type of plan you choose, your age, your health status, and other factors.
What is a deductible?
A deductible is the amount of money you must pay out of pocket before your health insurance coverage begins. Deductibles can vary depending on the type of plan you choose and can range from a few hundred dollars to several thousand dollars.
What is a copayment?
A copayment is a fixed amount of money you must pay for a medical service or prescription drug. Copayments can vary depending on the type of plan you choose, the service or drug you are receiving, and other factors.
Conclusion
Choosing the right health insurance plan can be a daunting task. However, understanding the different types of plans available and the benefits and drawbacks of each plan can make the decision-making process much easier. When selecting a plan, it is important to consider your personal health care needs, your budget, and your preferred providers. With the information provided in this article, you should be able to make an informed decision about the best health insurance plan for your needs.