Calling it one of the major hallmarks of health insurance reform, U.S. Rep. Bill Pascrell, Jr. (D-NJ-8) today praised the announcement of the U.S. Department of Health and Human Services' agreement with the State of New Jersey to provide coverage for individuals who have traditionally been denied health insurance. A subsidy of $141 million from the Federal Pre-Existing Condition Insurance Program, colloquially known as the "high risk pool" program
"Today, people in New Jersey are seeing tangible benefits on the landmark health insurance reform legislation that became law in March. This is a huge step in ending some of the madness that has existed in health insurance coverage for far too long," said Pascrell, a member of the House Ways and Means Committee who proudly voted for the Patient Protection and Affordable Care Act in March. "Through this partnership of the federal and state governments, we are putting an end to the practice of denying someone coverage because they had a previous condition or because they have had difficulty acquiring coverage."
NJ Protect, the insurance new program that will be buoyed by a $141 million federal subsidy , will allow legal residents who have been without insurance for at least six months to buy coverage with better benefits than they could have obtained before, and for 30 percent less.
Those with pre-existing conditions will be immediately covered instead of fulfilling the previously required 12-month waiting period.
Preventive care will be covered with no copay, coinsurance or deductible. NJ
The state has subcontracted with Horizon Blue Cross Blue Shield of New Jersey to administer NJ Protect by accepting and processing applications, collecting premiums and paying claims.
We expect Horizon to begin accepting applications this week, with coverage to take effect Aug. 23. Depending on the applicant's age and the benefits package he or she selects, premiums will range from $213 to $768 a month.
To be eligible for NJ Protect, an applicant must:
* Be a U.S. citizen or national or legal resident alien.
* Be a New Jersey resident.
* Have been uninsured for at least six months.
* Not be eligible for coverage under Medicare or a group plan.
* Have a pre-existing, chronic condition. The applicant need not be currently symptomatic or undergoing treatment for that condition; a cancer that is in remission will qualify.
Although NJ Protect is modeled on the coverage already available in New Jersey's individual health insurance market, premiums will be 30 percent lower and benefits will be superior. These superior benefits can be offered for 30 percent less because the program is federally subsidized. The Federal Pre-Existing Condition Insurance Program, colloquially known as the "high risk pool" program, is designed to cover people who cannot purchase insurance because of pre-existing health problems.
Services covered by NJ Protect will include office visits, hospital and emergency room care, home health care, rehabilitation services and hospice care.
Prescription drugs are covered subject to 50 percent coinsurance but there is a $5,000 ceiling on out-of-pocket expenses.
State officials project NJ Protect will benefit 21,000 New Jersey residents.