New Jersey Response to COVID-19

Good news! More financial help is coming soon through Get Covered New Jersey

The American Rescue Plan & Additional Financial Relief

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. 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.

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 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 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 (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.

 

COVID-19 Special Enrollment Period Q&A

Get Covered New Jersey, the state’s official health insurance marketplace, has announced a COVID-19 Special Enrollment Period from February 1, 2021 to May 15, 2021 for all eligible  residents seeking health insurance at this critical time. Visit GetCovered.NJ.gov to shop and compare plans and see if you qualify for financial help.

Note: The state of New Jersey has announced that the enrollment window will remain open through the end of the year.

Was the 2021 health insurance enrollment window extended beyond January 31?

A: Yes. The Open Enrollment Period ran from November 1, 2020 through January 31, 2021. Governor Murphy announced on January 29, 2021 an extension of the enrollment window for  New Jerseyans seeking coverage to May 15, 2021 through a COVID-19 Special Enrollment Period. On March 29, the state announced that the enrollment window will be extended through the end of the year.

Will I need to prove I was directly impacted by COVID-19 (positive coronavirus test or a job loss, for example) to enroll in a plan through Get Covered New Jersey during the COVID-19 Special Enrollment Period?

A: 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.

If I am uninsured but also have a qualifying life event, should I enroll through the COVID-19 Special Enrollment Period or through a Special Enrollment Period that is specific to my circumstance?

A: 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.

The coverage effective dates are as follows:

Enroll by February 28, coverage effective March 1;

Enroll by March 31, coverage effective April 1;

Enroll by April 30, coverage effective May 1;

Enroll by May 15, coverage effective June 1.

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.

If I have a life changing event such as pregnancy, having a baby, or adoption, which SEP should I enroll through?

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.

I have health insurance, but am losing my job-based coverage soon and therefore will qualify for a Special Enrollment Period (loss of Minimum Essential Coverage). Which SEP should I enroll through?

A: 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.

I already have health insurance through Get Covered New Jersey. Can I switch plans through the COVID-19 Special Enrollment Period?

A: Yes. Special Enrollment Periods are available throughout the year for residents who have a major life change, called a qualifying life event (QLE), which allow for enrollment outside of the open enrollment period. Certain QLEs also allow for enrollees to change their existing plan. They include: birth, adoption, marriage, death, dependent aging off coverage, moving, income loss that changes eligibility for Marketplace coverage (for example, newly qualifies you for financial help). Remember to update your application with any income or household changes as it may impact your financial help. Additionally, changes to current coverage unrelated to a specific life event can be made through the COVID-19 Special Enrollment Period.

I enrolled during the Open Enrollment Period, but the health insurance company I selected a plan from made an error. Should I re-enroll through the COVID-19 Special Enrollment Period?

A: Errors made by a health insurance carrier or by the program qualify you for an Exceptional Circumstance Special Enrollment Period. Documentation of the error will be required (see standard form here). Your coverage may be retroactively updated back to the date of the error, if applicable.

How do I enroll?

To enroll, visit GetCovered.NJ.gov. Select “2021 COVID-19 Enrollment Period” 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.

Is the COVID-19 Special Enrollment Period also available for enrollment in plans that are sold directly through a health insurance company?

A: 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.

Is Coronavirus care covered under plans available through Get Covered New Jersey?

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.

Can you qualify for the COVID-19 Special Enrollment Period even if you are not sick?

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.

Coronavirus Resources

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.

Additional Resources

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

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

 


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