New Jersey, despite having three less carrier options this 2017 in its state exchange, fares better than a lot of other states, which only have a single option. However, its residents on the hunt for coverage can expect rate increases going beyond the national average of 25%. So before you start shopping around, make sure you educate yourself more about the other key changes in the state’s health insurance. This way, you can prepare yourself better when making your final decision, as well as ready yourself for premiums higher than last year.

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Health ranking of the state: Just above average

One thing that can help mitigate potential exorbitant premiums the state’s residents may face in the future is improvement in its health care industry. Although it performed well in the 2015 Commonwealth Fund’s Scorecard on State Health System Performance, where it ranked 20th out of 51, it can do a lot better. Doing so can result in 609,511 more people gaining insurance.

Here are some of the study’s key findings in terms of health and lifestyle:

  • Mortality amenable to healthcare: 75 out of 100,000 people

  • Breast cancer fatalities: 23.2 out of 100,000 women

  • Colorectal cancer fatalities: 14.9 out of 100,000 people

  • Percentage of adult smokers: 14%

  • Adult obesity: 27%

  • Obesity in children aged 10-17: 25%

As for access to health insurance, below are a few statistical comparisons taken from the study:

  • 16% of adults (19 to 64 years old) don’t have insurance, compared with the national average of 15%

  • 5% of children (infants to 18 years old) are uninsured, as opposed to the countrywide average of 6%

  • 14% of the adult population chose not to obtain insurance due to the high costs associated with it

  • 13% of adults had expensive out-of-pocket medical bills

Metal tiers and portion they cover

Your out-of-pocket expenses for medical and hospital costs depend on the metal tier you have. Bronze offers the least reimbursement, at 60%, followed by Silver (70%), then Gold (80%), and lastly, Platinum (90%). Note though that this year, the state exchange carriers haven’t offered Platinum plans.

Bronze – 60%

Silver – 70%

Gold – 80%

Platinum – 90%

Bronze
Silver
Gold
Platinum

You can use the following premium average projections from the United States Department of Health & Human Services to have some idea on how much your insurance costs will be this year:

  • Average lowest-cost, monthly premium within metal level: $463

  • Average net premium for lowest cost plan within metal tier: $178

  • Second-lowest silver before advance premium tax credit (for a 27-year old with a $25,000 household income): $286

  • Second-lowest silver after advance premium tax credit (for a 27-year old with a $25,000 household income): $142

  • Second-lowest silver before advance premium tax credit (for a family of four with a $60,000 household income): $1,036

  • Second-lowest silver after advance premium tax credit (for a 27-year old with a $25,000 household income): $405

Uninsured rating of the state impacts premiums

Not a lot of people are aware that the state’s other residents also affect their premiums. Those with insurance have a positive impact, and those without bring negative effects. Fortunately, The Garden State has seen a considerable reduction in the number of individuals who go without insurance. The U.S. Department of Health & Human Services backs this up after a 5-year study showing a drop of 4.5% from 2010 to 2015. In 2015, the state, with a then estimated population of 8,958,013 (2015, latest data1), only had an 8.7% uninsured rating.

Getting coverage even after the open enrolment

The open enrolment ended in January 2017. However, this doesn’t mean you no longer have the chance to obtain coverage. You still have several options when it comes to private insurers; just make sure you exhaust all your options before making a decision. This way, you can find a plan that will protect you from the high costs of medical services without having to pay really expensive premiums.

References:

https://www.healthinsurance.org/new_jersey-state-health-insurance-exchange/

http://datacenter.commonwealthfund.org/scorecard/state/32/new-jersey/

https://aspe.hhs.gov/sites/default/files/pdf/212721/2017MarketplaceLandscapeBrief.pdf

https://aspe.hhs.gov/compilation-state-data-affordable-care-act

1Latest data: The U.S. census is conducted every 10 years as per requirement of the United States Constitution. The 23rd edition and the latest data is the 2010 United States Census. Source: https://en.wikipedia.org/wiki/2010_United_States_Census
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