New Jersey: Get Covered NJ Open Enrollment kicks off Nov. 1st w/historic levels of financial assistance available

via the NJ Dept. of Banking & Insurance:

Nine in 10 people Who Enroll Will Qualify for Savings; Many Will Pay $10 Per Month or Less; Visit GetCovered.NJ.gov to Compare Available Plans, Review Financial Help Eligibility

TRENTON — Open enrollment for Get Covered New Jersey, the state’s Official Health Insurance Marketplace, kicks off on Friday, November 1, Governor Phil Murphy and New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman announced today. New Jersey residents and families will continue to benefit from historic levels of financial help to purchase health insurance and lower the cost of monthly premiums.

As a result of state and federal investments, nine in 10 people enrolling in health insurance through Get Covered New Jersey will qualify for savings and many can find a plan for $10 a month or less. For the 2025 plan year, consumers will also benefit from action taken by Governor Murphy that limits prescription drug costs by capping copays for certain medications. All Get Covered New Jersey health plans will cap the out-of-pocket cost of insulin at $35 per month as well as cap out-of-pocket costs for EpiPens and asthma inhalers at $25 and $50 respectively for a month’s supply.

“Access to health care has been a priority of our Administration since day one. We are proud to build on the continued success of Get Covered New Jersey,” said Governor Murphy. “Individuals and families can find quality, affordable health insurance through our state marketplace, and the overwhelming majority will be eligible for financial assistance to lower their monthly costs. With record levels of financial help remaining available for residents, we encourage anyone who needs health insurance to check out the variety of plan options available during this annual Open Enrollment Period.”

For the 2024 plan year, nearly 400,000 residents signed up for Get Covered New Jersey – a 16 percent increase over the previous year’s Open Enrollment Period and a 61 percent increase since the Murphy Administration took over operations of the marketplace in 2020 for plan year 2021. The state expanded the Open Enrollment Period in 2020 to three months – from the previous six-week window – and began offering state subsidies, and invested more in outreach and trained experts, Get Covered New Jersey Navigators, who provide free, unbiased enrollment assistance to residents in the community. 

“Get Covered New Jersey has provided quality, affordable health insurance to hundreds of thousands of residents,” said Commissioner Zimmerman. “With state and federal assistance, cost-savings options are available to nearly everyone. Nine in 10 residents enrolling qualify for financial help and many can find a plan for $10 a month or less. Open enrollment is a once-a-year opportunity to enroll in coverage, and free local assistance is available to help you sign up.”

The Open Enrollment Period for 2025 coverage at Get Covered New Jersey runs from November 1, 2024, to January 31, 2025. Consumers must enroll by December 31, 2024, for coverage starting January 1, 2025; if they enroll by January 31, 2025, coverage will start February 1, 2025.

Health plans offered through GetCovered.NJ.gov cover preventive services, emergency services, prescription drugs, prenatal and pediatric care, and more. No one can be denied coverage due to a pre-existing condition.

As of November 1, Deferred Action for Childhood Arrivals (DACA) recipients now qualify to enroll in coverage through Get Covered New Jersey under a new policy issued by the U.S. Department of Health and Human Services.

Financial Help for Additional Savings

As a result of the federal savings available through 2025, no one pays more than 8.5 percent of their income for health insurance (for a benchmark plan) through Get Covered New Jersey. In addition, New Jersey provides state subsidies, called New Jersey Health Plan Savings, which are available to eligible consumers with an annual household income of up to 600 percent of the federal poverty level ($90,360 for an individual and $187,200 for a family of four).

Nine out of 10 residents enrolling in Get Covered New Jersey receive financial assistance. The average amount of financial help for 2024 coverage was $566 per person per month or $6,792 a year. Six insurance companies are offering plans through the marketplace: Aetna, Ambetter from WellCare of New Jersey, AmeriHealth, Horizon Blue Cross Blue Shield of New Jersey, Oscar, and UnitedHealthcare. The number of carriers offering plans on Get Covered New Jersey has doubled over the last four years.

Based on plan rates for 2025 submitted by carriers, rates will increase on average by 6.2 percent over 2024 in the individual market, which includes on marketplace and off marketplace plans (sold directly by insurance companies). However, because of the state and federal savings available to most consumers enrolling in a plan through Get Covered New Jersey, consumers who receive financial help, on average, will not see an increase in their monthly premium. Average rate increases by carrier are available on the department’s website. 

Residents at certain income levels (up to $30,120 for an individual or $62,400 for a family of four for 2025) are eligible for nearly free coverage year-round through the Expanded Access Special Enrollment Period.

Using the Get Covered New Jersey Shop and Compare tool, residents can compare plans and easily find out if they are eligible for financial assistance. All consumers need is their zip code, birth date and income. 

Open enrollment is the only time of year residents can enroll in a plan, unless they have a major life event, such as marriage, pregnancy, or a move, or meet certain income requirements that qualify them for a Special Enrollment Period. 

Help with Enrolling

Get Covered New Jersey consumers are encouraged to use the free assistance available in local communities throughout the state by visiting the “We Can Help” section at GetCovered.NJ.gov or calling the Customer Call Center at 1-833-677-1010 TTY 711.

The department awarded $5 million in grant funding to 27 community organizations to serve as Navigators, providing assistance in connecting uninsured New Jersey residents to health coverage through Get Covered New Jersey. Each organization is able to assist residents in-person and remotely, and perform year-round outreach and education for 2025 coverage, including before and during the Open Enrollment Period. Navigator grantees will provide local assistance in various languages at locations across the state. 

In addition, DOBI and Navigator partners will be doing outreach throughout the following New Jersey malls to increase awareness of the program and assist people in enrolling November through January: 

• Willowbrook Mall, Wayne: November 8, 14; December 8, 28, 29; and January 19, 26 and 31.
• Newport Centre, Jersey City: November 10; December 12; and January 16, 30.
• Paramus Park, Paramus: November 22; December 28; January 17, 29.
• Menlo Park Mall, Edison: November 7; December 11, 31; and January 26.
• Freehold Raceway Mall, Freehold: November 17; December 15, 29; and January 18, 23.
• Quaker Bridge Mall, Lawrenceville: November 9; December 13, 30; and January 24.
• Deptford Mall, Deptford Township: November 21; December 14, 31; and January 19, 25.
• Cumberland Mall, Vineland: November 15, 23; December 27; and January 30.
• Hamilton Mall, Mays Landing: November 16; December 7; and January 22, 31.

In New Jersey, a requirement to have health coverage remains. Residents who do not qualify for an exemption from the Shared Responsibility Payment will pay a penalty at tax time.