Healthcare Gov Comparison of 27 Plans

Remove plan 1 AmeriHealth New Jersey AmeriHealth NJ Tier 1 AdvantageBronze EPO H.S.A.
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AmeriHealth New Jersey Cooper Advantage Silver EPO
AmeriHealth New Jersey AmeriHealth AmeriHealth New Jersey AmeriHealth NJ Premium Local Value Bronze HSA NJ Tier 1 AdvantageSilver EPO H.S.A. EPO Save Save
Save
Monthly premium
$681.45 /mo.
Monthly premium
$749.61 /mo.
Monthly premium
$759.90 /mo.
Monthly premium
$773 /mo.
The deductible range

Deductible $4,700 group total



The out-of-pocket-maximum
Out-of-pocket maximum $12,700 Summary of Benefits Plan Brochure Provider directory Costs for medical care Close -
Out-of-pocket maximum $12,700 Summary of Benefits Plan Brochure Provider directory
Primary care doctor visit

$50 Copay after deductible InNetwork, Not Covered Out-ofNetwork 50% Coinsurance after deductible In- $50 Copay after deductible In$15 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network Not Covered Network
Specialist visit
$75 Copay after deductible InNetwork, Not Covered Out-ofNetwork
50% Coinsurance after deductible In- $75 Copay after deductible In$35 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network Not Covered Network
X-rays and diagnostic imaging

50% Coinsurance after deductible In- 50% Coinsurance after deductible In- 50% Coinsurance after deductible In- 50% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Network Not Covered Network Not Covered Network Not Covered
Laboratory and outpatient professional services

50% Coinsurance after deductible InNo Charge In-Network, Not Covered Network, Not Covered Out-ofOut-of-Network Network Not Covered 50% Coinsurance after deductible In- 50% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Network Not Covered
Hearing aids
50% Coinsurance after deductible In$50 Copay after deductible In$50 Copay after deductible In$15 In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Limits and Exclusions Apply Network Not Covered Limits and Network Limits and Exclusions Apply Network Limits and Exclusions Apply Exclusions Apply
Routine eye exam for adults

No Charge In-Network, No Charge No Charge In-Network, No Charge No Charge In-Network, No Charge No Charge In-Network, No Charge Out-of-Network Limits and Exclusions Out-of-Network Limits and Exclusions Out-of-Network Limits and Exclusions Out-of-Network Limits and Exclusions Apply Apply Apply Apply
Routine eye exam for children
No Charge After Deductible InNetwork, Not Covered Out-ofNetwork 1 Visit(s) per Year ;
No Charge In-Network, Not Covered Out-of-Network 1 Visit(s) per Year ;
Eyeglasses for children

No Charge After Deductible InNetwork, Not Covered Out-ofNetwork 1 Item(s) per Year ; Limits and Exclusions Apply No Charge In-Network, Not Covered Out-of-Network 1 Item(s) per Year ; Limits and Exclusions Apply No Charge After Deductible InNetwork, Not Covered Out-ofNetwork 1 Item(s) per Year ; Limits and Exclusions Apply No Charge After Deductible InNetwork, Not Covered Out-ofNetwork 1 Item(s) per Year ; Limits and Exclusions Apply
Yes
Health Savings Account eligible plan
No
Yes
Yes
Prescription drug coverage Close -
Generic drugs
50% Coinsurance after deductible In50% Coinsurance after deductible InNetwork, 50% Out-of-Network Not $7 In-Network, 50% Out-of-Network Network, Not Covered Out-of$7 In-Network, 50% Out-of-Network Covered Network Not Covered
Preferred brand drugs

50% Coinsurance after deductible In- 50% Coinsurance after deductible In- 50% Coinsurance after deductible In- 50% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork, 50% Out-of-Network Not Network, 50% Out-of-Network Not Network, 50% Out-of-Network Not Network Not Covered Covered Covered Covered
Non-preferred brand drugs
50% Coinsurance after deductible In- 50% Coinsurance after deductible In- 50% Coinsurance after deductible In- 50% Coinsurance after deductible InNetwork, 50% Out-of-Network Not Network, 50% Out-of-Network Not Network, Not Covered Out-ofNetwork, 50% Out-of-Network Not Covered Covered Network Not Covered Covered
Specialty drugs
List of covered drugs

View Covered Drugs
Yes
Three month in-network mail order pharmacy benefit Prescription drug deductible Prescription drug out-ofpocket maximum
4,700
View Covered Drugs
View Covered Drugs
View Covered Drugs
Yes
Yes
Yes
5,000
2,700
12,700 Access to doctors and hospitals Close -
12,700
12,700
10,200
Provider Directory
Provider Directory Provider Directory Provider Directory Provider Directory
National provider network

No No No No
Multi-state plan
No Hospital services Close -
No
No
No
Emergency room care

50% Coinsurance after deductible InNetwork, 50% Coinsurance after deductible Out-of-Network Not Covered 20% Coinsurance after deductible InNetwork, 50% Coinsurance after deductible Out-of-Network Not Covered 50% Coinsurance after deductible In$100 Copay after deductible InNetwork, 50% Coinsurance after Network, 50% Coinsurance after deductible Out-of-Network Not deductible Out-of-Network Covered
Inpatient doctor and surgical services

Inpatient hospital services (like a hospital stay)

20% Coinsurance after deductible In- 20% Coinsurance after deductible In- 50% Coinsurance after deductible In- 10% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Network Not Covered Network Not Covered Network Not Covered Cost and coverage examples Close -
Data Not Available
Total cost for a healthy pregnancy and normal
Data Not Available Adult dental coverage Close -
Total cost of managing type 2 diabetes
Data Not Available
Data Not Available
Data Not Available
Data Not Available
Data Not Available
Data Not Available
Routine dental care

Not Covered Not Covered Not Covered Not Covered
Basic dental care

Major dental care

Orthodontia
View Dentist Directory

View Dentist Directory Child dental coverage Close View Dentist Directory View Dentist Directory View Dentist Directory
Check-up
Basic dental care

Major dental care

Not Covered
Medically necessary orthodontia Orthodontic
Not Covered
Not Covered
Not Covered
Not Covered Medical management programs Close Asthma program not available
Not Covered
Not Covered
Not Covered
Asthma program not available
Heart disease program not available Heart disease program not available Heart disease program not available Heart disease program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available
Low back pain program not available Low back pain program not available Low back pain program not available Low back pain program not available Pain management program not available Pregnancy program not available Weight management program not available Other benefits Close Pain management program not available Pregnancy program not available Weight management program not available Pain management program not available Pregnancy program not available Weight management program not available Pain management program not available Pregnancy program not available Weight management program not available
Acupuncture
Chiropractic care
$75 Copay after deductible InNetwork, Not Covered Out-ofNetwork 30 Visit(s) per Year ; 50% Coinsurance after deductible In$75 Copay after deductible In$35 In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork 30 Visit(s) per Year ; Network Not Covered 30 Visit(s) per Network 30 Visit(s) per Year ; Year ;
Infertility treatment
Mental/behavioral health outpatient services

Mental/behavioral health inpatient services

Habillitative services
50% Coinsurance after deductible In$75 Copay after deductible In$75 Copay after deductible In$35 In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Limits and Exclusions Apply Network Not Covered Limits and Network Limits and Exclusions Apply Network Limits and Exclusions Apply Exclusions Apply
Bariatric services
Outpatient rehabilitative services
$75 Copay after deductible InNetwork, Not Covered Out-ofNetwork 30 Visit(s) per Year ;
50% Coinsurance after deductible In$75 Copay after deductible In$35 In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork 30 Visit(s) per Year ; Network Not Covered 30 Visit(s) per Network 30 Visit(s) per Year ; Year ;
Skilled Nursing Facility care

50% Coinsurance after deductible In- 50% Coinsurance after deductible In- 50% Coinsurance after deductible In$100 Copay per Day In-Network, Not Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofCovered Out-of-Network Network Not Covered Network Not Covered Network Not Covered
Private-duty nursing
50% Coinsurance after deductible In- 50% Coinsurance after deductible In- 50% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Network Not Covered Network Not Covered
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AmeriHealth New Jersey AmeriHealth NJ Select Local Value Silver HMO
AmeriHealth New Jersey AmeriHealth AmeriHealth New Jersey AmeriHealth Horizon Blue Cross Blue Shield of NJ Standard Local Value Silver EPO NJ Premium Regional Preferred New Jersey Advantage EPO Bronze H.S.A. Bronze HSA EPO Save Save Save
Save
Monthly premium
$784.07 /mo.
Monthly premium
$829.84 /mo.
Monthly premium
$844.28 /mo.
Monthly premium
$848.59 /mo.




$50 Copay after deductible In$50 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network
50% Coinsurance after deductible In- $30 Copay after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Network
50% Coinsurance after deductible In- 50% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Network Not Covered
No Charge In-Network, Not Covered Out-of-Network
No Charge After Deductible InNetwork, Not Covered Out-ofNetwork
50% Coinsurance after deductible In$50 Copay after deductible In$30 Copay after deductible In$50 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Limits and Exclusions Apply Network Not Covered Limits and Network Limits and Exclusions Apply Network Limits and Exclusions Apply Exclusions Apply
No Charge In-Network, No Charge No Charge In-Network, No Charge No Charge In-Network, No Charge No Charge In-Network, Not Covered Out-of-Network Limits and Exclusions Out-of-Network Limits and Exclusions Out-of-Network Limits and Exclusions Out-of-Network Apply Apply Apply
No Charge In-Network, Not Covered Out-of-Network 1 Item(s) per Year ; Limits and Exclusions Apply
No Charge After Deductible InNetwork, Not Covered Out-ofNetwork 1 Item(s) per Year ; Limits and Exclusions Apply
No Charge In-Network, Not Covered Out-of-Network 1 Item(s) per Year ;
No
Yes
Yes
Yes
50% In-Network, 50% Out-ofNetwork Not Covered
50% Coinsurance after deductible In- 50% Coinsurance after deductible In- 50% Coinsurance after deductible InNetwork, 50% Out-of-Network Not Network, Not Covered Out-ofNetwork, Not Covered Out-ofCovered Network Not Covered Network Not Covered
View Covered Drugs
View Covered Drugs
View Covered Drugs
View Covered Drugs
Yes
Yes
Yes
Yes
3,600
5,000
5,000
12,700
9,000
12,700
12,700
Provider Directory
Provider Directory
Provider Directory
Provider Directory
No
No
No
No
No
No
No
No
$100 Copay after deductible InNetwork, $100 Copay after deductible Out-of-Network
50% Coinsurance after deductible InNetwork, 50% Coinsurance after deductible Out-of-Network Not Covered
$100 Copay before deductible/50% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork
50% Coinsurance after deductible InNo Charge In-Network, Not Covered Network, Not Covered Out-ofOut-of-Network Network Not Covered
50% Coinsurance after deductible In- 50% Coinsurance after deductible In50% Coinsurance after deductible In$500 Copay per Day In-Network, Not Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofCovered Out-of-Network Network Not Covered Network Not Covered Network Not Covered
Data Not Available
Data Not Available
Data Not Available
$3,650
Data Not Available
Data Not Available
Data Not Available
$3,900
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Asthma program available
Heart disease program not available Heart disease program not available Heart disease program not available Heart disease program available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Depression program available Diabetes program available High blood pressure & cholesterol program not available
Low back pain program not available Low back pain program not available Low back pain program not available Low back pain program not available Pain management program not available Pregnancy program not available Weight management program not available Pain management program not available Pregnancy program not available Weight management program not available Pain management program not available Pregnancy program not available Weight management program not available Pain management program not available Pregnancy program not available Weight management program not available
Not Covered
Not Covered
Not Covered
Not Covered
$75 Copay after deductible In$75 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork 30 Visit(s) per Year ; Network 30 Visit(s) per Year ;
50% Coinsurance after deductible In$30 Copay after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered 30 Visit(s) per Network 30 Visit(s) per Year ; Year ;
50% Coinsurance after deductible In$75 Copay after deductible In$75 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Limits and Exclusions Apply Network Not Covered Limits and Network Limits and Exclusions Apply Exclusions Apply
50% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork Not Covered 30 Visit(s) per Year ; Limits and Exclusions Apply
$75 Copay after deductible In$75 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork 30 Visit(s) per Year ; Network 30 Visit(s) per Year ;
50% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork Not Covered 30 Visit(s) per Year ;
50% Coinsurance after deductible In- 50% Coinsurance after deductible In50% Coinsurance after deductible In$500 Copay per Day In-Network, Not Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofCovered Out-of-Network Network Not Covered Network Not Covered Network Not Covered
Remove plan 9
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Remove plan 12 AmeriHealth New Jersey AmeriHealth NJ Premium National Access Bronze HSA EPO Save
Horizon Blue Cross Blue Shield of New Jersey Advance EPO Silver
Health Republic Insurance of New Jersey SolidBronze
Health Republic Insurance of New Jersey PrimeBronze
Save
Save
Save
Monthly premium
$866.80 /mo.
Monthly premium
$882.76 /mo.
Monthly premium
$882.76 /mo.
Monthly premium
$886.48 /mo.




50% Coinsurance after deductible In- 50% Coinsurance after deductible In- 50% Coinsurance after deductible In$30 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network Not Covered Network Not Covered Network Not Covered
50% Coinsurance after deductible InNetwork, Not Covered Out-of$30 In-Network, Not Covered Out-ofNetwork Not Covered 2 Item(s) per Network Limits and Exclusions Apply Benefit Period ; Limits and Exclusions Apply
50% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork Not Covered 2 Item(s) per Benefit Period ; Limits and Exclusions Apply
50% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork Not Covered Limits and Exclusions Apply
50% Coinsurance after deductible InNo Charge In-Network, No Charge Network, Not Covered Out-ofOut-of-Network Limits and Exclusions Network Not Covered Limits and Apply Exclusions Apply
No
Yes
No
Yes
50% Coinsurance after deductible In30% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Limits and Network Not Covered Exclusions Apply
View Covered Drugs
View Covered Drugs
View Covered Drugs
View Covered Drugs
Yes
Yes
Yes
Yes
3,000
5,000
5,000
5,000
10,000
12,700
12,700
12,700
Provider Directory
Provider Directory
Provider Directory
Provider Directory
No
No
No
Yes
No
No
No
Yes
50% Coinsurance after deductible InNetwork, 50% Coinsurance after deductible Out-of-Network Not Covered Limits and Exclusions Apply
$2,550 Data Not Available
Data Not Available
Data Not Available
$2,670 Data Not Available
Data Not Available
Data Not Available
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered Limits and Exclusions Apply
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Heart disease program available Depression program available Diabetes program available High blood pressure & cholesterol program not available
Heart disease program available Depression program available Diabetes program available High blood pressure & cholesterol program available
Heart disease program available Depression program available Diabetes program available High blood pressure & cholesterol program available Low back pain program available
Heart disease program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Low back pain program not available Pain management program not available Pregnancy program not available Weight management program not available
Low back pain program not available Low back pain program available Pain management program not available Pregnancy program not available Weight management program not available
Pain management program available Pain management program available Pregnancy program available Weight management program not available Pregnancy program available Weight management program not available
Not Covered
Not Covered
Not Covered
Not Covered
50% Coinsurance after deductible In$30 In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork 30 Visit(s) per Year ; Network Not Covered 30 Visit(s) per Year ; Limits and Exclusions Apply
Remove plan 13 AmeriHealth New Jersey AmeriHealth NJ Standard Local Value Gold HMO Save
Remove plan 14 Horizon Blue Cross Blue Shield of New Jersey Advantage EPO Silver Save
Remove plan 15 Health Republic Insurance of New Jersey SolidSilver Save
Remove plan 16 Health Republic Insurance of New Jersey PrimeSilver Save
Monthly premium
$900.41 /mo.
Monthly premium
$957.92 /mo.
Monthly premium
$975.81 /mo.
Monthly premium
$980.11 /mo.




20% Coinsurance after deductible In- 30% Coinsurance after deductible In$15 In-Network, Not Covered Out-of- $25 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network Network Not Covered Network Not Covered
40% Coinsurance after deductible In- 20% Coinsurance after deductible In- 30% Coinsurance after deductible In$50 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network Not Covered Network Not Covered Network Not Covered
40% Coinsurance after deductible In- 20% Coinsurance after deductible In- 30% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Network Not Covered Network Not Covered
20% Coinsurance after deductible InNetwork, Not Covered Out-of$15 In-Network, Not Covered Out-of- $25 In-Network, Not Covered Out-ofNetwork Not Covered 2 Item(s) per Network Limits and Exclusions Apply Network Limits and Exclusions Apply Benefit Period ; Limits and Exclusions Apply
No Charge In-Network, No Charge No Charge In-Network, Not Covered Out-of-Network Limits and Exclusions Out-of-Network Apply
No Charge In-Network, Not Covered Out-of-Network 1 Item(s) per Year ; Limits and Exclusions Apply No Prescription drug coverage Close -
No Charge In-Network, Not Covered Out-of-Network 1 Item(s) per Year ; Limits and Exclusions Apply Yes
No Charge In-Network, Not Covered Out-of-Network 1 Item(s) per Year ; Limits and Exclusions Apply No
No
20% Coinsurance after deductible InNo Charge In-Network, Not Covered $10 In-Network, Not Covered Out-of- $15 In-Network, Not Covered Out-of- Network, Not Covered Out-ofOut-of-Network Limits and Exclusions Network Network Network Not Covered Limits and Apply Exclusions Apply
20% Coinsurance after deductible In$40 In-Network, Not Covered Out-of- 40% In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork Network Not Covered Network Not Covered Limits and Exclusions Apply
20% Coinsurance after deductible In$60 In-Network, Not Covered Out-of- 50% In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork Network Not Covered Network Not Covered Limits and Exclusions Apply
20% Coinsurance after deductible In$50 In-Network, Not Covered Out-of- 50% In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork Network Not Covered Network Not Covered Limits and Exclusions Apply View Covered Drugs View Covered Drugs View Covered Drugs
30% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork Not Covered Limits and Exclusions Apply View Covered Drugs
Yes 0 9,300 Access to doctors and hospitals Close Provider Directory No No Hospital services Close -
Yes 0 12,700
Yes 5,000 9,000
Yes 4,000 12,700
Provider Directory No No
$100 Copay before deductible/40% $100 In-Network, $100/100% Out-of- Coinsurance after deductible InNetwork Network, Not Covered Out-ofNetwork
20% Coinsurance after deductible In40% Coinsurance after deductible In- 40% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Limits and Network Not Covered Network Not Covered Exclusions Apply
Cost and coverage examples Close Data Not Available Data Not Available Adult dental coverage Close Not Covered Not Covered Not Covered Not Covered View Dentist Directory Child dental coverage Close Not Covered Not Covered Not Covered Not Covered Medical management programs Close Asthma program not available Not Covered Not Covered Not Covered Not Covered View Dentist Directory $3,160 Data Not Available $3,050 Data Not Available Data Not Available Data Not Available
Not Covered Not Covered Not Covered Not Covered View Dentist Directory
Not Covered Limits and Exclusions Apply Not Covered Not Covered Not Covered Limits and Exclusions Apply
Heart disease program not available Heart disease program available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Depression program available Diabetes program available High blood pressure & cholesterol program not available
Low back pain program not available Low back pain program not available Low back pain program available Pain management program not available Pregnancy program not available Weight management program not available Other benefits Close Not Covered Pain management program not available Pregnancy program not available Weight management program not available
Not Covered
Not Covered
Not Covered 30% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork Not Covered 30 Visit(s) per Year ; Limits and Exclusions Apply
20% Coinsurance after deductible In$30 In-Network, Not Covered Out-of- $25 In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork 30 Visit(s) per Year ; Network 30 Visit(s) per Year ; Network Not Covered 30 Visit(s) per Year ; Limits and Exclusions Apply
20% Coinsurance after deductible In40% Coinsurance after deductible In$30 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network Not Covered Limits and Network Not Covered Exclusions Apply
20% Coinsurance after deductible In40% Coinsurance after deductible In$30 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network Not Covered Limits and Network Not Covered Exclusions Apply
40% Coinsurance after deductible In$30 In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork Limits and Exclusions Apply Network Not Covered 30 Visit(s) per Year ; Limits and Exclusions Apply
40% Coinsurance after deductible In$30 In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork 30 Visit(s) per Year ; Network Not Covered 30 Visit(s) per Year ;
Remove plan 17 Health Republic Insurance of New Jersey CoreSilver Save
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AmeriHealth New Jersey AmeriHealth AmeriHealth New Jersey AmeriHealth AmeriHealth New Jersey AmeriHealth NJ Standard Local Value Gold EPO NJ Premium Regional Preferred Silver NJ Premium National Access Silver H.S.A. EPO POS+ Save Save Save
Monthly premium
$1,001.83 /mo.
Monthly premium
$1,010.46 /mo.
Monthly premium
$1,017.90 /mo.
Monthly premium
$1,068.99 /mo.




20% Coinsurance after deductible In$50 In-Network, Not Covered Out-of- $40 In-Network, 50% Coinsurance $20 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork after deductible Out-of-Network Network Network Not Covered
20% Coinsurance after deductible In- 50% Coinsurance after deductible In- No Charge In-Network, 50% $35 In-Network, Not Covered Out-ofCoinsurance after deductible Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network Not Covered Network Network Not Covered
20% Coinsurance after deductible InNetwork, Not Covered Out-of$50 In-Network, Not Covered Out-of- $40 In-Network, Not Covered Out-ofNetwork Not Covered Limits and Network Limits and Exclusions Apply Network Limits and Exclusions Apply Exclusions Apply
No Charge In-Network, No Charge No Charge In-Network, No Charge No Charge In-Network, No Charge $20 In-Network, Not Covered Out-ofOut-of-Network Limits and Exclusions Out-of-Network Limits and Exclusions Out-of-Network Limits and Exclusions Network Limits and Exclusions Apply Apply Apply Apply
No Charge In-Network, 50% Out-ofNetwork 1 Visit(s) per Year ;
No Charge After Deductible InNetwork, Not Covered Out-ofNetwork 1 Item(s) per Year ; Limits and Exclusions Apply Yes
$10 In-Network, Not Covered Out-of- $10 Copay after deductible InNetwork Limits and Exclusions Apply Network, 50% Out-of-Network
$30 In-Network, Not Covered Out-of- $40 Copay after deductible InNetwork Limits and Exclusions Apply Network, 50% Out-of-Network
30% Coinsurance after deductible In50% In-Network, 50% Out-ofNetwork, Not Covered Out-of$60 In-Network, 50% Out-of-Network Network Not Covered Network Not Covered Limits and Exclusions Apply
30% Coinsurance after deductible In50% Coinsurance after deductible In50% In-Network, 50% Out-ofNetwork, Not Covered Out-of$50 In-Network, 50% Out-of-Network Network, 50% Out-of-Network Not Network Not Covered Network Not Covered Limits and Covered Exclusions Apply View Covered Drugs View Covered Drugs View Covered Drugs View Covered Drugs
Yes 4,000 12,700
Yes 2,500 5,000
Yes 0 12,700
Yes 0 12,700
Provider Directory Yes Yes
20% Coinsurance after deductible In$100 Copay after deductible InNetwork, 20% Coinsurance after Network, $100 Copay after deductible Out-of-Network Not deductible/100% Out-of-Network Covered
30% Coinsurance after deductible In20% Coinsurance after deductible In- No Charge After Deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Limits and Network Not Covered Network Exclusions Apply
30% Coinsurance after deductible In20% Coinsurance after deductible In$500 Copay per Day In-Network, Not Network, Not Covered Out-ofNetwork, Not Covered Out-ofCovered Out-of-Network Network Not Covered Limits and Network Not Covered Exclusions Apply
Data Not Available Data Not Available
Heart disease program available Depression program available Diabetes program available High blood pressure & cholesterol program available Low back pain program available Pain management program available Pregnancy program available Weight management program not available
Heart disease program not available Heart disease program not available Heart disease program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available
Low back pain program not available Low back pain program not available Low back pain program not available Pain management program not available Pregnancy program not available Weight management program not available Pain management program not available Pregnancy program not available Weight management program not available Pain management program not available Pregnancy program not available Weight management program not available
Not Covered
Not Covered
Not Covered
Not Covered
20% Coinsurance after deductible In$50 In-Network, 50% Coinsurance $35 In-Network, Not Covered Out-ofNetwork, Not Covered Out-of$75 In-Network, Not Covered Out-ofafter deductible Out-of-Network 30 Network 30 Visit(s) per Year ; Limits Network Not Covered 30 Visit(s) per Network 30 Visit(s) per Year ; Visit(s) per Year ; and Exclusions Apply Year ;
30% Coinsurance after deductible In20% Coinsurance after deductible In$75 In-Network, Not Covered Out-of- $50 In-Network, 50% Coinsurance Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork after deductible Out-of-Network Network Not Covered Limits and Network Not Covered Exclusions Apply
20% Coinsurance after deductible In$75 In-Network, Not Covered Out-of- $50 In-Network, 50% Coinsurance $20 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork after deductible Out-of-Network Network Limits and Exclusions Apply Network Not Covered
30% Coinsurance after deductible In30% Coinsurance after deductible In20% Coinsurance after deductible InNetwork, Not Covered Out-of$500 In-Network, Not Covered Out-of- Network, 50% Coinsurance after Network, Not Covered Out-ofdeductible Out-of-Network Not Network Not Covered Limits and Network Network Not Covered Covered Exclusions Apply
20% Coinsurance after deductible In$35 In-Network, Not Covered Out-of$50 In-Network, 50% Coinsurance Network, Not Covered Out-of$75 In-Network, Not Covered Out-ofNetwork 30 Visit(s) per Year ; Limits after deductible Out-of-Network Network Not Covered Limits and Network Limits and Exclusions Apply and Exclusions Apply Limits and Exclusions Apply Exclusions Apply
30% Coinsurance after deductible In20% Coinsurance after deductible In- $500 Copay after deductible InNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Limits and Network Not Covered Network Exclusions Apply
20% Coinsurance after deductible InNo Charge In-Network, 50% Network, Not Covered Out-of$75 In-Network, Not Covered Out-ofCoinsurance after deductible Out-ofNetwork Not Covered 30 Visit(s) per Network 30 Visit(s) per Year ; Network 30 Visit(s) per Year ; Year ;
30% Coinsurance after deductible In20% Coinsurance after deductible In$500 Copay per Day In-Network, Not Network, Not Covered Out-ofNetwork, Not Covered Out-ofCovered Out-of-Network Network Not Covered Limits and Network Not Covered Exclusions Apply
Remove plan 21 Horizon Blue Cross Blue Shield of New Jersey Advance EPO Gold Save
Remove plan 22 Health Republic Insurance of New Jersey SolidGold Save
Remove plan 23 Health Republic Insurance of New Jersey CoreGold Save
Remove plan 24 AmeriHealth New Jersey AmeriHealth NJ Standard Regional Preferred Gold EPO Save
Monthly premium
$1,078.53 /mo.
Monthly premium
$1,106.06 /mo.
Monthly premium
$1,114.01 /mo.
Monthly premium
$1,116.72 /mo.




20% Coinsurance after deductible In$10 In-Network, Not Covered Out-of- $30 In-Network, Not Covered Out-of$15 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network Network Network Not Covered
20% Coinsurance after deductible In$25 In-Network, Not Covered Out-of- $50 In-Network, Not Covered Out-of$30 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Network Network Network Not Covered
20% Coinsurance after deductible In- 20% Coinsurance after deductible In$25 In-Network, Not Covered Out-of- No Charge In-Network, Not Covered Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Out-of-Network Network Not Covered Network Not Covered
20% Coinsurance after deductible InNo Charge In-Network, No Charge Network, Not Covered Out-of$10 In-Network, Not Covered Out-ofOut-of-Network Limits and Exclusions Network Not Covered Limits and Network Limits and Exclusions Apply Apply Exclusions Apply
No Charge In-Network, Not Covered Out-of-Network 1 Item(s) per Year ; Limits and Exclusions Apply Yes
No
20% Coinsurance after deductible In$10 In-Network, Not Covered Out-of- Network, Not Covered Out-of$10 In-Network, Not Covered Out-of- $10 Copay before deductible InNetwork Network Not Covered Limits and Network Limits and Exclusions Apply Network, 50% Out-of-Network Exclusions Apply
20% Coinsurance after deductible In40% In-Network, Not Covered Out-of- Network, Not Covered Out-of$25 In-Network, Not Covered Out-of$40 In-Network, 50% Out-of-Network Network Not Covered Network Not Covered Limits and Network Limits and Exclusions Apply Exclusions Apply
20% Coinsurance after deductible In50% In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork Not Covered Network Not Covered Limits and Exclusions Apply
20% Coinsurance after deductible InNetwork, Not Covered Out-of$60 In-Network, 50% Out-of-Network Network Not Covered Limits and Exclusions Apply
20% Coinsurance after deductible In50% In-Network, Not Covered Out-of- Network, Not Covered Out-ofNetwork Not Covered Network Not Covered Limits and Exclusions Apply View Covered Drugs View Covered Drugs
20% Coinsurance after deductible InNetwork, Not Covered Out-of$50 In-Network, Not Covered Out-ofNetwork Network Not Covered Limits and Exclusions Apply View Covered Drugs View Covered Drugs
Yes 0 5,000
Yes 3,500 4,000
Yes 4,000 6,000
Yes 0 10,000
20% Coinsurance after deductible In$100 Copay before deductible InNetwork, 20% Coinsurance after Network, Not Covered Out-ofdeductible Out-of-Network Not Network Covered Limits and Exclusions Apply
$1,860 Data Not Available $1,830 Data Not Available
Heart disease program available Depression program available Diabetes program available High blood pressure & cholesterol program not available
Heart disease program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Low back pain program not available Pain management program not available Pregnancy program not available Weight management program not available
Low back pain program not available Low back pain program available Pain management program not available Pregnancy program not available Weight management program not available
Not Covered
Not Covered
Not Covered
Not Covered
20% Coinsurance after deductible In$25 In-Network, Not Covered Out-of$15 In-Network, Not Covered Out-of- Network, Not Covered Out-of$50 In-Network, Not Covered Out-ofNetwork 30 Visit(s) per Year ; Limits Network 30 Visit(s) per Year ; Network 30 Visit(s) per Year ; Network Not Covered 30 Visit(s) per and Exclusions Apply Year ; Limits and Exclusions Apply
20% Coinsurance after deductible InNetwork, Not Covered Out-of$50 In-Network, Not Covered Out-ofNetwork Network Not Covered Limits and Exclusions Apply
20% Coinsurance after deductible In20% Coinsurance after deductible In$50 Copay before deductible InNetwork, Not Covered Out-of$10 In-Network, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork, Not Covered Out-ofNetwork Not Covered Limits and Network Limits and Exclusions Apply Network Not Covered Network Exclusions Apply
20% Coinsurance after deductible In$25 In-Network, Not Covered Out-ofNetwork, Not Covered Out-of$50 In-Network, Not Covered Out-ofNetwork 30 Visit(s) per Year ; Limits Network Not Covered 30 Visit(s) per Network Limits and Exclusions Apply and Exclusions Apply Year ; Limits and Exclusions Apply
20% Coinsurance after deductible InNetwork, Not Covered Out-of$50 In-Network, Not Covered Out-ofNetwork Not Covered 30 Visit(s) per Network 30 Visit(s) per Year ; Year ; Limits and Exclusions Apply
Remove plan 25 Health Republic Insurance of New Jersey CorePlatinum Save General Information
Remove plan 26
Remove plan 27
AmeriHealth New Jersey AmeriHealth AmeriHealth New Jersey AmeriHealth NJ Premium National Access Gold NJ Select National Access Platinum POS+ POS+ Save Save
Monthly premium
$1,228.92 /mo.
Monthly premium
$1,297.41 /mo.
Monthly premium
$1,418.97 /mo.



Deductible $0 group total
$10 In-Network, Not Covered Out-of- $30 In-Network, 40% Coinsurance Network after deductible Out-of-Network
$15 In-Network, 30% Coinsurance after deductible Out-of-Network
No Charge In-Network, 40% No Charge In-Network, 30% $25 In-Network, Not Covered Out-ofCoinsurance after deductible Out-of- Coinsurance after deductible Out-ofNetwork Network Network 20% Coinsurance after deductible InNetwork, Not Covered Out-of$30 In-Network, 40% Coinsurance Network Not Covered 2 Item(s) per after deductible Out-of-Network Benefit Period ; Limits and Exclusions Limits and Exclusions Apply Apply
$15 In-Network, 30% Coinsurance after deductible Out-of-Network Limits and Exclusions Apply
No Charge In-Network, No Charge No Charge In-Network, No Charge $10 In-Network, Not Covered Out-ofOut-of-Network Limits and Exclusions Out-of-Network Limits and Exclusions Network Limits and Exclusions Apply Apply Apply No Charge In-Network, Not Covered Out-of-Network 1 Visit(s) per Year ; No Charge In-Network, Not Covered Out-of-Network 1 Visit(s) per Year ; No Charge In-Network, Not Covered Out-of-Network 1 Visit(s) per Year ;
No Charge In-Network, Not Covered Out-of-Network 1 Item(s) per Year ; Limits and Exclusions Apply No Prescription drug coverage Close -
$5 In-Network, Not Covered Out-of$7 In-Network, 50% Out-of-Network $10 In-Network, 50% Out-of-Network Network Limits and Exclusions Apply
$25 In-Network, Not Covered Out-of- 50% In-Network, 50% Out-ofNetwork Limits and Exclusions Apply Network Not Covered
$40 In-Network, 50% Out-of-Network
20% Coinsurance after deductible InNetwork, Not Covered Out-of50% In-Network, 50% Out-ofNetwork Not Covered Network Not Covered Limits and Exclusions Apply
$60 In-Network, 50% Out-of-Network
20% Coinsurance after deductible In20% In-Network, 40% Coinsurance $50 In-Network, 50% Coinsurance Network, Not Covered Out-ofafter deductible Out-of-Network Not after deductible Out-of-Network Network Not Covered Limits and Covered Exclusions Apply View Covered Drugs Yes 1,500 2,500 Access to doctors and hospitals Close Provider Directory No Provider Directory Yes View Covered Drugs Yes 0 6,000 View Covered Drugs Yes 0 9,000
Provider Directory Yes
No Hospital services Close -
Yes
Yes
20% Coinsurance after deductible InNetwork, 20% Coinsurance after $100 In-Network, $100 Out-ofNetwork deductible Out-of-Network Not Covered Limits and Exclusions Apply
$75 In-Network, $75 Out-of-Network
20% Coinsurance after deductible InNo Charge In-Network, 30% Network, 40% Coinsurance after Coinsurance after deductible Out-ofdeductible Out-of-Network Not Network Covered
20% Coinsurance after deductible InNetwork, Not Covered Out-ofNetwork Not Covered Limits and Exclusions Apply Cost and coverage examples Close Data Not Available Data Not Available Adult dental coverage Close Not Covered Not Covered
20% Coinsurance after deductible In$300 Copay per Day In-Network, 30% Network, 40% Coinsurance after Coinsurance after deductible Out-ofdeductible Out-of-Network Not Network Covered
Not Covered Not Covered
Not Covered Not Covered
Not Covered Not Covered View Dentist Directory Child dental coverage Close Not Covered Limits and Exclusions Apply Not Covered Not Covered Not Covered Limits and Exclusions Apply Medical management programs Close Asthma program available Heart disease program available Depression program available Diabetes program available High blood pressure & cholesterol program available Low back pain program available Pain management program available Pregnancy program available
Not Covered Not Covered View Dentist Directory
Not Covered Not Covered View Dentist Directory
Heart disease program not available Heart disease program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available Depression program not available Diabetes program not available High blood pressure & cholesterol program not available
Low back pain program not available Low back pain program not available Pain management program not available Pregnancy program not available Pain management program not available Pregnancy program not available
Weight management program not available Other benefits Close Not Covered
Weight management program not available
Weight management program not available
Not Covered
Not Covered $25 In-Network, 30% Coinsurance after deductible Out-of-Network 30 Visit(s) per Year ;
$25 In-Network, Not Covered Out-of- $50 In-Network, 40% Coinsurance Network 30 Visit(s) per Year ; Limits after deductible Out-of-Network 30 Visit(s) per Year ; and Exclusions Apply
20% Coinsurance after deductible InNetwork, Not Covered Out-of$50 In-Network, 40% Coinsurance after deductible Out-of-Network Network Not Covered Limits and Exclusions Apply
$10 In-Network, Not Covered Out-of- $50 In-Network, 40% Coinsurance Network Limits and Exclusions Apply after deductible Out-of-Network
20% Coinsurance after deductible InNetwork, 40% Coinsurance after $300 In-Network, 30% Coinsurance deductible Out-of-Network Not after deductible Out-of-Network Covered
$25 In-Network, Not Covered Out-of- $50 In-Network, 40% Coinsurance Network 30 Visit(s) per Year ; Limits after deductible Out-of-Network and Exclusions Apply Limits and Exclusions Apply
$25 In-Network, 30% Coinsurance after deductible Out-of-Network Limits and Exclusions Apply
20% Coinsurance after deductible InNetwork, 40% Coinsurance after $300 In-Network, 30% Coinsurance deductible Out-of-Network Not after deductible Out-of-Network Covered
20% Coinsurance after deductible InNo Charge In-Network, 40% No Charge In-Network, 30% Network, Not Covered Out-ofCoinsurance after deductible Out-of- Coinsurance after deductible Out-ofNetwork Not Covered 30 Visit(s) per Network 30 Visit(s) per Year ; Network 30 Visit(s) per Year ; Year ; Limits and Exclusions Apply
20% Coinsurance after deductible In$300 Copay per Day In-Network, 30% Network, 40% Coinsurance after Coinsurance after deductible Out-ofdeductible Out-of-Network Not Network Covered
20% Coinsurance after deductible InNo Charge In-Network, 30% Network, 40% Coinsurance after Coinsurance after deductible Out-ofdeductible Out-of-Network Not Network Covered

Healthcare Gov Comparison of 27 Plans

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Healthcare Gov Comparison of 27 Plans

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Remove plan 1 AmeriHealth New Jersey AmeriHealth NJ Tier 1 AdvantageBronze EPO H.S.A.

Save General Information

AmeriHealth New Jersey Cooper Advantage Silver EPO

The deductible range

The deductible range

The deductible range

The deductible range

Primary care doctor visit

$75 Copay after deductible InNetwork, Not Covered Out-ofNetwork

X-rays and diagnostic imaging

Laboratory and outpatient professional services

Routine eye exam for adults

Routine eye exam for children

No Charge In-Network, Not Covered Out-of-Network 1 Visit(s) per Year ;

Eyeglasses for children

Health Savings Account eligible plan

Prescription drug coverage Close -

Preferred brand drugs

Non-preferred brand drugs

List of covered drugs

View Covered Drugs

View Covered Drugs

View Covered Drugs

12,700 Access to doctors and hospitals Close -

National provider network

No Hospital services Close -

Emergency room care

Inpatient doctor and surgical services

Inpatient hospital services (like a hospital stay)

Data Not Available

Total cost for a healthy pregnancy and normal

Data Not Available Adult dental coverage Close -

Total cost of managing type 2 diabetes

Data Not Available

Data Not Available

Data Not Available

Data Not Available

Data Not Available

Data Not Available

Routine dental care

Basic dental care

Major dental care

View Dentist Directory

Basic dental care

Major dental care

Medically necessary orthodontia Orthodontic

Asthma program not available

Asthma program not available

Asthma program not available

Mental/behavioral health outpatient services

Mental/behavioral health inpatient services

Outpatient rehabilitative services

Skilled Nursing Facility care

AmeriHealth New Jersey AmeriHealth NJ Select Local Value Silver HMO

The deductible range

The deductible range

The deductible range

The deductible range

No Charge In-Network, Not Covered Out-of-Network

No Charge After Deductible InNetwork, Not Covered Out-ofNetwork

No Charge In-Network, Not Covered Out-of-Network 1 Visit(s) per Year ;

No Charge In-Network, Not Covered Out-of-Network 1 Visit(s) per Year ;

No Charge In-Network, Not Covered Out-of-Network 1 Item(s) per Year ;

50% In-Network, 50% Out-ofNetwork Not Covered