Health Insurance Companies New Jersey Options and Coverage

New Jersey residents have several health insurance companies to choose from, each offering a range of coverage options.

Aetna is one of the most popular health insurance companies in New Jersey, offering individual and family plans, as well as group plans for small and large businesses.

New Jersey's health insurance market is regulated by the Affordable Care Act, which requires health insurance companies to cover essential health benefits.

UnitedHealthcare offers a range of health insurance plans in New Jersey, including catastrophic plans for young adults and bronze plans for individuals and families.

Horizon Blue Cross Blue Shield of New Jersey is another well-established health insurance company in the state, offering a variety of plans for individuals, families, and small businesses.

Cigna is also a major health insurance company in New Jersey, offering individual and family plans, as well as group plans for employers.

You can find affordable health insurance in New Jersey through GetCoveredNJ, which offers federal income-based subsidies that can reduce your premium costs. Eighty-eight percent of people who enrolled via GetCoveredNJ in 2024 were eligible for these subsidies, which paid an average of $521/month.

New Jersey also offers additional state-funded subsidies, known as the New Jersey Health Plan Savings subsidies, which are available to enrollees with household incomes up to $87,480 for a single individual or $180,000 for a family of four. These subsidies can be combined with federally-provided subsidies, further reducing your premium costs.

More than half of GetCoveredNJ enrollees in 2024 were receiving federal cost-sharing reductions (CSR), which reduce out-of-pocket expenses for Silver-level plans. If you're eligible for both premium subsidies and CSR, you can use them together if you select a Silver-level plan through GetCoveredNJ.

Managed Long Term Services and Supports (MLTSS) is a program that helps seniors and people with disabilities live at home for as long as they can. It provides and coordinates primary, acute, behavioral, and long-term care.

You can receive these services in your home or an assisted living center, eliminating the need to live in a nursing home or other facility. This means you can maintain your independence and stay in a familiar environment.

To qualify for MLTSS, you must meet certain state and plan criteria.

If you're looking for affordable health insurance in New Jersey, you're in luck. Eighty-eight percent of people who enrolled in GetCoveredNJ during the open enrollment period for 2024 coverage were eligible for advance premium tax credits, which paid an average of $521/month.

These subsidies significantly reduced the average subsidized enrollee's premium to about $156/month. The state-funded NJ Health Plan Savings subsidies are also available to enrollees with household incomes up to 600% of the federal poverty level.

For 2024 coverage, that's $87,480 for a single individual, and $180,000 for a family of four. Applicants with household income up to 250% of the federal poverty level are also eligible for federal cost-sharing reductions (CSR), which reduce the deductible and other out-of-pocket expenses for Silver-level plans.

More than half of GetCoveredNJ enrollees were receiving CSR benefits as of 2024. If you're eligible for premium subsidies, including APTC and NJ Health Plan Savings subsidies, as well as CSR, you can use them all if you select a Silver-level plan through GetCoveredNJ.

New Jersey also has a reinsurance program that helps keep unsubsidized premiums lower than they would otherwise be. Depending on your income and circumstances, you may be able to enroll in free or low-cost health coverage through New Jersey Family Care.

Insurance coverage in New Jersey is robust, with a record high of 397,942 people signing up for private plans through GetCoveredNJ during the 2024 open enrollment period.

This growth is partly due to enhanced premium subsidies under the American Rescue Plan and Inflation Reduction Act, as well as New Jersey's additional state subsidy program. Over 48,000 residents transitioned from Medicaid to a Marketplace plan by April 2024.

The number of people covered by type of health insurance in New Jersey is notable, with increases in individual and Medicaid coverage, and a decline in group coverage. Specifically, there were increases of 251,700 and 229,800 people respectively in individual and Medicaid coverage.

Here are the key statistics on the number of people covered by type of health insurance in New Jersey:

To be eligible for Marketplace health insurance in New Jersey, you must live in the state and be lawfully present in the United States, among other requirements.

Dental coverage is a smart addition to your health coverage, especially if you're hoping to improve your smile. Our guide explores dental coverage options in New Jersey.

Dental insurance can be a cost-effective way to prevent and treat dental problems. Many people in New Jersey choose to add dental coverage to their health insurance plans.

If you're considering dental insurance, know that it may cover routine cleanings, fillings, and other basic procedures. This can help prevent costly dental problems down the line.

In New Jersey, dental coverage options are available through various insurance providers. You can choose from a range of plans that suit your budget and needs.

Some dental insurance plans in New Jersey may also cover more complex procedures like crowns, bridges, and dentures. This can be a huge relief if you're facing a major dental issue.

Dental coverage can be purchased separately or added to an existing health insurance plan. It's essential to research and compare different options to find the best fit for you.

Medicare coverage and enrollment in New Jersey can be a bit complex, but it's essential to understand the options available to you.

Medicare coverage is available in New Jersey, and you can learn more about it through a guide that explains the different types of coverage, including Medicare Advantage and Medigap.

In New Jersey, the state's Medicare supplement regulations are in place to ensure you have access to the coverage you need.

As of the latest data, there are 379,896 enrollees in Medicare Advantage plans in New Jersey.

Medicare Advantage plans are offered by private companies that contract with Medicare, and they include various types of plans, such as HMOs, PPOs, and Special Needs Plans.

The cost of Medicare and Medicare Advantage coverage includes participation from employers, individuals, federal, state, and local government, but excludes any form of co-pay or deductible.

To qualify for extra care through Managed Long Term Services and Supports (MLTSS), you must meet certain state and plan criteria.

MLTSS helps seniors and people with disabilities live at home for as long as they can, providing and coordinating primary, acute, behavioral, and long-term care.

In New Jersey, the frequency of doctor visits among residents with all types of insurance is above the national average, with people with group and individual insurance visiting their doctors approximately double the national average.

In New Jersey, you can enroll in a Marketplace plan through GetCoveredNJ, which is the state's health insurance exchange. To enroll, you can visit GetCoveredNJ's website or call their call center at 1-833-677-1010.

The enrollment process is relatively straightforward, and you can even get help from licensed agents, navigators, or certified application counselors.

To be eligible to enroll in a Marketplace plan, you must live in New Jersey and be lawfully present in the United States, and you cannot be incarcerated or enrolled in Medicare.

To qualify for financial assistance, such as federal and state subsidies, you must meet certain parameters, including not being eligible for an affordable employer plan and not being eligible for Medicaid or premium-free Medicare Part A.

Here's a breakdown of the types of health insurance coverage available in New Jersey:

Individual coverage is a type of insurance that's often referred to as Obamacare or the Affordable Care Act (ACA), and it's designed for people who don't qualify for other types of insurance. This type of coverage includes Bronze, Silver, and Gold Plans, and the premiums earned are based on the premiums paid by the individual.

The open enrollment period for Marketplace plans in New Jersey begins on November 1 and continues through January 31, which is a couple of weeks longer than in most other states.

New Jersey residents insured with group coverage use non-doctor health care visits nearly three times as much as the national average.

People with individual insurance use this type of care roughly 35% more than the national average.

Patients covered by Medicaid managed care have non-physician visits roughly equivalent to the national average.

Non-physician care tends to be an expensive form of treatment, often costing more than a doctor visit.

Many non-physician visits are to outpatient facilities owned and operated by hospitals, which can be more expensive than a doctor visit.

In New Jersey, you can enroll in a Marketplace plan through GetCoveredNJ, the state's health insurance exchange, at any time of the year if you experience a qualifying life event, such as giving birth or losing other health coverage.

To enroll in an ACA Marketplace/exchange plan in New Jersey, you can visit GetCoveredNJ's website to compare available health plans and determine whether you're eligible for financial assistance. You can also enroll in a GetCoveredNJ plan with the help of licensed agents, navigators, or certified application counselors.

The open enrollment period in New Jersey begins November 1 and continues through January 31. During this time, you can enroll in a health plan through GetCoveredNJ, and if you enroll by December 31, your new coverage will take effect on January 1. If you enroll in January, your new coverage will take effect on February 1.

Here's a quick rundown of the eligibility requirements for Marketplace health insurance in New Jersey:

Additionally, to qualify for income-based Advance Premium Tax Credits (APTC), federal cost-sharing reductions (CSR), or New Jersey’s Health Plan Savings subsidies, you must meet certain parameters, including not being eligible for an affordable plan offered by an employer and not being eligible for New Jersey Family Care (Medicaid or CHIP).

You can enroll in an ACA-compliant plan in New Jersey through Get Covered NJ, the state's health insurance exchange.

To enroll, you can visit GetCoveredNJ's website to compare available health plans and determine if you're eligible for financial assistance, including federal and state subsidies.

To be eligible to enroll in a private health plan through Get Covered NJ, you must live in New Jersey and be lawfully present in the United States, not be incarcerated, and not be enrolled in Medicare.

To qualify for income-based Advance Premium Tax Credits (APTC), federal cost-sharing reductions (CSR), or New Jersey's Health Plan Savings subsidies, you must not be eligible to enroll in an affordable plan offered by an employer, not be eligible for New Jersey Family Care (Medicaid or CHIP), or premium-free Medicare Part A, and file a joint tax return if married, with very limited exceptions.

The individual health plan is for people who do not qualify for other types of insurance, such as those who are self-employed or unemployed and not eligible for employer-provided insurance.

Individual coverage includes all types of plans, referred to as Bronze, Silver, and Gold Plans.

Here's a summary of the plan types:

If you're unsure if you qualify for a plan or need help choosing one, you can use the screening tool at NJ FamilyCare to get started.

Employer-Sponsored Coverage is a type of health insurance provided by companies to their employees as a benefit. This type of coverage is also known as group insurance.

The cost of group coverage is based on total premiums paid to the insurance company, which includes payments from both employers and employees. Premiums do not include payments for services such as deductibles, co-pays or other out-of-pocket costs.

Group coverage includes several types of health plans, such as Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Point-of-Service (POS) Plans, and High-Deductible Health Plans.