RESIDENTS ENCOURAGED TO ENROLL IN GET COVERED NEW JERSEY AHEAD OF JANUARY 31 DEADLINE FOR HEALTH COVERAGE

The following information was released by the New Jersey Department of Banking and Insurance:

As the January 31 final deadline for Open Enrollment approaches, New Jersey residents still in need of health insurance are encouraged to explore plan options for 2026 through Get Covered New Jersey, the State's Official Health Insurance Marketplace, New Jersey Department of Banking and Insurance Acting Commissioner Susan Ochs said today, reminding residents that financial help and community-based enrollment assistance remains available.

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 that qualifies them for a Special Enrollment Period.

"Time is running out to enroll in a health plan for 2026 through Get Covered New Jersey," said Acting Commissioner Ochs. "While federally mandated changes to the marketplace drive increased coverage costs for New Jerseyans, we want residents to know that free help is available across the state to help them find the best plans for themselves and their families. We encourage eligible residents in need of health care to explore their options and the financial help available to get covered before the end of open enrollment."

As of January 2, 2026, a total of 493,727 residents are signed up for 2026 health coverage with Get Covered New Jersey, including 50,108 new consumers and 203,836 consumers who actively selected a plan. During the 2025 plan year, a total of 481,151 residents were signed up for 2025 health coverage with Get Covered New Jersey, including 70,507 new consumers as of January 2, 2025. The number of new consumers enrolling in coverage has decreased by nearly 30% in plan year 2026.

State and federal financial help remains available, as well as community-based assistance to answer questions and guide residents in enrolling in a quality, affordable health insurance plan. Eight in 10 people enrolling in a health plan at Get Covered New Jersey qualify for financial help.

New Jersey continues to offer state subsidies (NJ Health Plan Savings) to qualifying residents with household incomes up to 600% of the Federal Poverty Level. In 2026, an individual with an income of up to $93,900 and a family of four who makes up to $192,900 can receive state subsidies to lower the costs of health coverage. From plan year 2021 to plan year 2026, New Jersey has invested over $1 billion in state support for Get Covered New Jersey consumers.

With the reduction in federal financial support as a result of Congressional inaction on continuing enhanced premium tax credits, more New Jerseyans are continuing to "buy down" from silver plans to bronze plans that have higher out-of-pocket costs.

The Marketplace plans offered through Get Covered New Jersey are categorized into three types (or "metal levels"): Bronze, Silver, and Gold. There has been an increase in consumers actively selecting the lowest metal level plans, from 16% of active shoppers selecting Bronze plans for plan year 2025 to 30% of active shoppers selecting Bronze plans for plan year 2026 as of January 2. Active silver plan selections have fallen to 69% from 83% in plan year 2025. Nearly half (48%) of enrollees receiving financial help in Open Enrollment 2025 paid $10 a month or less for coverage, which has fallen to 10% for plan year 2026 as of January 2.

Five insurance companies are offering 2026 plans through the marketplace: Ambetter from WellCare of New Jersey, AmeriHealth, Horizon Blue Cross Blue Shield of New Jersey, Oscar, and UnitedHealthcare.

For the upcoming plan year, consumers will again benefit from legislation 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.

The Department continues to partner with Navigators community-based organizations that provide free enrollment assistance in a robust outreach effort in pop-up events in malls and supermarkets throughout New Jersey. The Department is investing $5 million in 30 Navigators, up from $400,000 in federal funding provided for just one Navigator under the federal government in 2019. Certified brokers are also available to assist consumers.

Remaining January pop-up events include:

Deptford Mall, Deptford Township: January 30

Menlo Park Mall, Edison: January 31

Ocean County Mall, Toms River: January 29

Quaker Bridge Mall, Lawrence Township: January 29

Willowbrook Mall, Wayne: January 31

ShopRite, West Orange: January 30

ShopRite, Absecon: January 30

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

The Department also reminds consumers to avoid short-term limited duration plans, which are prohibited in New Jersey and do not cover the basic services consumers would expect from insurance and that are required in the state. All 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.

ABOUT GET COVERED NEW JERSEY

Get Covered New Jersey is the state's Official Health Insurance Marketplace, operated by the New Jersey Department of Banking and Insurance, where New Jerseyans can find quality, affordable insurance from private health insurance companies. Get Covered New Jersey is the only place where individuals who qualify can get financial help to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that best fits their health needs and budget. Depending on their income, some consumers may qualify for low-cost or free coverage from NJ FamilyCare. Get Covered New Jersey was established by state law and created by New Jersey, for New Jersey.