Do you want to know what is the best health or medical insurance in New Jersey? Are you worrying how to pay medical bills in the future for your children? Are you wondering how to save money from emergency care or urgent care for your kids? Do you really understand how health insurance works?

Difference between Medical Insurance and Health Insurance in New Jersey

According to an article by Finserv, Health insurance policies are designed to cover a broad range of medical expenses, including preventive care, doctor visits, and prescription drugs.

On the other hand, medical insurance gives coverage for specific medical expenses related to a serious illness or injury

Let us dig a bit deeper about this but honestly, they are almost interchangeable. 

The word “Medical” is derived from the Latin word mederi, meaning “to heal,” 

Meanwhile, the word “health” is derived from an old English word, “hale”, which means “wholeness, being whole or sound.”

Moreover, according to etymology online, the word insurance, means “engagement to marry,” a variant of ensurance “an assurance, pledge, guarantee,” from Old French enseurance “assurance,” from ensurer, from en-“make” (see en- (1)) + sur “safe, secure, undoubted”. Commercial sense of “security against loss or death in exchange for payment” is from 1650s. Assurance was the older word for this specific sense (late 16c.). C

So, a health or medical insurance is an assurance that your HEALTH and/or MEDICAL needs will be GUARANTEED by your insurance provider.

But to make it easier to understand, health’s the best general term to use. Using medical insurance term is quite specified to a particular illness.

So, what is the difference? To make your life easier, think about it generally as the same.

Anyway, read this page about the health insurance in New Jersey for you to know what are the best that fits your needs and preferences.

What is the best Health Insurance for kids in New Jersey?

If you have read the link above about health insurance you will notice that there are a number of insurance available. According to NAIC the number of Health insurers filing the health statement type with the NAIC increased to 1,127 from 1,096 in 2020. Try to read this 2020-Annual-Health-Insurance-Industry-Analysis-Report for reference.

If there are hundreds or even thousands of insurance, it is difficult to find the best health insurance. However, you must understand that there are different medical or healthcare needs that a child may find.

There is dental, vision, heart, and other specific needs of a child. Some health insurance is not comprehensive. Some are not covered so it is either you pay out of pocket or get another insurance that cover a particular illness.

Therefore, to answer the question what the best health insurance for kids is, do take note of the following questions:

1. Is it comprehensive coverage for your child?
2. Is there any waiting period, deductibles, and other conditions before you can use it?
3. Do you have pre-existing conditions that may decline your claims?
4. How guaranteed are the benefits? 
5. Does your insurance really pay?
6. Do they have a number of in-network doctors? The cost will be different for out of network doctor.
7. Is it affordable or worth the price?

There are still more things or factors to consider but if the above questions have YES answers – you got the best health insurance for your child! 

How Health Insurance for child works?

If you have found the best health insurance for your child, it is about time to understand how it works or how it can benefit you the fullest!

According to UCLA “Health insurance pays for many (if not all) of the medical needs you may have. Each month, you make a payment to a health insurer, such as Medicare or your insurance company. Some employers chip in for this payment.

In return, your insurer covers all or some of your medical costs, as long as you follow the insurer’s rules. For example, your insurer may only sign contracts with certain doctors and hospitals. You must stay in this “network” or risk having your insurer decline coverage.”

This is what you have read above questions about factors to consider in getting health insurance.

Insurance for your child works as umbrella. When rain comes, you can use it so that you are protected.

Of course, you will never know when it will rain or (worst) storm but one thing is for sure – you will experience bad wheather anytime, anywhere.

If you have no insurance for your child, you must have CASH to pay for whatever cost of hospital bills. If the government will pay it for you, that is luck. However, there are requirements you need to comply before you can avail the government aids.

Let us narrate how health insurance works for your child.

• When your child got sick or injured you may be in panic mode so you will look for the best pediatrician or doctor near you.
• Either you have no insurance, or you have it with your company. Assuming you have it, the URGENT CARE NEAR YOU will ask you what your health insurance is and make a quick eligibility and benefits check.
• If your child is covered, you will not pay anything but maybe some copay if ever there is.
• The insurance will be billed by the urgent care and most likely you have nothing to pay anymore!

This is case to case basis. There are many conditions or parameters to consider which will be explained by your insurance company based on your contract with it.

Again, some illnesses are covered, some are not. There are also pre-existing conditions that may affect your situation.

This is the reason why you should talk to your agent one way or another and ask everything.

Try to look at the infographics below on how US aided many Americans out of health insurance

These infographics show the utilization of health insurance in US. 

Government Health Insurance vs Private Health Insurance in New Jersey

Medi-Cal is California’s Medicaid program. The state and the federal government jointly fund it. It provides free or low-cost care to children and adults with limited incomes.

Medicare covers people 65 and older, as well as some people with certain diseases or disabilities. Medicare includes Parts A and B (coverage for hospitals and doctors). Part D (prescription drug coverage) is optional and costs extra. You may only join during certain enrollment periods.

Health insurance through private plans

Medicare Advantage plans are similar to traditional Medicare, but approved, private companies offer them. They cover services from doctors and hospitals. They frequently cover prescription drugs as well.

HMOs (health maintenance organizations) you can only see doctors and use hospitals within a set network. You must also choose a PCP, or primary care physician. To see a specialist, you first need a referral from your PCP.

PPOs (preferred provider organizations) You can see any doctor or use any hospital as long as you stay within your insurer’s approved network of providers and hospitals. Your plan may allow you to receive care out-of-network but may not cover as much of it.

POS (point of service) plans: combination of HMOs and PPOs, with a network of approved doctors and hospitals. Like an HMO, you must choose a primary care physician and secure referrals to see specialists. Like a PPO, there is often some flexibility with going out of network.

Things to know before getting Health Insurance in New Jersey 

Before getting your preferred health insurance you must understand first this information and the contract as a whole.

• The deductible is the amount you pay out of pocket every year before the insurer begins to meet the costs. This is now capped by federal law. You can also ask your insurance company if you have deductibles because sometimes you have not.
• Copays are set fees that subscribers must pay for specific services such as doctor visits and prescription drugs even after the deductible is met. You need to ask your agent or insurance company directly for any copays for each coverage that you have. The more detailed the better so that you will not be upset when the billing or claims arrived.
• Coinsurance is the percentage of healthcare costs that the insured must pay even after they’ve met the deductible (but only until they reach the out-of-pocket maximum for the year).
• Waiting period- Ask your insurance company if when you can use your benefits because sometimes you need to wait a certain time before you can avail your benefits or before you can be covered.

Read more about this in Investopedia for more details.

TIPS AND WARNINGS IN GETTING HEALTH INSURANCE FOR YOUR CHILD:

1. Be careful with too good to be true benefits! Always ask the agent or insurance company about the TRUTH!
2.  For sure insurance company give their best to sales-talk you so be aware about the offer, quotation, or the contract itself.
3. Be mindful about the pre-existing conditions coverage. Eventually it will be denied once you do not declare it upon signing the contract or subscription.
4. Check your budget. If it is under your employer, ask for information on how much you are covered. If you signed up as individual be mindful of the fact that it is a long-time commitment. If you lost money to pay for the premiums you will not be covered anymore.
5. Ask the agent who are covered or who are not. If your child is not covered, try to customize the plan by requesting it to them. But remember that premiums will change if you add a beneficiary so cheek your budget before you sign.