Best Health Insurance in New Jersey

Jump right to it: To get the best health insurance in New Jersey, get quotes from competing companies using this form.

The best health insurance company for low premiums in Jersey is AmeriHealth, perfect for single adults and families alike.

Looking for the best health insurance in NJ? If you are a NJ resident wondering where you can find the best cheap health insurance, check out our options for the most affordable insurance plans in New Jersey. We analyzed the options to help you find affordable and comprehensive health insurance plans to fit various health insurance needs and budgets. 

Quick Look: Best Health Insurance Companies in New Jersey

• Best for Low Premiums: AmeriHealth
• Best for Nationwide Coverage: Horizon Blue Cross Blue Shield
• Best for No-Cost Virtual and Preventative Care: Oscar
• Best for PPO Plans: Humana
• Best for Adult and Child Orthodontia Benefits: Ameritas
• Best for No Enrollment Period Health Insurance: Sidecar Health

Best Health Insurance in New Jersey

Benzinga wants to help you find the best healthcare coverage available in NJ and has provided a list of the best health insurance providers in the state, along with their best attributes to help you get started.

Now that you understand how to get health insurance and what insurance covers, it’s time to get covered. Let’s take a more in-depth look at some of the best health insurance providers offering plans in the Garden State. 

1. Best for Low Premiums: AmeriHealth

AmeriHealth is one of the top health insurance providers in New Jersey, offering both individual and family health plans on the ACA Marketplace. All of its plans include each of the ACA’s essential benefits, and many higher-tier options also include discounts on dental plans as well.

AmeriHealth offers health insurance to both individuals and employers in NJ with both health maintenance organization (HMO) and preferred provider organization (PPO) plans following the ACA essential benefits and higher-cost options that provide more comprehensive coverage. There are 4 individual plans and sub-plans: bronze, silver, gold and a catastrophic plan. Plan types include HMO, point-of-service (POS), exclusive provider organization (EPO) and PPO. Health savings accounts (HSAs) are available with several plan options as well as dental and vision insurance. A range of plans is available to AmeriHealth members all the way from the most essential coverage to comprehensive plans with add-on coverage options.

You can manage your claims and benefits through AmeriHealth’s website or through its convenient mobile app. You can choose your network of doctors to balance the personalized care you want and keep your premium costs low. 

2. Best for Nationwide Coverage: Horizon Blue Cross Blue Shield 

Horizon Blue Cross Blue Shield is New Jersey’s most popular choice for independent health insurance plans. Horizon now offers paperless online account management for all plan holders — giving you easier and safer access to your sensitive medical data. 

Horizon Blue Cross Blue Shield offers health insurance plans to individuals in NJ and has a vast network of doctors, hospitals and specialists in its provider network. Horizon Blue Cross Blue Shield is an independent licensee of the Blue Cross Blue Shield Association. Horizon Blue Cross Blue Shield offers insurance policies on the healthcare exchange.

First-time health insurance buyers will find the FAQs page very helpful. It is loaded with information on the benefits available and how to find medical providers in your network. In addition, the company offers a wide range of plans suitable for almost any type of budget and healthcare needs.

Its comprehensive FAQ page is also packed with information on finding doctors in your network and using your benefits, which can be particularly useful for first time shoppers. Finally, Horizon offers a wide range of plan types and tiers suitable for nearly any budget.  

3. Best for No-Cost Virtual and Preventative Care: Oscar Health

If you’re looking for plans with lower monthly premiums, consider Oscar Health when you compare coverage options. You can get an ACA-compliant plan for around $300 per month, and deductibles begin at $2,300 for more expensive options.

The company offers lower monthly premiums for plans that are compliant with the Affordable Care Act (ACA) while also offering higher-cost options for more comprehensive plans. In addition, plan members have low copayments (most tiers have $25 copays for both doctor’s visits and prescriptions) and provide access to telehealth services with in-network healthcare providers.

Oscar offers EPO plans, which means you have to use in-network plans to cover the cost of services. However, preventive care is free, and the company also offers members virtual visits with 24/7 accessibility.

Most Oscar plans have low copays — you’ll pay $25 for a doctor’s visit and $25 for prescription drugs on most tiers. Oscar’s plans even include 24/7 telehealth conferences with in-network doctors — get a refill for a prescription or expert medical advice without making a trip to the doctor. 

4. Best for PPO Plans: Humana

Looking for a way to add dental and vision insurance to your plan without breaking the bank? Be sure to consider Humana when you compare insurance providers.

In addition to its group health insurance plans, Humana offers comprehensive dental and vision insurance plans. Humana provides health insurance to employees at businesses of any size. In addition, the company has HMO, PPO and indemnity plans. The indemnity plan is the most expensive option but allows you to choose your own provider. 

Humana offers comprehensive dental insurance plans from $23 in many parts of Jersey, while vision insurance starts at just $15. Its plans even include affordable PPO coverage, meaning that you can use your benefits without worrying about finding an in-network dentist. 

Humana has 3 dental plans: Dental Savings Plus, Preventive Value and Dental Preventive Plus. The most significant savings is through the Dental Savings Plus plan, but you must use only in-network dentists. Humana vision insurance is called Vision Focus Plan and is very affordable with a $14.99 premium. It covers routine eye exams, contact lenses and frames.

5. Best for Adult and Child Orthodontia Benefits: Ameritas

Ameritas offers comprehensive dental and vision plans for Jersey residents. In addition, Ameritas has one of the most inclusive dental insurance plans covering 100% of preventive and pediatric orthodontic care.

If you’re looking to add more comprehensive dental and vision coverage, consider a package plan from Ameritas. Ameritas’s dental insurance options start at $50 per month but offer more inclusive coverage.

Ameritas’s vision plans begin at just $11 per month and include low $25 copays for eye exams. Like Humana, you can quickly add both dental and vision coverage to your household coverage in as little as 15 minutes through Ameritas’s website. 

Vision insurance through Ameritas provides screening coverage and coverage for contacts and prescription eyewear. The 20/20 Plus plan includes coverage for dental, vision and hearing with discounted prices for hearing aids

6. Best for No Enrollment Period Health Insurance: Sidecar Health

If you are a NJ resident looking for a healthcare provider with no enrollment period, Sidecar Health is a great option to consider. Sidecar Health is not a traditional insurance company but allows you to pay healthcare providers upfront using the Sidecar Health payment card. By using the Sidecar Health payment card, you can receive as much as 40% savings on healthcare costs. In addition, all Sidecar plans are ACA compliant.

Sidecar Health insurance is ideal for healthy people needing short-term coverage who do not have any preexisting conditions and may not want to enroll in a major healthcare plan.

Open Enrollment for Medicaid Marketplace Coverage

Key dates for New Jersey Medicaid Marketplace coverage:

• Open enrollment begins Nov. 1.
• Open enrollment ends Jan. 31.
• Coverage begins Jan. 1 if you enroll by Dec. 31.
• Coverage begins Feb. 1 if you enroll in January.

How Does Health Insurance Work?

Every month, you’ll pay your health insurance company a premium that keeps your health insurance NJ coverage current. You’ll also pay a set dollar amount out-of-pocket toward your own medical care costs — this is your plan’s “deductible.” Once you meet your deductible, you only need to pay a set percentage of your medical bills called a “coinsurance percentage.” Your plan will also include an “out-of-pocket maximum” that limits the total amount of money you can spend per year on healthcare.

Insurance plans can cost hundreds of dollars per month — are they really worth the cost? It’s always a good idea to maintain some type of health care coverage. Here are just a few of the benefits of having health insurance:

• Insurance helps you pay your medical bills. If you don’t have health insurance, you must pay for 100% of your medical care costs. This can mean spending upwards of $4,000 per day you spend in the hospital and upwards of $170,000 for a major, life-saving surgery.
• An illness can strike at any time. You shouldn’t wait for a new job or upcoming marriage to get coverage. An illness or accident can hospitalize you at any time — and you need to be protected.
• You might be breaking the law. As a Jersey resident, you’re required to have some form of long-term health insurance unless you qualify for an exemption.

Most people get their health insurance through their employer or through a government-sponsored program like Medicare or Medicare Advantage. If you don’t qualify for either of these, you can buy an independent plan from the ACA Marketplace by visiting Healthcare.gov. After creating an account on Healthcare.gov, you can shop for specific plan choices and browse plans by deductibles, premiums and covered drugs. 

Average Cost of Health Insurance in NJ

The average NJ resident spends about $451 per month on their individual insurance plan. The specific amount you’ll pay for your health coverage will depend on where you live, your plan provider, household size and income level, number of people enrolled on your plan, your age and whether you use tobacco.

If your total household income is less than $50,000, you may qualify for a health care subsidy through the Marketplace plans. Enter your financial information on your Healthcare.gov account to learn more about subsidies you qualify for. 

Types of Health Coverage

When you start shopping for a health insurance NJ plan, you’ll see a myriad of plan types and acronyms. You might even see multiple types of plans available from a single insurance company.

The biggest difference among plan types is the size of the network of doctors and specialists who accept your insurance.

Remember, you can also change policies if you have a life event like marriage, childbirth, etc. that qualifies. Let’s take a look at a few of the most common types of health plans you’ll see on the ACA Marketplace.

Health Maintenance Organization (HMO) Plans

HMO plans have a set network of doctors and specialists contracted to provide discounted services to insurance holders. If you have an HMO plan, you must see a doctor in your network — otherwise, you cannot use your benefits. You also typically need to get a referral from your primary care provider before you can see a specialist. For most people, an HMO plan is the most affordable health insurance option.

Preferred Provider Organization (PPO) Plans

PPO plans aren’t as restrictive as HMOs. With a PPO, you can see any doctor or specialist you like without worrying about whether they’re in your network. You can also see a specialist without getting a referral from your doctor. PPOs are more expensive than HMOs, but they give you more freedom when using your benefits.

Point of Service (POS) Plans

With a POS plan, you can see any doctor or specialist you want — like a PPO. However, you’ll save money if you choose to see an in-network care provider. You also need to get a referral before seeing a specialist. A POS plan might be right for you if you want to balance the cost and plan benefits between a PPO and an HMO. 

What Does Health Insurance Cover?

After you create your Marketplace profile, you’ll be able to browse insurance plans available in your area. Every plan you see on the Marketplace is compliant with the regulations set by the ACA. This means that each plan must cover all of the ACA’s “essential benefits,” including these:

Ambulatory Patient Services

This includes the care that you receive without going to the hospital.

Hospitalization

This includes both overnight stays and surgeries.

Emergency Services

Your insurance must cover emergency services at both in-network and out-of-network hospitals. The ACA prohibits insurance companies from requiring you to visit a specific hospital or contact them in a true emergency.

Prescription Drugs

Insurance companies need to cover all major classes of prescription drugs. The ACA doesn’t compel insurance providers to cover every brand-name and generic drug. If you’re already taking a specific prescription, you can shop for ACA plans that include coverage for it using the Marketplace’s prescription search tools.

Rehabilitative Devices and Treatments

This includes mobility devices and treatments intended to help you regain mobility after an illness or accident.

Pregnancy, Maternity and Newborn Care

Your insurance provider must offer coverage for all treatments and services you need throughout your pregnancy. It’s against the law for an insurance company to drop you from coverage or increase your premium because you’re now pregnant.

Preventive Care and Screenings

This includes both routine tests (like STD tests and lipid panels) as well as regular preventive care (like vaccinations and annual physicals).

Laboratory Tests

This includes specialized diagnostic tests.

Mental Health and Substance Abuse Treatments

This includes both inpatient and outpatient treatment for mental illness and substance abuse disorders.

Pediatric Services

Your insurance provider must offer all essential benefits to any children enrolled in your plan. Your plan also needs to include coverage for pediatric vision and dental benefits.

Female Birth Control

If you’re a woman, your insurance provider must offer coverage for birth control. This requirement extends to hormonal methods (like birth control pills), implanted devices (like the IUD), barrier methods (like the sponge) and emergency contraceptives (like Plan B). 

What Does Health Insurance Not Cover? 

No matter which plan tier you choose and who services your insurance, your plan won’t cover everything. Let’s look at a few of the most commonly-excluded treatments and services.

Male Birth Control

The ACA only requires insurance companies to provide coverage for male methods of birth control. This means that most health insurers don’t cover male contraceptives like condoms and vasectomies.

Adult Vision and Dental Services

Your insurance needs to include coverage for vision and dental services for children on your plan. There’s no federal mandate that requires insurance providers to extend these services to adults. You can, however, purchase a separate vision and dental plan to supplement your coverage.

Travel Vaccinations

Health insurance only covers the routine set of recommended vaccinations set by the CDC. If you need a special vaccination for travel abroad (like an immunization for Yellow Fever or typhoid) you’ll need to pay for it out-of-pocket.

Cosmetic Surgery

No form of purely elective surgery is covered by health insurance.

Bariatric Surgery

There is no federal mandate that requires health insurance companies to cover bariatric surgery — even when deemed medically necessary. Insurance providers may elect to voluntarily provide this benefit on a plan-by-plan basis. So, you may want to shop plans to find the best option.

Rehab

Often, substance use treatment and rehab stays are not covered under your insurance. Check your policy documents to learn what might be covered, but remember that some disclaimers may disqualify rehab care. This is similar to many group plans on the market. 

Factors to Consider When Choosing Health Insurance

When you are looking for health coverage in NJ, there are a few things you want to take to heart before making your first payment.

Are Your Providers a Part of the Network?

When you are looking at new health coverage, make sure that your preferred providers are available. Not all doctors, nurses, NPs, PAs, etc. are paneled with every insurance carrier. Reach out to the provider to check before you commit to an health plan.

How Much is the Total Premium?

Make sure you know how much the exact premium total will be. If you’re not sure of the cost, you need to verify that number before committing to make that payment every month.

How Easy is It to Access the Customer Service Team?

If you can easily get a hold of the customer service team, you’ll be much happier. If not, you may have issues with this policy, even though you’re paying handsomely for coverage that might ask more questions than it answers.

Are Your Medications Covered at a Reasonable Price?

If you use certain medications regularly, make sure that you know if they are covered and about how much they cost. Without this critical information, you may end up spending more money than you thought.

Finding Affordable NJ Health Insurance

You have several good options when looking for health insurance in New Jersey. To find the most complete health insurance coverage at the most affordable rate, you can get free quotes from the aforementioned health insurance providers at GetCoveredNJ or by researching with Benzinga. All of the companies have their own guidelines when calculating your insurance rates, so the rates will vary from company to company. 

Frequently Asked Questions