Health insurance is a type of coverage that pays for medical expenses incurred by you or your dependents in case of illness, injury, or preventive care.
Having health insurance can protect you from unexpected and high medical bills, as well as provide access to quality health care services.
In this article, we will explain how to buy health insurance in New Jersey, what the eligibility requirements, enrollment periods, available plans and costs, and what to consider before buying health insurance.
Understanding Health Insurance Coverage in New Jersey
New Jersey has its own online health insurance marketplace called GetCoveredNJ, where you can shop for health plans that cover essential health benefits as required by the Affordable Care Act (ACA).
You can also apply for financial help to lower your health insurance costs through GetCoveredNJ. Depending on your income and household size, you may qualify for one or more of the following types of financial help:
- Premium tax credits: These are subsidies that reduce your monthly health insurance premium payments.
- Cost-sharing reductions: These are discounts that lower your out-of-pocket costs like deductibles and copays when you receive health care services.
- New Jersey Health Plan Savings: These are additional savings offered by the state of New Jersey to most people purchasing coverage on the marketplace.
- NJ FamilyCare: This is the state’s publicly funded health insurance program that provides free or low-cost coverage to eligible residents of any age.
To be eligible to buy health insurance through GetCoveredNJ, you must:
- Be a U.S. citizen, national, or lawfully present immigrant
- Live in New Jersey
- Not be incarcerated
- Not be eligible for Medicare
To be eligible for financial help through GetCoveredNJ, you must:
- Meet the income and household size criteria for each type of financial help
- Not having access to affordable and adequate health coverage through an employer, a spouse’s employer, or another government program
You can enroll in health insurance through GetCoveredNJ during two periods:
- Open Enrollment Period: This is the annual period when anyone can enroll in or change their health plan for the next year. The open enrollment period for 2023 coverage ran from November 1, 2022, to January 31, 2023.
- Special Enrollment Period: This is a period outside of the open enrollment period when you can enroll in or change your health plan if you have a qualifying life event. A qualifying life event is a change in your situation that affects your eligibility for coverage or financial help, such as getting married, having a baby, losing other health coverage, moving to a new area, or experiencing a change in income.
Available Plans and Cost
GetCoveredNJ offers four categories of health plans: Bronze, Silver, Gold, and Platinum. These categories differ in how much they cover and how much you pay. Generally, the higher the metal level, the higher the monthly premium but the lower the out-of-pocket costs. You can compare plans and prices using the shop and compare tool on GetCoveredNJ’s website.
The cost of health insurance depends on several factors, such as:
- The type and level of plan you choose
- The amount of financial help you qualify for
- Your age, location, and tobacco use
- The number and ages of people in your household
How to Sign Up for Health Insurance in New Jersey?
There are two ways to sign up for health insurance through GetCoveredNJ:
You can apply online at GetCoveredNJ’s website by following these steps:
- Create an account or log in if you already have one.
- Fill out an application with information about yourself and your household, such as income, residency, citizenship status, and current health coverage.
- Review your eligibility results and see how much financial help you can get.
- Compare plans and prices based on your eligibility and preferences.
- Choose a plan and enroll.
Working with a Certified Expert
You can also get free help from certified experts who can answer your questions and guide you through the enrollment process. These experts include:
- Health insurance agents (brokers): These are licensed professionals who can help you compare plans and enroll in a plan that meets your needs. They may receive commissions from insurance companies for enrolling customers.
- Certified assisters: These are trained individuals who can help you complete an application and enroll in a plan that meets your needs. They do not receive commissions from insurance companies.
You can find a certified expert near you by using the get help tool on GetCoveredNJ’s website.
What to Consider Before Buying Health Insurance?
Before buying health insurance through GetCoveredNJ, you should consider the following factors:
If you already have health coverage through an employer, a spouse’s employer, or another government program, you should check if it meets the minimum standards of the ACA and if it is affordable and adequate for your needs. If you have existing coverage, you may not qualify for financial help through GetCoveredNJ or you may have to pay back some or all of the financial help you receive when you file your taxes.
Preferred Doctors and Providers
If you have doctors or other healthcare providers that you prefer to see, you should check if they are in the network of the plan you are considering. A network is a group of doctors, hospitals, and other providers that have agreed to provide services at a certain rate to the plan’s members. If you see a provider outside of your plan’s network, you may have to pay more or the full cost of the service.
Budget and Needs
You should also consider your budget and healthcare needs when choosing a plan. You should think about how much you can afford to pay for monthly premiums and out-of-pocket costs, as well as how often you expect to use health care services and what kind of services you need. You should balance the cost and coverage of the plan to find the best option for you.
Buying health insurance in New Jersey can be easy and affordable if you use GetCoveredNJ and apply for financial help. By following the steps and tips in this article, you can find a health plan that suits your needs and protects your health.