New Jersey Response to COVID-19

Good news! More financial help is now available through Get Covered New Jersey

New Federal and State Savings

The federal government recently passed a COVID-19 relief bill, the American Rescue Plan Act of 2021, which was signed into law by President Biden on March 11, 2021. The new law will reduce health insurance premiums by providing more financial help to eligible consumers who purchase a plan through Get Covered New Jersey. The State of New Jersey is also providing more financial help to lower health insurance costs for residents enrolling at Get Covered New Jersey.

More people than ever will qualify for financial help. If you did not qualify for financial help before because your income was too high, you may qualify under the state and federal changes. If you already receive financial help, you will likely be eligible for additional premium reductions. These new changes make coverage more affordable at many income levels.

During the COVID-19 pandemic, the State of New Jersey has remained focused on improving residents’ access to quality, affordable health insurance. The financial help available through this relief bill and the State of New Jersey builds on the state’s efforts to provide access to health coverage for more New Jerseyans.

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 for all eligible consumers. The amount of financial help is based on household income just like before, but has increased at every income level due to more financial help provided by both the state and federal government.

  • 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 federal law ensures that no family spends more than 8.5% of their income on health insurance premiums - at any income. This means many individuals who previously did not qualify for financial help from the federal government may now see more affordable premiums. On top of the federal financial help, the State of New Jersey has also increased financial help to higher incomes, to further lower premiums, effective beginning May 1st

  • Financial help for unemployed. Households receiving unemployment compensation in 2021 may be eligible for nearly free coverage for the rest of the year through GetCoveredNJ. Find more information here.

Use these step-by-step guides to see if you qualify now:

  • New to GetCoveredNJ? Click here for the 5 steps you should take.

  • Already enrolled in GetCoveredNJ? Click here for the 4 steps you should take.

  • Applied before but don’t have a plan? Click here for the 4 steps you should take.

  • Received unemployment income in 2021? Click here for the 4 steps you should take.

Enroll or Update Your Account or Estimate Your Financial Help

Enroll or Update Your Account or Estimate Your Financial Help

American Rescue Plan Q&A

Yes, the new financial help is here! If you are new to GetCoveredNJ, you can create an account to find out how much financial help you may qualify for. If you are an existing customer, you can now log in to your GetCoveredNJ account to see if increased financial help has been applied to your account. If not, update your information to see if you can receive more savings.

Start or update your application now. Once you update your application, the increased financial help will begin at the start of the following month.

NOTE: The new savings became available on April 15th, with lower premiums taking effect as early as May 1, 2021. During the month of June, Get Covered New Jersey automatically updated financial help for as many existing consumers as possible to reduce premiums for customers who had not yet taken action. Get Covered New Jersey enrollees can check their accounts now to see if updates were made or if action is needed.

Current GetCoveredNJ enrollees who have received unemployment compensation in 2021, those who do not receive financial help, and those who have opted to apply only a portion of their financial help to their premium each month, will need to update their application to receive the lower premiums for which they qualify.

For more details, please use the guides on how to access your increased savings.

Get Covered New Jersey automatically updated financial help for as many existing consumers as possible during the month of June to reduce premiums for customers who had not yet taken action. The changes made to accounts automatically are effective June 1st. If you are currently enrolled and do not see changes to your coverage, you may need to update your application for the new financial help to take effect. If you updated your application after April 15th, and are eligible for savings, the new financial help is already in effect.

NOTE: Current GetCoveredNJ enrollees who have received unemployment compensation in 2021, those who do not receive financial help, and those who have opted to apply only a portion of their financial help to their premium each month, will need to update their application to receive the lower premiums for which they qualify.

For more details, please use our guide on how to access your increased savings.

Current enrollees may also choose to change their plans due to increased affordability through the COVID-19 SEP which will run until the end of the year. While your overall deductible may roll over from plan to plan, any costs you have already paid under your current plan may not count towards the annual maximum out-of-pocket limit of a new plan. If you have already paid significant amounts for medical care this year, you may want to consult with your insurance company, assister, or agent/broker to see how this might affect you and what options you may have to apply these payments to your new plan.

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. 

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 you are an existing customer, log in to your account to see if the new financial help has been applied to your account. If not, update your information to see if you can receive more savings.

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. 

Individuals who have received unemployment insurance may be eligible for nearly free premiums regardless of their income. If you are an existing customer, log in and update your application to see the savings you may qualify for. If you are a new customer, create a GetCoveredNJ account and fill out an application to view your potential savings. Consumers will be asked to attest to receiving unemployment compensation.

NOTE: Only the tax filer and/or spouse are eligible to attest to receiving unemployment compensation to be eligible for this additional financial help. Do not click the attestation if the only individual receiving unemployment in the tax household is a dependent.

Received unemployment income in 2021? Click here for our step-by-step guide.

During the month of June, GetCoveredNJ will automatically update financial help for as many current enrollees as possible to reflect the new federal and state premium reductions without the consumer needing to take any action. This will happen for most current consumers, but it will not be possible to update existing enrollees that fall into certain categories.

NOTE: Current GetCoveredNJ enrollees who have received unemployment compensation in 2021, those who are currently not receiving financial help, and those who have opted to apply only a portion of their financial help to their premium each month, will need to update their application to receive the lower premiums for which they qualify.

For more details, please use our guide on how to access your increased savings.

If you already paid your June premium, your July bill will show your new lower premium. Your health insurance company will provide a credit to future bills for any extra you paid in June. You can also ask your health insurance company for a refund.

The new financial help is only available for consumers enrolled through GetCoveredNJ. You could be newly eligible for increased financial savings if you switch your health insurance coverage to a plan on GetCoveredNJ. You can use the Shop and Compare tool to get an estimate of your potential savings before submitting a full application.

If you are enrolled with a company that offers plans on GetCoveredNJ, you may be able to switch to the same plan through the marketplace. You can talk to your health insurance company about carrying over the money spent on your deductible to your GetCoveredNJ plan. If you have questions, you can Find Local Help to guide you through the process.

The new financial help will take effect the month after you submit a new application, or update your existing application. For example, submitting a new application in June could result in lower premiums starting July 1st. Many current GetCoveredNJ enrollees will have their financial help automatically updated for June 1st coverage.

Yes, the federal law has removed any requirement to pay back APTC if you underestimated your income in 2020. As of now, the requirement to reconcile your premium tax credits  using IRS Form 8962 remains in place for 2021. (See Reconcile Your Taxes in Glossary)

GetCoveredNJ does not offer tax advice. For more information please visit www.irs.gov or contact a local tax advisor.

You will need to review your options and make the decision that works best for you and your family. Fully subsidized COBRA plans began April 1st and end on September 30th. GetCoveredNJ does not offer COBRA plans. More information is available from the federal government here: https://www.dol.gov/COBRA-subsidy.

Please Note: You may qualify for nearly free coverage through GetCoveredNJ if you have received unemployment compensation at any point throughout 2021.

Yes. The Open Enrollment Period ran from November 1, 2020 through January 31, 2021. Governor Murphy announced an extension of the enrollment window for New Jerseyans seeking coverage through a COVID-19 Special Enrollment Period through the end of 2021.

No. Residents do not need to be directly impacted by the coronavirus in order to enroll in a plan through the COVID-19 SEP, and no documentation will be required to demonstrate a direct impact of COVID-19. All eligible residents in need of health insurance can enroll.

It depends. No documentation specific to COVID-19 is required for eligible residents to enroll in a plan through the COVID-19 Special Enrollment Period. Coverage will take effect on the first day of the month following a plan selection through the COVID-19 SEP.

Coverage effective dates may vary for SEPs specific to a life-changing event, allowing for an earlier effective date. Additionally, some SEPs specific to a life change require verification documentation.

Certain events, such as having a baby and adopting a child are qualifying life events that provide for SEP enrollment back to the date of the event. Additionally, pregnancy is a new NJ-specific qualifying life event that allows for SEP enrollment back to the month of the confirmed pregnancy. If you need retroactive coverage related to these events, you may apply through the SEP specific to your life event. (Note: Pregnancy, adoption and birth do not require verification documentation).

More information may be found on the When Can I Buy Insurance page. If you have questions, trained certified assisters are available at Find Local Assistance.

Loss of Minimum Essential Coverage requires documentation to verify the loss of coverage and allows 60 days from the event to enroll in a plan. Coverage can start the first of the month after you apply and enroll. If you know you are losing coverage within the next 60 days, you can submit an application on GetCovered.NJ.gov before you lose your coverage to ensure you can stay covered throughout the year. For example, if you know you’ll lose coverage on February 28, and you apply and enroll in plan on February 10, your new coverage will start March 1.

If you lose coverage and become uninsured, you can enroll through the COVID-19 Special Enrollment Period without providing documentation. Your coverage will begin on the first day of the month following your plan selection.

To enroll, visit GetCovered.NJ.gov. Select “2021 Special Enrollment COVID-19” when submitting your application.

Trained navigators and brokers can help you enroll by phone, virtually, and may have in-person availability. Information may be found on our website under Find Local Assistance. You may also call our Consumer Assistance Center: 1-833-677-1010.

If you are eligible for NJ FamilyCare, the state’s publicly funded low or no cost health insurance program (Medicaid or Children’s Health Insurance Program), you can enroll any time of year.

Yes. The state established a COVID-19 Special Enrollment Period for enrollment in plans available through Get Covered New Jersey and directly from insurance carriers in the individual market. All available plans may be viewed by using our Shop and Compare tool.

Yes. Health insurance companies are required to waive cost-sharing, including lab fees, co-payments, coinsurance, and deductibles for any visit to test for coronavirus at a doctor’s office, urgent care center, or emergency room, and for a coronavirus vaccine. Additionally, if the primary purpose of an office visit is the delivery of the COVID-19 immunization, then insurance companies may not impose cost-sharing requirements for the office visit.

Yes. All eligible New Jerseyans in need of coverage may qualify for this COVID-19 Special Enrollment Period.

Additional information about Special Enrollment Periods may be found on our When Can I Buy Insurance page.

For more information on the coronavirus, including testing and vaccine locations, visit the New Jersey COVID-19 Information Hub at https://covid19.nj.gov/ For vaccine information, you may also call the state’s COVID-19 Vaccine Call Center at 855-568-0545.

New Jersey Department of Health: https://www.nj.gov/health/

Centers for Disease Control and Prevention: https://www.cdc.gov/

 


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