3 New Jersey Health Insurance Laws That Policy Holders Should Understand
Saturday, August 27th, 2011 by adminAlthough federal health care laws have been the subject of much debate and legislation recently, state laws regarding health insurance are no less important in obtaining health coverage. Federal laws establish broad policies and requirements for health insurance laws across the country. However, it is state law which largely oversees and regulates the issuance of health insurance policies within the borders of each state. New Jersey health insurance laws meet all federal health care mandates but also provide coverage and benefits not required by federal law. Here are three New Jersey health insurance laws a consumer should be aware of when purchasing health coverage in the state.
New Jersey health insurance law requires that each policy issued contain a provision specifically addressing guaranteed renewability. Guaranteed renewability simply means the insurance company issuing the policy must let the policy holder renew it as many times as he or she wants when it is due to expire. In order to benefit from this law, the policy holder must have obeyed all the terms of the policy and paid all the premiums due on time. As long as policy holders have done those two things, they cannot have their coverage involuntarily canceled and be denied continued coverage for any reason, including health complications.
Another law it is important to have knowledge of concerns how pre-existing conditions are designated. Under New Jersey law, it is possible for insurance companies to term any health issue or problem that exists up to six months before beginning coverage under a new policy as a "pre-existing condition." The effect that has is to make any costs that occur as a result of the condition exempt from coverage. The policy holder must pay them him or herself, but after 12 months, the health insurance laws in New Jersey mandate that the costs must be covered under the new policy.
Finally, it is essential to know the law regarding denial of insurance. New Jersey laws do permit insurance companies to deny applications for health insurance for a variety of reasons. What the law prohibits companies from doing is denying coverage due to age, gender, health status, occupation and similar factors. Not only that, but companies cannot use these factors in determining health insurance premiums. However, the cost of coverage is allowed to vary with the size of the family.
Although health insurance legislation in New Jersey has created some favorable conditions for policy holders, there is still a lot to be said for researching alternative coverage in the state when policies are set to expire. Comparison shopping can lead to a health plan that meets your needs at an excellent price.

