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Choosing a Plan on New Jersey’s Health Insurance Marketplace


Open enrollment is here! What does this mean? New Jersey’s marketplace exchange opens November 1 for NJ residents to purchase health insurance coverage for calendar year 2023. If you need to buy health insurance, for example, because you are not on Medicaid or don’t have health insurance through your employer, open enrollment is the time to do that. You can also change your plan during open enrollment.

New Jersey’s exchange is called GetCoveredNJ. GetCoveredNJ provides financial assistance to NJ residents, depending on income level, who need to purchase health insurance coverage.

What time deadlines should I know about?

New Jersey’s open enrollment period starts on November 1, 2022 and will end on January 31, 2023. This period is a little longer than the federal marketplace’s enrollment window, so NJ residents get a little more time to enroll in plans for 2023.

If you enroll from November 1 through December 31, your coverage will start on January 1, 2023. If you enroll in January, your coverage will start on February 1, 2023.

If you do not enroll during open enrollment, you may still be able to get coverage. Special enrollment periods are available for people whose circumstances have changed. For example, if you lose your employer-based insurance, lose Medicaid eligibility, or become pregnant, you will qualify for a Special enrollment period. If your situation changes, you need to apply quickly. People with low incomes, who do not qualify for NJ FamilyCare (Medicaid), may apply at any time.

If you miss the open enrollment window, and do not qualify for a Special enrollment period, then you will have to wait until next year to apply. This is why it is important to enroll now if you need health insurance.

Who can enroll in a plan using GetCoveredNJ?

Any NJ resident can shop on GetCoveredNJ as long as you do not have insurance through another source, such as an employer, Medicaid, or Medicare. Your entire household does not need to be eligible. For example, if you have coverage through an employer, but your children do not, you can purchase a separate plan for them.

You can also purchase a plan if you are an immigrant and lawfully present in the US but do not have other insurance. However, you may not qualify for financial subsidies.

How do I qualify for financial assistance?

NJ residents can get health insurance either free or at a reduced cost, depending on their income. For NJ residents with low income, free health insurance (Medicaid) is available through NJ FamilyCare. People on those plans pay no premiums or cost-sharing. (Cost-sharing means health care costs in addition to premiums, such as deductibles, co-pays, or co-insurance.) The qualifying income limits for children and pregnant women are higher than for adults, so children may qualify for NJ FamilyCare coverage when their parents do not.

GetCoveredNJ provides financial help to NJ residents who do not qualify for Medicaid. You will need to provide an estimate of your annual income for 2023. Depending on your estimate, federal and state subsidies will be used to reduce the cost of health insurance premiums. You may also qualify for additional financial assistance with cost-sharing, again depending on your income.

To access this financial assistance with purchasing a health care plan, you must:

  • Apply on the state website: GetCoveredNJ.
  • Check “yes” to the question: will you be filing a federal tax return? (Even if you don’t think you will owe any taxes.)

The GetCoveredNJ website has a list of certified assisters that can help you apply and enroll in a plan, such as the Center for Family Services (877-962-8448), which operates statewide. See GetCoveredNJ's Search for in-person assistance page to search for an assister. Certified assisters will help you for free but cannot recommend a specific plan. Insurance agents and brokers can also help you but they may be only able to sell you plans from certain companies.

What if I am not sure if my income level qualifies for financial assistance?

Don’t worry if you are not sure what level of help you may qualify for. GetCoveredNJ will calculate the amount of federal and state subsidies you are eligible for, based upon the information you provide. That financial help will be shown in the cost of plans that you are offered. Nine out of ten consumers who enroll on GetCoveredNJ qualify for financial help. Even if you do not, you may still purchase a plan on GetCoveredNJ.

If you apply through GetCoveredNJ, and it appears that you or a family member qualifies for Medicaid, it will send the application to NJ FamilyCare. If you receive mail from NJ FamilyCare asking for more information, be sure to respond.

How do I choose a plan?

The insurance companies that offer plans on GetCoveredNJ are AmeriHealth, Horizon (BCBS), Oscar Health, and Ambetter (Wellcare). All of the plans on GetCoveredNJ cover essential health benefits, as mandated by the Affordable Care Act (ACA).

When you apply through GetCoveredNJ, you can compare plans and prices before you chose one. The plans are grouped into tiers, based upon what percentage of costs the health plan will pay.

  • Bronze plans have the lowest premiums but the highest cost-sharing. Bronze plans are the cheapest up-front but you will pay more health care costs yourself if you need care.
  • Silver plans are the best choice for people who qualify for cost-sharing reductions, so the co-pays and the deductibles will be lower. Silver is the only tier that qualifies for that form of financial help.
  • Gold plans have more expensive premiums but lower cost-sharing, so you will pay less out of pocket for medical care.
  • Catastrophic plans may be an option for people under 30 but should be chosen with caution, because they do not cover most medical care.

If you have more questions, the GetCoveredNJ website has a very helpful list of frequently asked questions (FAQs).

Watch out for scams!

If you do an internet search for “NJ health insurance,” the state-run insurance exchange, GetCoveredNJ, will not be the first result. You need to be sure that you are at GetCoveredNJ.

Other insurance companies run ads that look helpful, but they are not. They use phrases like “NJ Affordable Health Plans” and “ObamaCare Enrollment” to mislead people. The plans on these websites do not qualify for government financial help in buying them, which you get when you buy plans through GetCoveredNJ. Even though they appear to be a good deal, they may end up being more expensive.

Worse, some of them are not even good health insurance. They may not provide coverage when you need it, such as for a hospital stay or lab tests. They may not cover pre-existing conditions. They may not even be an insurance plan, even though they appear to be on their website. Health care sharing ministries are a type of these plans and should be avoided. Unless you buy a plan through GetCoveredNJ, you can’t be sure that the plan will cover essential health benefits.​​