If youre x eligible NJ Family care...

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Forum -> Inquiries & Offers -> Lakewood, Toms River & Jackson related Inquiries

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amother

Tue, Jun 16 2020, 9:55 am

What insurance do u have if not eligible for NJ Family Care? How did u apply?

amother

cornflower

Tue, Jun 16 2020, 9:59 am

We have bcbs we got through a broker

stillnewlywed

Tue, Jun 16 2020, 10:00 am

Horizon Blue Cross Blue Shield through the Healthcare Marketplace

amother

Tue, Jun 16 2020, 10:10 am

stillnewlywed wrote:

Horizon Blue Cross Blue Shield through the Healthcare Marketplace

I applied by the marketplace. They told me I'm approved but there isnt any insurance available in my area-Toms river. Does that make sense? Thought they have all over

stillnewlywed

Tue, Jun 16 2020, 10:18 am

amother [ OP ] wrote:

I applied by the marketplace. They told me I'm approved but there isnt any insurance available in my area-Toms river. Does that make sense? Thought they have all over

That’s weird. What do you mean in your area? Plans go by state, not by areas...
It didn’t bring you to a screen to compare and select a plan?

amother

Oak

Tue, Jun 16 2020, 11:33 am

I use Cosmo insurance and they've been very helpful in finding a plan that meets my needs. For marketplace questions lrrc probably has most answers

amother

Wed, Jun 24 2020, 12:45 pm

OP here again, I'm bh pregnant and need insurance. Im not eligible to get NJ Family care. I applied to marketplace again now and they say pregnancy isnt a life changing event. Did that change recently? Because I think it was considered life changing event in past. So how do I get insurance now??

21young

Wed, Jun 24 2020, 12:51 pm

I have Aetna through Cosmo - call them, I think you can enroll at any time.

amother

Cerulean

Wed, Jun 24 2020, 1:19 pm

I have amerihealth. I got a cheaper plan cuz I’m not yet pregnant and plan on switching to a better plan once I am.

stillnewlywed

Wed, Jun 24 2020, 1:30 pm

amother [ OP ] wrote:

I don't think pregnancy is a life changing event (eligible for special enrollement) although giving birth is.
What insurance did you have until now?
If the marketplace isn't working for you, then call a broker and they can give you your options.

amother

Cobalt

Wed, Jun 24 2020, 1:47 pm

amother [ Cerulean ] wrote:

I have amerihealth. I got a cheaper plan cuz I’m not yet pregnant and plan on switching to a better plan once I am.

Be careful. Pregnancy does not give you special enrollment to change plans

amother

Lemon

Wed, Jun 24 2020, 1:59 pm

Pregnancy is not considered to be a qualifying event that enables one to get insurance outside of the Open Enrollment period.

If people are permitted to sign up for insurance only when they know they need it for expensive care, it makes health insurance economically impossible since there is no incentive to insure until you know you would have costs in excess of your premiums. If everyone did that, the system would collapse and insurance would become more expensive for those who have it all the time.

Depending on your delivery date, you could get insurance that starts on January 1 which would cover hospital and delivery fees. Your baby can get insured as soon as they are born even if you aren’t eligible.

amother

Wed, Jun 24 2020, 5:20 pm

21young wrote:

I have Aetna through Cosmo - call them, I think you can enroll at any time.

Do you habe this Cosmo #? Also how does it work regarding payment. Do I have to pay them for their service?

amother

Denim

Wed, Jun 24 2020, 9:35 pm

21young wrote:

I have Aetna through Cosmo - call them, I think you can enroll at any time.

Aetna as private Insurance?

Is there a reason you went with Aetna and not horizon?

amother

Pearl

Wed, Jun 24 2020, 9:39 pm

amother [ Denim ] wrote:

Aetna as private Insurance?

Is there a reason you went with Aetna and not horizon?

I’m gonna hijack. My aetna provides us with out of state coverage while the horizon plan is NJ only, with certain hospitals out of NJ

amother

Denim

Wed, Jun 24 2020, 9:44 pm

amother [ Pearl ] wrote:

I’m gonna hijack. My aetna provides us with out of state coverage while the horizon plan is NJ only, with certain hospitals out of NJ

My Aetna does too; but I didn’t know you could get it privately and not through an employer.

amother

Silver

Wed, Jun 24 2020, 10:54 pm

OP, are you completely uninsured now? Because if you are I'm afraid you might have an issue getting on to a plan.
It's not open enrollmemt right now, and pregnancy is not a life changing event that would let you enroll outside of open enrollment.
If your income has changed recently then that could be a special enrollment period, or if you've lost other coverage recently.

amother

Gold

Wed, Jun 24 2020, 10:59 pm

Call the LRRC (Lakewood resource and referral center) 732-942-9292. They can give you general insurance info and help you with questions regarding the marketplace. You can also email them at questions@lrrcenter.org

amother

Lemon

Wed, Jun 24 2020, 10:59 pm

amother [ Denim ] wrote:

My Aetna does too; but I didn’t know you could get it privately and not through an employer.

A plan you get through your employer is not necessarily the same even if it is the same insurance company because employers - especially large employers - have custom plans and determine what the coverage will be like. A larger employer will generally have more generous plans because the cost per employee is less than for an individual or a small company.

Also very large companies often self insure - they use the insurance company to administer the insurance but the company is the one that actually funds the medical care. These types of self funded plans are completely individual to the company as they can include whatever they want as long as they provide the services required by Obamacare.

So a recommendation from a person who has Aetna Insurance through an employer is meaningless generally for a person who is purchasing private health insurance since coverage would most likely be different.

amother

Denim

Thu, Jun 25 2020, 12:57 am

amother [ Oak ] wrote:

I use Cosmo insurance and they've been very helpful in finding a plan that meets my needs. For marketplace questions lrrc probably has most answers

Did you go through cosmo and not exchange because you’re not eligible for subsidy?

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