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