Health insurance in NJ for adults

amother

Mon, Oct 27 2014, 11:37 pm

Hi!

It's a long post, I thank all that have patience to read through it and could chime in.

My old grandfathered Horizon Blue plan that was relatively cheap (not cheap but much cheaper than other private plans, and offered decent coverage) is being terminated thanks to the new laws, and I have to get new private insurance.

I'm utterly confused as to subsidy eligibility.
Kids are currently covered under Jersey Care for a monthly fee.

I tried Horizon Blue subsidy calculator, and when I enter family size=X, covered individuals only adults -- it shows no subsidy.

If I indicate all family members as being covered it does show a subsidy.
But I don't need their coverage for the kids.

How do I find out what is the best option out there?

Also, with regards to applying through marketplace: I'm self-employed, how am I supposed to know what my income is going to be next year? Last year it was one thing, and this year quite another, quite unexpectedly...

Same question for current premiums for kids: my income varies, when do I notify them if it changed? Looking at the past 3 months? Do they consider entire amount you've earned year to date, or some recent period of time, like 3 months? I did call them but didn't get a straight answer re. income change notification.

On the same note, Jersey Care page says income eligibility is determined based on Modified Adjusted Gross Income. How do I estimate that based on gross income?

Thank you all in advance!

Notsobusy

Wed, Oct 29 2014, 10:30 am

If you are in Lakewood you can call LRRC 732 942 9292. They are an agency that helps people with all kinds of social services and health insurance. If you're not in Lakewood you may have an agency like that where you live. You can also call someone who sells health insurance policies, but they may not know as much about Jersey Care or the marketplace.

I had the same problem, my old plan was terminated, the new plans cost more and give me much less. Thanks Obama!

amother

Wed, Oct 29 2014, 1:47 pm

glutenless wrote:

If you are in Lakewood you can call LRRC 732 942 9292. They are an agency that helps people with all kinds of social services and health insurance. If you're not in Lakewood you may have an agency like that where you live. You can also call someone who sells health insurance policies, but they may not know as much about Jersey Care or the marketplace.

Thank you for the suggestion. As a matter of fact, I am in Lakewood Smile

I had the same problem, my old plan was terminated, the new plans cost more and give me much less. Thanks Obama!

With new plans, the craziest thing - or so it seems- is the fact that you end up paying premium+deductible+coinsurance. And the premiums are high! In the past, there were some decently priced options with good coverage, w/o deductibles.

Do you mind if I ask whether you found out anything useful in particular during your search for new insurance? Is it better to go directly to the company and just shop on their website, or through exchange, or through a broker? I am now signed up with Horizon, and they said they would automatically enroll me in Bronze plan if I didn't choose anything myself. It has super-high coinsurance though...and deductible of course. Nuts

It is kind of crazy to choose a policy not knowing how much it's going to cost in the end, because how are you supposed to know what your income is going to be?

Notsobusy

Wed, Oct 29 2014, 1:55 pm

Unfortunately I really didn't find out anything helpful at all. My broker recommended I try the exchange even though it was the wrong time of the year, just to see if it would work for me. The exchange claimed I was eligible for Jersey Care, I called Jersey Care, they said our income is too high. Went back to the exchange, but it kept saying to apply for jersey care. I don't know if I was doing something wrong or not, but I couldn't get any helpful info. I went back to my broker and took the most economical plan he could offer me.
I keep davening that neither of us gets sick, there is no way we can afford to go to a dr at with our new deductibles and copays. I used Ideal insurance. Definitely try calling LRRC. Good luck!

amother

Wed, Oct 29 2014, 4:55 pm

With Jersey Care, the question remains how do I know if I'm eligible based on Modified Gross Income if I don't know what it's going to be until I file my taxes. My last year's income was higher than this year's is so far, so going by last year's tax return wouldn't make sense.
Do you have an idea if Jersey Care looks at year to date amount earned, or current income?

amother

Mon, Nov 03 2014, 10:14 pm

glutenless wrote:

Thank you for the suggestion, I should try both LRRC and Ideal.