Monday, April 12, 2021

Open Enrollment for NJ Extended to end of Year, More Financial Help To Reduce Premiums

More financial help is coming soon through Get Covered New Jersey. If you enrolled in health insurance through the market place at get covered NJ you you will likely be eligible for additional premium reductions. If you did not qualify for financial help before because your income was too high, you may qualify under the federal changes.

 The COVID-19 relief bill will reduce health insurance premiums by providing more financial help to eligible consumers who purchase a plan through Get Covered New Jersey. Get Covered New Jersey is working to implement the changes and update its system to ensure that New Jerseyans receive this relief as soon as possible.

 These new changes make coverage more affordable at many income levels. To ensure that as many residents as possible can benefit from the new financial help, the State of New Jersey has extended the health insurance enrollment window through the end of the year.

Here are more details on what you can expect:

Increases in financial help (Advance Premium Tax Credits or APTC) for all eligible consumers. The amount of financial help is based on household income just like before, but has increased at every income level. Families making less than 150% of the Federal Poverty Level (FPL) – or $19,140 a year for an individual or $39,300 for a family of four - will be eligible for near zero-dollar premiums under the new law.

New financial help for higher incomes. Previously, financial help was not available for households making more than $51,040 for an individual or $104,800 for a family of four. The new law ensures that no family spends more than 8.5% of their income on health insurance premiums. This means many individuals who previously did not qualify for financial help from the federal government may now see more affordable premiums.

Financial help for unemployed. Additional financial help may be available for anyone who has received unemployment benefits in 2021.

GetCoveredNJ will be working to ensure these new benefits are implemented in a timely manner. Check back to this page for updates. All enrolled consumers should be sure to read any notices sent by GetCoveredNJ.

American Rescue Plan Q&A

When will these new financial benefits start?

A: Get Covered New Jersey is working as quickly as possible so consumers can see these benefits in the near future. We will provide updates on our website in the coming weeks about when the benefits will be available. Current enrollees will be notified when the benefits are available and any action that needs to be taken to receive them.


Will I be able to change my health plan due to these changes?

A: Yes, you will be able to change your coverage based on any additional financial help you may receive.


If you change 2021 health plans without a gap in coverage during the calendar year, the amount you paid toward your deductible in your current plan will go toward your new deductible. If the new plan is with a different carrier, the carrier will request documentation of the amount of deductible paid under the prior plan. Any costs that have accumulated towards your out-of-pocket maximum for your current health plan, other than deductible, will not be carried over to your new plan.


How do I know if I qualify for more financial help?

A: Financial help is still based on your individual household income. The amount you and/or your family make yearly will determine how much financial help you will receive.


If I need coverage now, should I wait until the new financial help is available?

A: There are low cost plans available now and you can enroll through the COVID-19 Special Enrollment Period. If you need coverage, you should check out your options. Consumers will be provided information about how to obtain the new financial help once it is available.


I received notifications from Healthcare.gov that I can update my account on April 1st to receive the new financial help. Should I go to Healthcare.gov or GetCovered.NJ.gov?

A: All New Jersey residents must go through GetCovered.NJ.gov to receive Marketplace coverage and financial help. You may still receive notifications from Healthcare.gov if you previously had coverage or applied through the federal website. New Jersey now has its own Marketplace, and no longer uses Healthcare.gov.


I heard the American Rescue Plan Act helps those who have recently been unemployed or are unemployed – what help is available?

A: Any individual who has received or qualified for unemployment insurance is eligible for significantly reduced premiums. Consumers will be provided information about how to obtain the new financial help for those who have received unemployment compensation once it is available.


Will GetCoveredNJ automatically update premium tax credits on behalf of current enrollees?

A: Current enrollees will receive more information soon about what actions are needed to receive the financial help and whether any application updates are needed.

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