Review your New Jersey Health Insurance for the New Year

Many states made health care and health insurance legislation priority issues in 2009. Changes in state law could have a big impact on what you pay for your New Jersey health care insurance in the future. As the new year approaches, now is a great time to review your policy and look for competitive health insurance quotes from New Jersey providers. Here’s a quick run-down on changes that took place in 2008-2009 session.

A1073 requires that your New Jersey health insurance coverage reimburse for hairpieces for patients receiving cancer chemotherapy. A similar bill, A1171, mandates coverage for scalp hair prostheses for cancer patients in chemotherapy.

A1206 requires employers and birthing facilities to notify insured pregnant women if  their New Jersey health care insurance coverage is subject to the 48-hour maternity law. Under the 48-hour law, the insurance company must pay for a full two days of hospital care for mothers and their newborns after a normal delivery (96 hours for a Caesarian delivery). Previously, the coverage only extended to 24 hours (48 for Caesarian). However not all insurance companies are required to comply.  For instance, the state statutes do not apply to insurance policies written outside New Jersey, which includes more than 400,000 New Jersey residents who commute to work outside the state. It also doesn’t extend to some three million residents whose hospital insurance is not regulated by state law because they have insurance from employers who are self-insured or self-funded. Such plans are regulated by the Federal Employee Retirement Income Security Act and, as federal law, take precedence over state law. A1206 eliminates unpleasant surprises and unexpected bills.

Also of interest to women and young families, A2297 now mandates that New Jersey small employer health insurance carriers offer coverage for treatment of infertility.

A2402 requires that all New Jersey health insurance providers use standard explanation of benefits forms. The regulation further requires that the language used be clearly understandable consistent with the “Life and Health Insurance Policy Language Simplification Act.” Under this law, the uniform explanation of benefits for current services must include the cost of the service, the amount paid by the insurer and the amount to be paid by the insured. Any denial of benefit must be clearly spelled out, too.


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