Choosing the right health plan for you and your family can be stressful. Fortunately, there are many options to choose from on the ACA exchange in New Jersey.
The Affordable Care Act (ACA) offers different types of plans grouped into metal tiers. These tiers vary in price and benefits. Depending on your needs, you may want to pick the higher tiers for more coverage.
Get Covered New Jersey
Get Covered New Jersey provides a one-stop shop for health insurance for residents who do not have coverage through an employer or other program. It is the only place residents can get financial help to purchase a plan through the Marketplace.
The Marketplace is where New Jerseyans can apply for Premium Tax Credits, Cost-Sharing Reductions and state subsidies to lower their costs. These subsidies are available through the federal American Rescue Plan Act and expanded state subsidies from the State of New Jersey.
Those eligible for these state subsidies will be able to enroll in a Silver or Gold Marketplace plan and save on their monthly premiums. The 2021 American Rescue Plan Act increased the amount of these premium subsidies and expanded the number of households who qualify.
Most of the people who enroll in a Silver or Gold Marketplace plan will pay less than 8.5% of their household income towards their insurance. For example, a 21-year-old in Newark, NJ, earning 25,000 per year would pay $38 per month with state subsidies ($318 without them). A family of four in Trenton, N.J., earning $50,000 per year, would pay $68 per month with state subsidies ($1,121 without them).
Open Enrollment Period
New Jersey residents can enroll in a health insurance plan under the Affordable Care Act (ACA) during an open enrollment period. This period is usually November 1 through December 7.
As with the federal marketplace, consumers in New Jersey can shop for ACA plans through Get Covered NJ, the state’s official healthcare exchange. This website allows you to compare ACA health insurance plans and find the best option for your needs.
Several types of financial assistance are available to lower the cost of your plan. These include premium tax credits, cost-sharing reductions and a state subsidy.
The state’s individual coverage mandate helps keep premiums low by ensuring that every person has minimum essential coverage. This requirement also prevents insurers from denying or reducing benefits to people with pre-existing conditions, which has driven up premiums all across the country.
Cost-Sharing Reductions
The Affordable Care Act (Obamacare) makes health insurance more affordable by lowering premiums and reducing cost-sharing costs, such as deductibles, copays and out-of-pocket maximums. This is done through advanced tax credits that reduce the amount you pay for your monthly premiums, and cost-sharing reductions that lower the total amount of out-of-pocket expenses.
New Jersey residents who purchase plans through the exchange may be eligible for additional financial assistance, depending on their income level. This assistance includes premium subsidies, cost-sharing reductions and new state subsidies called New Jersey Health Plan Savings, which lower your premiums.
These subsidies are available to people with incomes below 250% FPL, but they can only be applied to silver plans. These plans have built-in cost-sharing reductions that make deductibles and other out-of-pocket costs more similar to those under gold or platinum plans.
State Subsidies
State subsidies (also known as premium tax credits) are a key tool in addressing affordability gaps. They offer financial assistance to reduce premiums for consumers who purchase coverage on a health insurance exchange.
States can target subsidies to a wide range of needs and goals, and they are highly flexible. They can be targeted by income, age, geography or other factors.
New Jersey residents enrolled in 2021 Marketplace plans can receive additional financial help from a state subsidy called the New Jersey Health Plan Savings program. These savings are added to the federal subsidies provided on the Exchange to help lower the cost of health insurance for most enrollees.
The New Jersey exchange also has a Navigator program to help people understand and enroll in their Marketplace plan. This program is funded by the state and will be much more robust than in previous years.