Affordable Care Act (ACA)
Understanding your Health Insurance Options
Passage of the Affordable Care Act (ACA) put in place comprehensive health insurance reforms. Some of these reforms are focused on health insurance companies and mandates for coverage, many of which have already been implemented. Another component of the ACA requires that Americans purchase health insurance coverage.
Open Enrollment Period Begins November 1
Open enrollment for the upcoming insurance year (January 1 - December 31, 2021) begins on November 1, 2020, and ends on January 31, 2021.
For coverage to start on January 1, subscribers have to apply by January 31, 2021. Minimum essential health insurance coverage is mandatory in New Jersey for most citizens, unless they qualify for an exemption. Those who do not qualify for an exemption from this law may be required to pay a fee when they submit their tax return.
If you lost employer coverage or income, you may be able to enroll in Marketplace coverage now through a Special Enrollment Period. Free or low-cost coverage is also available through NJ FamilyCare for those who qualify. Learn more
New Jersey's Healthcare Marketplace
GetCoveredNJ is New Jersey’s official health insurance Marketplace and is focused on increasing access to affordable, high-quality health insurance for residents of New Jersey. Here you can find quality, affordable health insurance for you and your family. You can browse health plans now and check if you may qualify for financial help.
To shop for health insurance on GetCoveredNJ you:
- Must live in the United States and have a primary residence in New Jersey
- Must be considered a resident of the United States and New Jersey for tax purposes
- Must be a U.S. citizen or national. If you are a non-citizen, you must be lawfully present in the U.S. for the entire time you plan to have health coverage
- Cannot be currently incarcerated
Possible Cost Savings for You
One of the things that people express concern about when the subject of health insurance comes up, is the cost. Some relief may be in sight.
When applying through GetCoveredNJ, you may qualify for three types of financial assistance based on your income: premium tax credits, cost-sharing reductions and NJ Health Plan Savings, a new state subsidy offered by the state of New Jersey. Premium tax credits and the state subsidy help lower your monthly premium payments. Cost-sharing reductions help lower your out-of-pocket costs like deductibles and co-pays for doctor visits. See if you qualify to receive a financial help.
Renewing Your Coverage
If you are currently enrolled in a Marketplace place, GetCoveredNJ will take steps to enroll you in a similar plan for 2021. To see your health plan for 2021 or to pick a new plan, you will need to use the GetCoveredNJ Marketplace.
Enrollment during any other time of year is only permitted under the following circumstances:
- If you are eligible for Medicaid or CHIP (Children's Health Insurance Programs) you can enroll at any time of year, within 60 days of the time, you became eligible.
- If you are eligible to participate in a special enrollment period you can apply at a time that is outside of the open enrollment period, within 60 days of the time, you became eligible. To qualify for the special enrollment you must have had a qualifying life event (like getting married, having a baby, moving to a new area, or losing other health coverage) or have had a complex situation related to applying for coverage.
Get Help with Enrollment
If you are looking for someone who will personally walk you through the enrollment process consider the following resources.
- Navigators and their assistants - These professionals have completed a comprehensive training and will help consumers prepare applications to establish eligibility and enroll in coverage through the Marketplace. They will also run community programs to raise awareness and will refer consumers that have complaints to health insurance ombudsmen. Those eligible for NJ Family Care or Medicaid will be given assistance as well.
- Agents and Brokers - Licensed agents and brokers may assist in the application process as well. These professionals can assist consumers in the Marketplace but must first complete a two-part registration process. Agents and brokers are compensated by health insurance issuers for assisting consumers.
- You can also search in our database for navigators and counselors who will provide help to you. * Only those Counselors and Navigators who provide their services free-of-charge are included in our database.
Learn More at these Sites
Health Insurance Explained - The YouToons Have it Covered
This cartoon video is the third YouToons video produced by the Kaiser Family Foundation. It explains health insurance concepts, such as premiums, deductibles, and provider networks, in a light-hearted way and also talks about how individuals pay for coverage, how prescription coverage works and the variety of healthcare coverage that is available.
The Center for Consumer Information and Insurance Oversight (CCIIO) is charged with helping implement many reforms of the Affordable Care Act. CCIIO oversees the implementation of the provisions related to private health insurance. In particular, CCIIO is working with states to establish new Health Insurance Marketplaces. CCIIO works closely with state regulators, consumers, and other stakeholders to ensure the Affordable Care Act best serves the American people.