1. The basics
Obamacare is available to consumers who don’t get health insurance through Medicare, Medicaid or their employer.
Last year, 289,000 residents signed up through the exchange, which amounts to about 4 percent of the overall health insurance market, according to the New Jersey Association of Health Plans, a trade group.
New Jersey this year has three insurers selling policies in the exchange: Horizon, AmeriHealth New Jersey and Oscar. That’s up from two last year.
2. The Trump effect
Trump ended cost-sharing payments to insurance companies that lowered out-of-pocket costs for low-income consumers.
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And he has said he won’t enforce the so-called individual mandate that forced uninsured consumers to pay a tax of 2.5 percent of their household income, or $695 per adult and $347.40 per child under the age of 18, whichever is more.
Insurers said the moves increased premiums. Horizon, for example, said it was in line for a single-digit increase, but instead needed to raise average rates more than 16 percent.
A middle-of-the-road silver plan for individuals will cost on average $311.86 a month for AmeriHealth New Jersey; $346.72 for Horizon; and $349.30 for Oscar, before taking subsidies into account.
3. Shop around
Key terms consumers should know:
Premiums are the cost of health insurance.
Co-payments are a flat dollar amount paid to the provider at the point of service.
Deductibles are what consumers pay out of pocket before insurance kicks in.
And coinsurance is a percentage consumers can pay after they reach their deductible.
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