NJ Exchange “Healthplan Comparison Tool” Available 10.16.20

If you’re in the market for NJ individual health insurance, you’re in luck!

Starting with the 2021 Open Enrollment Period, which begins 11/1/2020, New Jersey residents will no longer use the Healthcare.gov website to enroll in NJ individual health insurance plans.

A new state-based platform (GetCovered.nj.gov) will be used to enroll in NJ individual health insurance starting 11/1/2020, and the GetCovered "2021 Plan Comparison Tool" is available to be used now.

The GetCovered platform offers several significant advantages over Healthcare.gov:

1. Better outreach to NJ residents;
2. Statewide access to the NJ individual health insurance market;
3. Flexibility to meet the specific needs of NJ residents; and
4. More financial help.

GetCovered offers financial help to many New Jerseyans to lower health insurance costs. Applicants may qualify for three types of financial help: premium tax credits, cost-sharing reductions and a new financial assistance program offered by the state of New Jersey. Premium tax credits help lower monthly health insurance premium payments. Cost-sharing reductions help lower out-of-pocket costs, such as deductibles and co-pays. A new state savings program – called “New Jersey Health Plan Savings”- will provide additional help to most people purchasing coverage through GetCovered.

What is the NJ state-based exchange?

The concept of an Exchange for individual health insurance was enabled by the Patient-Protection and Affordable Care Act (PPACA) that the US Congress enacted 3/23/2010. Effective 1/1/2014, each US state was given the option to have its residents utilize the Federal Exchange (Healthcare.gov) or to provide their own state-based exchange.

Initially, NJ chose to use the Federal Exchange, but on 6/29/2019, NJ decided that it would build its own Exchange, for individual health insurance policies effective 1/1/2021.

GetCovered is New Jersey’s official health insurance exchange, where individuals and families can easily shop for and buy coverage. It’s the only place where NJ residents can apply for financial help to lower the cost of monthly insurance premiums and out-of-pocket costs. Additionally, through GetCovered, applicants can learn if they might qualify for free or low-cost health insurance through NJ FamilyCare, New Jersey’s publicly funded health insurance program.

The GetCovered platform is made up of four parts:

1. NJ Residents;
2. Assisters;
3. GetCovered Website; and
4. NJ Health Insurance Companies.

Through GetCovered health insurance policies, residents obtain access to a network of providers from whom they can obtain the medical care they need. The insurance provides financial protection from the burden of large health care claims, and the insurance satisfies the government requirements that all residents are covered by qualified health insurance.

Summary

Open Enrollment using GetCovered is from 11/1/2020 to 12/31/2020 for 1/1/2021 effective date.

Open Enrollment also supports 2/1/2021 effective date for applications received no later than 1/31/21.

NJ residents can get assistance in shopping through the exchange for their health insurance, including from licensed insurance agents (e.g. ultimatebenefitsllc@att.net ) or assisters who can provide recommendations:

1. Initially on what plans might be most suitable for a resident to choose;
2. On an on-ongoing basis, for how a resident can best use the plan throughout the year; and
3. How to prepare for the next exchange Open Enrollment.