Best Health Insurance Agencies in Jersey City, NJ

FAQs

• Introduction

  If you're looking for health insurance for yourself or your family, an agent can help you save time, understand your options, and manage your costs. Insurance agents must be licensed in the state where they operate. They can provide information about on- and off-exchange plans to help you weigh all of your options, and they can see if you qualify for tax credits that can lower your monthly premiums. There's no cost to work with an agent, and they can help you save quite a bit by recommending the best plan for your needs. Here's what you should know before you get started.
  

• Is it a requirement to have health insurance in Jersey City?

  Jersey City residents are bound by New Jersey's State Individual Mandate, which necessitates having health insurance with minimum essential coverage year-round. This policy ensures uninterrupted access to healthcare services. Individuals who do not comply or qualify for an exemption are subject to a Shared Responsibility Payment when they file their Income Tax returns. This approach serves to promote healthcare coverage and financial responsibility among all Jersey City residents, ultimately contributing to the community's overall well-being.

• Are there any exemptions so you can bypass the health insurance mandate in Jersey City?

  According to New Jersey's State Individual Mandate, taxpayers must have health insurance throughout the year. However, Jersey City residents may be eligible for exemptions. Some of the exemptions available include earning less than a certain level of income, having no affordable coverage options, experiencing a short gap in coverage, or enduring hardship.

• Can young adults be dependents on their parents' health insurance coverage in Jersey City?

  Depending on the individual's age. As long as their child/children are 30 years old or younger, parents in Jersey City can add them as dependents on their health insurance plan. They must also be uninsured, single, and residents of the state or full-time students. Employers are not required to contribute to young adult health insurance coverage. Furthermore, even if they cover residents in New Jersey, this law does not apply to large companies' self-insured plans or plans issued and delivered outside of the state.

• Can parents be considered dependents on a health insurance plan in Jersey City?

  In Jersey City, individuals can add elderly parents, stepparents, or parents-in-law to their health insurance plans by claiming them as dependents on their federal income tax returns. For those considering this option, consulting with a tax professional is recommended due to the stringent eligibility requirements outlined by the IRS. To qualify, the parents must be US citizens or residents, have a gross income of less than $4,300 annually, not be someone else's legal dependent, and have more than half of their financial needs covered by the taxpayer each year.

• If you get a divorce in Jersey City, will you lose your health insurance through your ex-spouse's plan?

  Yes, non-spouses in Jersey City cannot be covered by an employer's health insurance plan. Even if you and your ex-spouse agree to remain civil or have a good relationship and wish to remain on the same health insurance plan, you cannot remain on your ex-spouse's policy if you are divorced. Ex-spouses are no longer considered family and therefore cannot be covered as such.

• How can you find affordable health insurance? 

  Affordable insurance is available through employers, Medicare, Medicaid, and the federal Health Insurance Marketplace, which offers subsidies in the form of tax credits. You can also purchase coverage through private insurance companies and independent agents. Nearly half of all Americans have employer-sponsored health insurance, and about 10% of the population is uninsured.

• What is health insurance?

  Health insurance policies are contracts that require an insurer to pay some or all of a beneficiary's health care expenses in exchange for a premium and deductible. Plans cover preventive care and emergency medical services arising from an injury or illness. They may also offer optional coverage for dental and vision.

• How do health insurance companies make money?

  Health insurance companies make money by collecting premiums from consumers and reinvesting the funds. Federal law requires insurers to put approximately 80-85% of collected funds toward claims, and 15-20% is used to pay for administrative expenses.

• What is subsidized health insurance?

  Subsidized health insurance is available exclusively through the Health Insurance Marketplace. This system applies federal tax credits that can reduce or eliminate premiums. Tax credits are available to consumers who earn up to 400% of the federal poverty level based on household size.

• What is a health insurance deductible? 

  A deductible is a fixed amount you must pay out-of-pocket before normal copays or coinsurance rates apply. Under the Affordable Care Act, some services, such as annual physicals and wellness screenings, must be covered at no charge.

• Is it illegal to not have health insurance?

  No. Starting in 2019, the federal government eliminated the penalty that applied to individuals who could afford health insurance but chose not to purchase it. Financial penalties still apply in California, Massachusetts, New Jersey, Rhode Island, Vermont, and Washington, D.C.

• Does health insurance cover therapy? 

  All Marketplace plans must cover behavioral health care services, including counseling, inpatient care, and substance abuse treatments. However, there are coverage limits, and preauthorization may be required.
  

• What is a copay?

  A copay is a fixed price that you pay at the time of service after your deductible is satisfied. Insurance companies set specific rates for primary and specialty care and other services, such as emergency room visits and X-rays. Alternatively, plans may have coinsurance rates that require beneficiaries to pay a certain percentage of covered charges.

• What is the Health Insurance Marketplace?

  The Health Insurance Marketplace is a federal service designed to help consumers compare and purchase subsidized health insurance plans that comply with the Affordable Care Act. A number of states operate their own insurance marketplaces, including California, Colorado, New York, and Pennsylvania.
  

• How can you find health insurance without a job?

  Individuals who don't have access to health insurance through their job can purchase ACA-compliant plans through the Health Insurance Marketplace. Off-exchange plans are also available through private insurers and independent agents. The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives certain individuals who are losing their coverage the right to maintain the same plan for a limited time period. 
  

• Can you cancel health insurance at any time? 

  Consumers can cancel their health coverage at any time. Cancellations may be effective immediately or at a specified date. However, you must wait until Open Enrollment to sign up for a new plan unless you qualify for a Special Enrollment period.

• Can you have more than one health insurance policy?

  It's possible to have primary and secondary health insurance. This is most common with Medicare and Medicaid beneficiaries, including dual enrollees and individuals who purchase supplemental plans. Secondary plans can cover some additional expenses, but you're still responsible for premiums and deductibles.

• Is health insurance pretax?

  Premiums for employer-sponsored health plans are generally deducted from the worker's pretax income. The same is true for voluntary contributions made to Flexible Spending Accounts and Health Savings Accounts that are paired with a qualifying high-deductible health plan.

• How long can a child stay on a parent\'s health insurance policy?

  Children can stay on their parents' health insurance plan until their 26th birthday. There's a 60-day special enrollment period following this date. Exemptions allow disabled adult children to remain on their parents' policy beyond this age.

• Do you have to pay a health insurance deductible upfront?

  In most cases, out-of-pocket expenses for approved services count toward your deductible. However, it's increasingly common for hospitals to request all or part of the deductible upfront when scheduling major services, such as CT scans and surgeries.

• Do employers have to offer health insurance?

  The Affordable Care Act requires companies with at least 50 full-time employees to make essential health benefits available to 95% of their workforce. Companies that choose not to offer such benefits may have to pay a penalty.

• Is there a tax credit for having health insurance?

  The Advance Premium Tax Credit is a federal tax rebate designed to lower the cost of health insurance plans purchased through the Marketplace. Eligibility is based on income and household size. Consumers can decide how much of their tax credit to put toward their premiums.