New Jersey Health Insurance

Do I have to get Health Insurance in New Jersey to avoid a tax penalty?

Answer:  Yes

The affordable care act stipulates that anyone under the age of 65 and not below the national poverty level must have health insurance that is Affordable Care Act compliant for at least 9 months out of the year in order to not be subject to a tax penalty.  The tax penalty has increased significantly for 2016 and now will cost 2.5% of household income or $625 per person, whichever number is higher.  This is a huge increase from 2015 which was 2% or $350 per person, whichever was higher.

Its no wonder that the public is starting to really push back on the law and look for alternative plans that cost less, provide better coverage, and protect the consumer from the tax penalty.

What Are My Health Insurance Options in New Jersey?

Obamacare

Although Obamacare has become a mediocre at best health insurance option, it is none the less and option that should be considered.  The problem with Obamacare is precisely what the architects of the law knew when it was written:  It’s way too expensive for the people that need it the least, young healthy people and way too cheap and readily available for those that need it the most.  Due to the government stepping in and providing subsidies, the people that need it the most now have basically unlimited health insurance for free or greatly reduced with out a care for how much the health they will need costs.  As with just about every other government program on the planet, the costs have risen dramatically and the service has become really bad for most people who have bought the plans.

Most Obamacare plans use what are called HMO networks (Health Maintenance Organizations).  These networks attempt to drive down costs through volume, as if health care was similar to a factory taking advantage of economies of scale.  The short story is that a majority of HMO networks provide subpar service if you can find a doctor that will take it.  Most doctors that still take Obamacare are stretched way too thin due to the amount of patients they have to see in order to make money.  Obamacare has reduced the payout amounts for procedures and preventative care to the medicaid schedules which makes it very difficult for doctors to see less patients and provide better service, but still pay the bills.

This is not to say that Obamacare has not worked well for some of our clients.  We are simply trying to be transaprent with our experiences and feedback we have received from clients over the years.  If you can afford it and do not have any serious pre existing conditions, we recommend PPO network plans as described below.

PPO Network Plans

PPO (Preferred Provider Organizaitons) offer flexible plans that allow you to go to any doctor of your choice and see a specialist without a referal.  These are large networks that focus on quality of care and flexibility.  These plans are often more expensive and sometimes have limitations on pre existing conditions.  We often recommend that clients at least get quotes for these plans and use Obamacare as a back up should they not be approved for a PPO plan or not be able to afford the premiums.  Also should something happen to you medically, a serious illness for example, you can not be denied Obamacare because of pre exisitng conditions.  There are many plans in New Jersey that are on and off exchange that use PPO networks.  Lastly there are to date 3 insurance companies in New Jersey offering Obamacare plans.