Get Covered New Jersey

Get Covered New Jersey

When can I get coverage?

The Open Enrollment Period is Nov. 1 through Dec. 15. Open Enrollment occurs once each year and it is the only time when you can enroll in coverage, unless you experience a major life event (such as having a baby, moving, or losing or changing jobs) that qualifies you for special enrollment OR if you’re eligible for the state’s NJ FamilyCare program, in which you can enroll year-round.

How much will insurance cost and can I really afford it?

You may be eligible to receive financial help to lower the cost of your plan. Last year, about 8 out of 10 New Jersey residents purchasing on the Marketplace received a tax credit to pay for their plan. Plans and prices change every year, so it’s important to check out your options to ensure you find the plan that fits your needs and your budget. In addition, the state’s NJ FamilyCare health insurance program provides free to low-cost health coverage to qualified residents of any age. Eligibility is based on income and household size.

Is financial assistance available to help lower the cost of my plan?

In 2019, nearly 200,000 New Jerseyans got a tax credit to help pay for their plan. In New Jersey, a family of four earning up to about $103,000 a year and an individual earning up to about $49,960 a year can qualify. In fact, in 2019 the average individual saved $366 a month with a tax credit.

Is there still a requirement to have health insurance in New Jersey?

Yes. New Jersey is committed to making sure health insurance is available and affordable to all residents. To help with this, the state has kept in place a requirement for New Jersey residents to have health coverage or make a shared responsibility payment during tax time. Making sure all residents have health coverage helps ensure there are more health plans available for consumers to pick from, that premiums remain affordable, and that comprehensive coverage is available for all who need it – including people with pre-existing conditions. Any funds from this penalty collected by the state are dedicated to reducing the cost of health insurance for individuals. Through New Jersey’s efforts to stabilize our insurance market, New Jerseyans have been able to obtain needed coverage for themselves and their families.

More detailed information on New Jersey’s health insurance requirement and the Shared Responsibility Payment may be found here

I don't qualify for financial help, but I heard there are new plans available this year. What are my options?

Plans and prices change every year so it's important to see what's new. Also, if you don't qualify for a tax credit on the Marketplace, silver plans are available Off The Marketplace (purchased directly from the carrier) and may be more affordable for you. The bottom line is that if you are not eligible for financial help, be sure to shop around. Check out your options both on and off the Marketplace.

I've read something about short-term coverage - is that an option?

Short-Term Limited Duration plans are prohibited in New Jersey. Sometimes called "skimpy" plans, they don't cover the basic services you would expect from insurance and that are required in New Jersey. Plans offered at HealthCare.gov/Marketplace and in New Jersey's individual market Off The Marketplace cover comprehensive benefits like preventive care, check-ups, prescriptions, hospitalizations, maternity care, mental health care, and more.

I want to protect my family – I’m ready to enroll in coverage but still have questions. Where can I find help?

Free help is available to find a health insurance plan that’s right for you. You can find a trained assister in your community on the Get Help page of GetCovered.NJ.gov to talk about your health insurance options and to get help enrolling.

I’ve been hearing a lot of about New Jersey establishing a State-Based Exchange, what is it?

The Affordable Care Act signed by Former President Obama in March 2010, requires each state to establish health insurance exchanges. Since the inception of the ACA, New Jersey utilized the Federally-Facilitated Exchange (FFE), or Marketplace, which provides a platform for consumers to shop for and enroll in coverage.

New Jersey intends to transition to its own State-Based Exchange. The development of a State-Based Exchange is vital to stabilizing New Jersey’s individual market and protecting residents’ access to quality and affordable coverage options.

When will New Jersey Become a State-Based Exchange?

The state will operate a State-Based Exchange on the Federal Platform (SBE-FP) for plan year 2020. This will allow the state to better transition to a State-Based Exchange (SBE) for plan year 2021, while providing additional outreach and enrollment assistance to New Jersey residents for the open enrollment period that runs Nov. 1 to Dec. 15.

For the open enrollment period and for special enrollment throughout 2020, consumers will continue to enroll in marketplace coverage and access financial assistance through Healthcare.gov.

Get Help