New Jersey Response to COVID-19

COVID-19 Special Enrollment Period Q&A

Get Covered New Jersey, the state’s official health insurance marketplace, has announced a COVID-19 Special Enrollment Period from February 1, 2021 to May 15, 2021 for all eligible uninsured residents seeking health insurance at this critical time. Visit GetCovered.NJ.gov to shop and compare plans and see if you qualify for financial help.

Was the 2021 health insurance enrollment window extended beyond January 31?

A: Yes. The Open Enrollment Period ran from November 1, 2020 through January 31, 2021. Governor Murphy announced on January 29, 2021 an extension of the enrollment window for uninsured New Jerseyans to May 15, 2021 through a COVID-19 Special Enrollment Period. Extending the enrollment timeframe for those who need insurance to May 15, 2021 helps to better protect New Jersey residents at this critical time.

Will I need to prove I was directly impacted by COVID-19 (positive coronavirus test or a job loss, for example) to enroll in a plan through Get Covered New Jersey during the COVID-19 Special Enrollment Period?

A: No. Residents do not need to be directly impacted by the coronavirus in order to enroll in a plan through the COVID-19 SEP, and no documentation will be required to demonstrate a direct impact of COVID-19. All eligible uninsured residents in need of health insurance can enroll through May 15, 2021.

If I am uninsured but also have a qualifying life event, should I enroll through the COVID-19 Special Enrollment Period or through a Special Enrollment Period that is specific to my circumstance?

A: It depends. No documentation specific to COVID-19 is required for uninsured residents to enroll in a plan through the COVID-19 Special Enrollment Period. Coverage will take effect on the first day of the month following a plan selection through the COVID-19 SEP.

The coverage effective dates are as follows:

Enroll by February 28, coverage effective March 1;

Enroll by March 31, coverage effective April 1;

Enroll by April 30, coverage effective May 1;

Enroll by May 15, coverage effective June 1.

Coverage effective dates may vary for SEPs specific to a life-changing event, allowing for an earlier effective date. Additionally, some SEPs specific to a life change require verification documentation.

If I have a life changing event such as pregnancy, having a baby, or adoption, which SEP should I enroll through?

Certain events, such as having a baby and adopting a child are qualifying life events that provide for SEP enrollment back to the date of the event. Additionally, pregnancy is a new NJ-specific qualifying life event that allows for SEP enrollment back to the month of the confirmed pregnancy. If you need retroactive coverage related to these events, you may apply through the SEP specific to your life event. (Note: Pregnancy, adoption and birth do not require verification documentation).

More information may be found on the When Can I Buy Insurance page. If you have questions, trained certified assisters are available at Find Local Assistance.

I have health insurance, but am losing my job-based coverage soon and therefore will qualify for a Special Enrollment Period (loss of Minimum Essential Coverage). Which SEP should I enroll through?

A: Loss of Minimum Essential Coverage requires documentation to verify the loss of coverage and allows 60 days from the event to enroll in a plan. Coverage can start the first of the month after you apply and enroll. If you know you are losing coverage within the next 60 days, you can submit an application on GetCovered.NJ.gov before you lose your coverage to ensure you can stay covered throughout the year. For example, if you know you’ll lose coverage on February 28, and you apply and enroll in plan on February 10, your new coverage will start March 1.

If you lose coverage and become uninsured, you can enroll through the COVID-19 Special Enrollment Period without providing documentation. Your coverage will begin on the first day of the month following your plan selection.

I already have health insurance through Get Covered New Jersey. Can I switch plans through the COVID-19 Special Enrollment Period?

A: Yes. Special Enrollment Periods are available throughout the year for residents who have a major life change, called a qualifying life event (QLE), which allow for enrollment outside of the open enrollment period. Certain QLEs also allow for enrollees to change their existing plan. They include: birth, adoption, marriage, death, dependent aging off coverage, moving, income loss that changes eligibility for Marketplace coverage (for example, newly qualifies you for financial help). Remember to update your application with any income or household changes as it may impact your financial help. Additionally, changes to current coverage unrelated to a specific life event can be made through the COVID-19 Special Enrollment Period.

I enrolled during the Open Enrollment Period, but the health insurance company I selected a plan from made an error. Should I re-enroll through the COVID-19 Special Enrollment Period?

A: Errors made by a health insurance carrier or by the program qualify you for an Exceptional Circumstance Special Enrollment Period. Documentation of the error will be required (see standard form here). Your coverage may be retroactively updated back to the date of the error, if applicable.

How long will the COVID-19 Special Enrollment Period last?

A: The COVID-19 SEP will allow eligible uninsured residents to enroll in a plan through May 15, 2021.

How do I enroll?

To enroll, visit GetCovered.NJ.gov. Select “2021 COVID-19 Enrollment Period” when submitting your application.

Trained navigators and brokers can help you enroll by phone, virtually, and may have in-person availability. Information may be found on our website under Find Local Assistance. You may also call our Consumer Assistance Center: 1-833-677-1010.

If you are eligible for NJ FamilyCare, the state’s publicly funded low or no cost health insurance program (Medicaid or Children’s Health Insurance Program), you can enroll any time of year.

Is the COVID-19 Special Enrollment Period also available for enrollment in plans that are sold directly through a health insurance company?

A: Yes. The state established a COVID-19 Special Enrollment Period for enrollment in plans available through Get Covered New Jersey and directly from insurance carriers in the individual market. All available plans may be viewed by using our Shop and Compare tool.

Is Coronavirus care covered under plans available through Get Covered New Jersey?

Yes. Health insurance companies are required to waive cost-sharing, including lab fees, co-payments, coinsurance, and deductibles for any visit to test for coronavirus at a doctor’s office, urgent care center, or emergency room, and for a coronavirus vaccine. Additionally, if the primary purpose of an office visit is the delivery of the COVID-19 immunization, then insurance companies may not impose cost-sharing requirements for the office visit.

Can you qualify for the COVID-19 Special Enrollment Period even if you are not sick?

Yes. All eligible, uninsured New Jerseyans may qualify for this COVID-19 Special Enrollment Period.

Additional information about Special Enrollment Periods may be found on our When Can I Buy Insurance page.

Coronavirus Resources

For more information on the coronavirus, including testing and vaccine locations, visit the New Jersey COVID-19 Information Hub at https://covid19.nj.gov/ For vaccine information, you may also call the state’s COVID-19 Vaccine Call Center at 855-568-0545.

Additional Resources

New Jersey Department of Health: https://www.nj.gov/health/

Centers for Disease Control and Prevention: https://www.cdc.gov/

 


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