Individual Health Coverage
Affordable Insurance Options
GetCoveredNJ is New Jersey’s official health insurance marketplace. It allows residents to shop for, compare, and enroll in health insurance plans that meet Affordable Care Act (ACA) standards. Plans include medical coverage with essential health benefits such as doctor visits, hospital care, preventive services, mental health care, and prescription drugs.
Obamacare
Affordable Care Act (ACA)
Health insurance is available with financial help for many individuals and families. Most U.S. citizens and lawfully present residents who don’t have affordable employer coverage may qualify. You can enroll during the yearly Open Enrollment Period or a Special Enrollment Period if you have a qualifying life event, such as losing coverage, moving, or a change in household size.
Many people can get financial help with Obamacare, including premium tax credits to lower monthly payments and cost-sharing reductions to cut out-of-pocket costs, based on their household income. When you apply, you can choose from private health plans, and the system will also check if you qualify for Medicaid or other state programs
Who Qualifies for Obamacare?
Income determines subsidies, with no upper limit for tax credits but specific levels for Medicaid. Eligibility for financial assistance is based on household income, family size, and state of residence, and many applicants qualify for premium tax credits and cost-sharing reductions that lower monthly premiums and out-of-pocket costs.
- U.S. Citizen
- Naturalized U.S. Citizen
- U.S. National
- Lawfully Present including Lawful Permanent Resident,
- Pending I-551 or Temp. I-551,
- Non-immigrant Visa holders
- Temporary Protected Status (TPS),
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Most people qualify for Obamacare (Affordable Care Act) coverage if:
- They live in the United States
- U.S. citizens or lawfully present immigrants
- Are not incarcerated
- Do not have access to affordable employer-sponsored health insurance that meets minimum coverage standards.
Individuals who are not eligible for Medicare may enroll, including:
- self-employed individuals
- part-time workers
- unemployed individuals
- those whose employer does not offer health insurance.
Are Prescription Drugs Covered?
Yes. All health insurance plans offered through Obamacare (the Affordable Care Act) include prescription drug coverage as part of their essential health benefits. Plans cover a wide range of medications, including generic and brand-name drugs, with costs varying depending on the plan’s formulary, tier structure, and any applicable copayments or coinsurance. Additionally, some plans may offer programs to help lower the cost of certain medications.
Special Enrollment Period
A Special Enrollment Period is a time outside the annual Open Enrollment period when you are allowed to enroll in or change a health insurance plan due to a qualifying life event. Special Enrollment Periods are typically time-limited, so it is important to apply soon after the qualifying event occurs
Here are some common examples of events that qualify you for a Special Enrollment Period.
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Losing job-based insurance, COBRA coverage, or other health plans.
Getting married, divorced, or legally separated.
Birth, adoption, or placement of a child for foster care.
Moving to a new state, county, or ZIP code that affects plan availability.
Significant changes in household income that affect eligibility for subsidies. Gaining or losing eligibility for Medicaid or CHIP.
Certain other situations, such as domestic abuse, natural disasters, or other hardships recognized by the marketplace.
Want A Lower Premium?
GetCoveredNJ determines whether you qualify for low-premium coverage by reviewing the information you provide on your application, including your household income, family size, age, and county of residence. If your income falls within certain limits, you may receive financial assistance that significantly reduces the cost of your health insurance plan.
Set up your account on GetCoveredNJ
Ready to save on health insurance? Create your GetCoveredNJ account and explore affordable coverage options tailored to your needs.
Setting Up Your GetCoveredNJ Account: Quick Checklist
- Have your Social Security number, income, and household information ready.
- Use a valid email address for confirmations and notifications.
- Create a strong, secure password with letters, numbers, and symbols.
- Pick a username you’ll remember for future logins.
- Double-check your information to ensure accuracy for eligibility and subsidies.
- Update your account if your income, household, or address changes.
- Keep your login details safe for easy access later.
Have a Question?
We can help. Our team will work with you to understand your goals, explore your options, and find the solution that fits your needs—without breaking the bank.