subject: Nj Protect Provides Health Coverage To Residents [print this page] New Jersey insurance officials have recently introduced a state health care program called NJ Protect. This plan offers health insurance to those who have a pre-existing condition their current insurance carrier will not cover. NJ Protect is designed as a less-costly alternative to other private carrier options. It is subsidized by the U.S. federal government. The day the policy goes into effect the pre-existing condition is covered, as is any preventive care.
To qualify for this state plan, a person must be a New Jersey resident, a US citizen or lawfully present in the country. She or he must also have a pre-existing condition not covered for the last six months or more. Those eligible for Medicare or group coverage through an employer would not be qualified for this coverage.
To prove qualification for this New Jersey insurance the applicant would need to provide his or her birth certificate, passport, citizenship certificate or naturalization certificate. A driver's license could be used to confirm residency in the state. A resident with no license could provide proof of a mortgage or rent payments, or present utility bills.
For purposes of eligibility, the pre-existing condition must be chronic. The patient need not be symptomatic at the time of application. Additionally, the applicant would not need to be undergoing current treatment for the condition. This New Jersey insurance plan is important, as the state allows carriers to exclude pre-existing conditions from coverage. It does not allow carriers to deny insurance to those who have pre-existing conditions, however.
The new NJ Protect covers medical office visits, emergency room visits and in-patient stays. It also pays for the care and treatment of the illness or injury whether surgical or not, as well as transplant costs and maternity and pre-natal care. Well-baby care, immunizations, and the cost of durable medical equipment are part of the plan too. Additionally, orthotic appliances, prosthetics, and services for mental illness that are biologically based are included. Other coverage includes alcoholism treatment, some substance abuse services, hospice care, rehabilitation service, and laboratory and X-ray service. NJ Protect also pays for anesthesia, transport by ambulance, prescriptions, physical and occupational therapy, and home health care. Some mental illnesses that are not biologically based and some infant formulas are covered under the state plan as well.
Costs for this New Jersey insurance are shared between the state and the insured; they vary according to the particular plan chosen by the patient. No one will pay more than $5000 out of pocket in any year. Additionally, coverage for preventive care begins day one. This means that the insured need not pay a co-pay or fulfill a deductible requirement for 100 percent reimbursement. Coverage by NJ Protect might still be beyond the financial means of some residents. Still, there are many with pre-existing conditions for whom the new coverage means better medical treatment for less cost.
by: Brenda Fullwerth
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