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Private Health Insurance in NJ, Lakewood
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amother




Bronze


Post  Fri, Feb 17 2017, 9:56 am
amother wrote:
Thanks for the replies. With silver HSA, your deductible is higher but the money you spend can come from an HSA which is non-taxable, is that correct? Is that the main benefit over plain HSA?


I don't really know, have to ask accountant.
The problem is I think the biggest chunk of payments (premiums) isn't deductible. But I may be mistaken.

Thank you for the reminder, I'll ask before filing.
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amother




Bronze


Post  Fri, Feb 17 2017, 10:05 am
amother wrote:
Wow, good for you. Seems you are very on top of your costs of care. What's your monthly premium like? Also, is Horizon widely accepted in Lakewood area? Do you know of any well regarded pediatricians or OBGs that specifically do NOT accept Horizon ? Thanks so much for your help!


I had to choose a new plan for the year, so combed through all the numbers but in the end it's still only a guesstimate projection for the year.

I can't answer your question really.
Before signing up I checked to see whether my ob, kids doctors (primary and specialists) and major hospitals accept it. Also checked to see which local urgent care centers take it.

Funny enough, some places like chop accept NJ family care united but don't accept NJ family care horizon, or my private horizon plan.
That is sometimes a challenge if you're referred to a chop specialist and have to find an adequate replacement in-state.

Just recently my kid was referred to a chop dr who has NJ locations too. However, for the particular problem we had the dr was seeing patients only in philly, which is tier2 for us (read: pay an unknown amount out of pocket, could be a thousand for a consult, or two, who knows).
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amother




Wine


Post  Fri, Feb 17 2017, 11:14 am
Wow so helpful. I see I need to be careful about Tier 1 or Tier 2. What you're saying is that even if CHOP officially accepts my Horizon plan it might be under tier 2 which can be very costly. Thanks.

Also, does Horizon "family care" NJ mean subsidized plan through exchange, or is that a private plan? Maybe CHOP just won't accept the exchange plans but will accept plans bought privately? (Because I know some doctors will accept my plan in NY now only if it was bought privately but not if was bought through exchange...)
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amother




Puce


Post  Fri, Feb 17 2017, 11:37 am
just want to add that even though we got knocked off jersey care (adults) our kids were able to stay on since there are different income guidlines for kids. We have a copay now and I believe there is even an option to purchase jersey care for the kids with low monthly premium if your income is higher. Look online for info or call lrrc.
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amother




Bronze


Post  Fri, Feb 17 2017, 11:54 am
amother wrote:
just want to add that even though we got knocked off jersey care (adults) our kids were able to stay on since there are different income guidlines for kids. We have a copay now and I believe there is even an option to purchase jersey care for the kids with low monthly premium if your income is higher. Look online for info or call lrrc.


Couldn't find the purchase option, only income table with max $144/ month payment
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amother




Bronze


Post  Fri, Feb 17 2017, 11:58 am
amother wrote:
Wow so helpful. I see I need to be careful about Tier 1 or Tier 2. What you're saying is that even if CHOP officially accepts my Horizon plan it might be under tier 2 which can be very costly. Thanks.

Also, does Horizon "family care" NJ mean subsidized plan through exchange, or is that a private plan? Maybe CHOP just won't accept the exchange plans but will accept plans bought privately? (Because I know some doctors will accept my plan in NY now only if it was bought privately but not if was bought through exchange...)


New Jersey family care (with a specific insurance, like united americhoice, or horizon etc) is a "Medicaid", or whatever the current official name is. It's not through exchange but state or county, not sure which one.

When I was checking out Horizon plans, I found the same ones on exchange and on horizon website. The only difference was that if you qualified and wanted to get a subsidy you would have to apply through exchange rather than buy directly from the company or through a broker.
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