Individual Health Insurance

Network Review of Horizon BCBS vs. Amerihealth vs. Health Republic

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NJ Health Insurance Exchange Network Review of Horizon BCBS vs. Amerihealth vs. Health Republic.- NJ

Reviewing the different plan options on the NJ Health Insurance Exchange can be difficult and the HealthCare.Gov website doesn’t always provide all of the details so today I’m going to go over the networks for each of the carriers.


In this video, I will specifically cover the networks for Amerihealth, Horizon BCBS and Health Republic.

NJ Health Insurance Carrier Options on the exchange


  • Regional Preferred – this is their standard network that they have always used. Includes of NJ and a good part of the Pennsylvania counties near Philadelphia. The Amerihealth Regional Preferred Network includes all of New Jersey and the following Pennsylvania counties: Northampton, Lehigh, Bucks, Berks, Montgomery, Philadelphi, Delaware, Chester and Lancaster.
  • Value Network – this is a subset of the Regional Preferred and includes roughly 79% of their larger Regional Preferred. Please note that the only Philadelphia hospital as of today that in that network is Childrens Hospital(CHOP)
  • Tier 1 Advantage – Tier 1 breaks down the Value Network even further. You will pay lower out of pocket for Tier 1 hospitals compared to Tier 2
  • National – This is the only National Network available from the individual carriers. Amerihealth uses the Multiplan network. The national option is only available on their POS+ plans. While you are in the Regional Preferred Service area, you must use that network. So for example, if your provider in Philadelphia does not accept Amerihealth but they are in the Multiplan network, that provider would be considered out of network. If you were in a county outside of that Regional Preferred network and they took Multiplan, you would be ok.
  • See my sheet for looking up physicians in the Amerihealth Regional Preferred and PHCS network

Amerihealth Local Value Hospitals

Multiplan National

Health Republic

Health Republic uses the Qualcare HMO network and includes hospitals in NJ, PA and even Sloan Kettering in New York. They look to be a strong competitor network wise.


Health Republic Hospital Network


Updated 2015 Information for Health Republic

Health Republic will only be offering no-referral plans for 2015 so this is great for consumers. They will continue to use the Qualcare network in New Jersey and then the expanded PHCS Network when outside of NJ.

Please see some of their marketing materials below including

1)Health Republic 2015 Individual Enrollment Kit– this is to enroll off the exchange, so if you would like to do so, please reach out to me with the application so it can be submitted.

2)Health Republic Network PHCS Flyer

3)Health Republic Vaccine sheet

4)Health Republic Benefit Highlights Flyer[schema type=”product” name=”Health Republic Individual Health Insurance” ]


Horizon Blue Cross Blue Shield of NJ

  • Advantage – these plans use the Managed Care network – this is the same as you have always had if you used their HMO, POS options
  • Omnia – The Omnia plans are new for 2016 and you can see my write up here. Horizon BCBS Omnia Review

Horizon BCBS Hospital List


New Jersey Insurance Exchange – Network Review of Horizon BCBS vs Amerihealth and Health Republic

Read more about the comparison of these plans and other NJ IHC plans here.

What You Need to Know About HealthRepublic of NJ

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Health Republic has been operating in NJ now for almost two years and I still find it to be not well understood by the public and even insurance brokers. My goal with this article is get you the important information and not the fluff you usually find online when you are trying to get the information you need to make a buying decision.

Don’t be like this guy! If you need help with your Health Republic plan or any plan for that matter, please give me a call.

health republic

If you want all the background of the company, please go here first. Health Republic

You may also want to download their summary sheets here.

Health Republic Benefit Highlights Flyer

What I like about HealthRepublic

  • Rates!!! For individuals and groups, Health Republic is very well priced and lately I’m finding them to be the best price especially on the lower Silver and Bronze plans. Specifically their Spotlight Silver Plan
  • Network: Health Republic uses the Qualcare network in NJ which isn’t probably the largest when compared to some of the others but it is still very large.  (Key tip, when you call your doctors to check if they accept Health Republic, you need to specifically ask if they accept Qualcare) You can search their network here by clicking on the image below. Their marketing focuses on adding out of state access to NYC with the Multiplan Health Directions network but it is actually nationwide. Great benefit!

qualcare health republic network


  • Teledoc – This comes with your enrollment into any of the Health Republic plans. You have round the clock access to doctors over the phone and its free!! So for those times when you don’t need the emergency room and still aren’t sure even about the using the urgent care, you can call Teledoc.
  • Plan Selection: Ok for me this is a plus and a minus. They have alot of plan options in the silver range which gives you a lot of options but in my opinion there might be too many. When I help people with quotes, there might be five silver plans within Health Republics suite of products within $5-$10 of each other. So yes, you have options and can tweak the plan a little but it can be confusing when trying to figure out what is different between them. The big things to focus on are the rx copays, hospital inpatient, physician copays..
  • Free labs at Quest- I know their summary sheets may say otherwise, but lab work done at Quest Diagnostics should be covered 100%. (you may not use Labcorp, as they are out of network)

What I don’t like about HealthRepublic

I don’t like to nitpick because I do like this company a lot but I will share with some things I would like changed.

  • Plan selections – I think there are too many silver plans with premiums too close to one another. They need to narrow this to maybe 2 plans.
  • Branding – they still need to get their message out to everyone in NJ so they becoming a more household name. There is something about having a known brand that makes consumers feel comfortable in purchasing their health insurance. This is why Horizon BCBS gets so much business. They are the name you know.
  • Network – this was one of my positives but they still need to continue contracting doctors until they are at the same levels as Horizon, Amerihealth and Aetna. Don’t think they have zero network just because I’m putting this here. It is good but still can grow a bit.


That’s all I have for now, I’m going to be updating this page as often as possible with even more details on the company. If you have questions or would like anything featured please contact me.

You can also check out my video on Health Republics network vs some of the other New Jersey Health Insurance Carriers.

If you need more information on individual health insurance in NJ or individual dental insurance please follow my links.

Review of Amerihealth NJ Individual Health Plans

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Amerihealth NJ Individual Health Plans

This is a quick review on why I think you should consider Amerihealth NJ for your individual health coverage in NJ.



My top three reasons are:
1) Provider networks – very strong throughout NJ and PA and you can also add nationwide coverage with their Multiplan network partnership
2)Plan options – they have 32 different plans so there is something to fit every budget. If you are looking for the best plans, I would start with them.
3)Customer service: They are great to work with as a broker and as a client. I have used them personally and they are always wonderful to work with for claims issues or anything that comes up.

If you have any questions on these plans or any plans, please contact me anytime at [email protected]


Read more about NJ Individual Health Insurance Plans

Amerihealth NJ Individual Health Insurance Plans – Networks

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Amerihealth New Jersey Networks

This is a review of the different plans Amerihealth is selling in NJ. It includes their HMO, EPO and POS plans. This video will also review their networks. Value Network, Regional Preferred and National.
If you have any question on health insurance plans for New Jersey please call or email me any time.

Amerihealth Network Options:

  • Regional Preferred
  • Value : roughly 79% of the Regional Preferred network
  • Regional Preferred with National Access: Includes all of Regional Preferred and National Access through the Multiplan Partnership

Please read more articles on Individual Health Insurance here.

Video Review of Amerihealth NJ Individual Health

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My review of the Amerihealth NJ Individual health insurance plans offered in New Jersey both on and off the healthcare exchange.


Amerihealth NJ

In this review I go over the three major reasons why I think Amerihealth NJ is a good choice for your individual health insurance.

  • Networks – they have one of the strongest networks of any of the health insurers in NJ and also provide access to many counties in Pennsylvania. They also give access to Nationwide coverage through their Multiplan partnership.
  • Plan Selection – they have 32 different plan offerings including HMO, EPO and POS plans. They also have a few HSA plan designs if you want to take advantage of low premiums and health savings account options.
  • Customer Service: Both as a broker and a consumer, I have found them to be very responsive and always getting things done when needed.


 Review of Amerihealth NJ Individual Health Plans


Read more About Individual Health Insurance Here