Learn everything about health insurance in New Jersey in this post. Access to healthcare is a priority supported by state policies and a top-tier platform like Get Covered NJ. Unlike many other states, the Garden State has a mandatory individual mandate: those who do not have health insurance could face penalties when filing their state taxes.
This measure encourages residents to maintain some form of coverage. It also promotes participation in programs like Get Covered New Jersey and New Jersey Health Plan Savings, which facilitate access to affordable health plans through federal and state subsidies.
Therefore, in this article we will explain the general outlook of the state in relation to the rest of the country and the new opportunities available in 2025. Read until the end and you will find all the answers.
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New Jersey: State Overview
New Jersey is a state with a population of 9.25 million people (2022) and a median age of 40 years, according to data from the last census in 2022. The median household income is $97,126, with an annual growth of 8.28%, reflecting an expanding economy. Contradictorily, the state has a poverty rate of 9.68%. And although this figure decreased compared to the previous year, the data directly impacts the health coverage of a significant percentage of its residents.
In terms of diversity, New Jersey is home to a multicultural population: 53% of residents are non-Hispanic whites, followed by 12.4% African Americans, 9.79% Asians, and 21.2% Hispanics, making the region a multicultural space.
Likewise, NJ offers a rich combination of culture, history, and natural landscapes. Highlights include the Newark Museum of Art and the Count Basie Center for the Arts, the beaches and boardwalks of Atlantic City, Cape May, and Asbury Park, as well as state parks such as Liberty State Park and High Point State Park.
This unique combination of natural beauty, strategic location, and quality of life has made the state much more than just a tourist destination: New Jersey is the place chosen by many people to settle down, work, and build their future.
Is healthcare in New Jersey accessible to its residents?
Within Get Covered NJ, 92.5% of the population has some form of medical coverage. Of this percentage, 54.1% are insured through employer-sponsored plans, 14.9% receive Medicaid coverage, 12.5% are on Medicare, 10.4% use individual non-group plans, and 0.58% are covered by military or VA plans.
However, of the 7.5% uninsured, 5.9% corresponds to individuals under 65 years of age, while 6.9% of this same population lives with some disability, according to the 2022 Census Bureau.
This outlook also significantly impacts vulnerable immigrant populations, due to legal status, lack of access to affordable plans, and language difficulties.
That is why at Dulcinea Insurance, we insist on the importance of understanding how GetCoveredNJ works and the possibilities of the New Jersey Health Plan Savings program.
GetCoveredNJ: The State Health Insurance Marketplace Record
Since the fall of 2020, New Jersey has been operating its own state health insurance marketplace, known as Get Covered NJ. Prior to that, state residents relied on the federal platform HealthCare.gov to purchase their health insurance plans.
With GetCoveredNJ, residents in the state began to have the opportunity to explore and purchase individual or family health insurance plans offered by various private insurers, especially those who did not qualify for Medicare, Medicaid, or an employer-sponsored plan.
During open enrollment for 2024 coverage, 397,942 people in New Jersey selected private plans through Get Covered New Jersey, marking a new state record for the third consecutive year.
The increase in enrollment is due to the expansion of subsidies under the American Rescue Plan and the Inflation Reduction Act, New Jersey state subsidies, and the end of the Medicaid continuous coverage rule. Following Medicaid cancellations in 2023, more than 48,000 residents migrated to Marketplace plans by April 2024.
Federal + State Support for Health Coverage: ACA and New Jersey Health Plan Savings
Under the Affordable Care Act (ACA) or Obamacare in Spanish, the federal government offers subsidies to reduce the cost of health insurance, such as Advanced Premium Tax Credits (APTC) and Cost-Sharing Reductions (CSR). All of this makes it possible for many people to qualify for free health insurance in New Jersey or at a very low cost, as we are going to demonstrate below.
These subsidies have been fundamental in allowing more people to access affordable health insurance coverage in New Jersey. For example, during 2022, the state enrolled a record 324,000 people in the state's individual health insurance market under the ACA, Governor Phil Murphy told Telemundo.
Added to this is the state program New Jersey Health Plan Savings (NJHPS), which complements federal subsidies by offering additional help for individuals with incomes up to $77,280 and families of four with incomes up to $159,000. This program further extends access to health insurance to those earning up to 600% of the federal poverty level.
New Jersey also has a state reinsurance program, which helps keep non-subsidized insurance premiums lower than they would be without this measure.
On the other hand, low-income residents can obtain free or low-cost coverage through New Jersey FamilyCare, which includes Medicaid and CHIP. Thanks to these tools and programs, 80% of enrollees manage to save significantly, facilitating access to essential health services at an affordable price.
All of these financial supports allow both families and individuals in New Jersey to find comprehensive and affordable health coverage options, reducing out-of-pocket expenses and ensuring equitable access to quality health services.
Which insurers will operate on Get Covered NJ in 2025?
For the year 2025, the NJ health insurance market will feature plans from the same six insurers that offered coverage in 2024: AmeriHealth, Horizon BCBS, Oscar Health, WellCare/Ambetter, Aetna, and UnitedHealthcare.
The recent behavior of these health insurance plans in NJ reflects both the leadership and strategic growth of the sector, adapting to consumer demands and strengthening competition in the marketplace:
- Horizon BCBS and AmeriHealth have established themselves as leaders in the state market, standing out for their extensive provider networks and a focus on quality of service.
- Oscar Health and WellCare/Ambetter have increased their market share by offering affordable options centered on specific needs, such as digital care and budget-friendly plans.
- Aetna and UnitedHealthcare have shown a strategic expansion, focusing on more robust plans and comprehensive coverage for consumers with higher demands for medical services.
The availability of NJ health insurance plans from each insurer may vary by region of the state, which is why it is essential to review each option in detail to ensure it fits coverage needs and the local provider network.
What are the insurance prices at Get Covered New Jersey?
New Jersey ranks 31st in the ranking of average health insurance costs in the United States, according to Average Health Insurance Costs by State. The average monthly price of insurance in the state is $441, which places it below the national average of $456.
Bronze plans, which cover fewer medical expenses, have an average cost of $451 per month, while Silver and Gold plans, which offer greater coverage, range between $630 and $900 per month.
For its part, family health insurance has a higher cost, around $1,483 per month. These prices reflect the full cost of the plans, before applying the subsidies available under the Affordable Care Act (ACA) and programs like the New Jersey Health Plan Savings.
According to data from Get Covered NJ, premiums in the New Jersey market will rise by an average of 6.2% for 2025, before applying subsidies. Adjustments vary among insurers, with UnitedHealthcare highlighting a 16.16% increase, and AmeriHealth with the lowest, at 3.96%.
For most enrollees, federal and state subsidies will keep premiums affordable. Since the implementation of reinsurance in 2019, increases have moderated, avoiding spikes like the 22% recorded in 2018.
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NJ Health Insurance: Starting at $10 month with federal and state subsidies
Within NJ health insurance, federal and state subsidies allow residents to access health insurance at much lower prices; it is even a trend to search for how to apply for free health insurance in New Jersey. During 2024 enrollment, 88% of enrollees through GetCoveredNJ qualified for advanced premium tax credits (APTC), with an average savings of $521 per month, reducing their monthly premiums to just $156.
Additionally, according to healthinsurance.org, 16% of enrollees managed to pay less than $10 a month thanks to the combination of federal subsidies and the state program New Jersey Health Plan Savings. In other words, it is not just that you should worry about how to apply for free health insurance in New Jersey, but that you can pay very little per month for a health plan if you cannot access free coverage.
Medical Insurance Updates in New Jersey for 2025: The Louisa Carman Medical Debt Relief Act
The state's health market (Get Covered NJ) will bring key changes in 2025 that seek to protect consumers and improve healthcare. According to WHYY News, starting in July, new provisions of the Louisa Carman Medical Debt Relief Act will come into effect, designed to prevent medical debts from affecting patients' credit scores.
Furthermore, interest on these debts will be limited to 3% and wage garnishment will be prohibited for individuals with incomes up to 600% of the federal poverty level (approximately $90,360 per year for an individual or $187,200 for a family of four).
Another important measure focuses on maternal health within Get Covered New Jersey. Starting in the spring of 2025, healthcare providers in New Jersey are required to create a personalized postpartum care plan for pregnant individuals and new mothers. Likewise, assistance will be offered to patients who have experienced pregnancy loss or stillbirth, ensuring comprehensive support during critical moments.
These measures seek to alleviate the financial burden associated with medical care and ensure more equitable access to essential services, especially benefiting the most vulnerable groups in New Jersey.
How to Apply for Free Health Insurance in New Jersey
In a context where economic adjustments and rising health insurance costs in NJ are a reality, finding a plan that fits your needs and budget is more important than ever. However, 2025 also brings positive news, such as the continuity of state and federal programs that facilitate access to more affordable health plans.
That is why at Dulcinea Insurance we are here to help you navigate this landscape and we show you how to apply for free health insurance in New Jersey. We want to ensure that you take full advantage of the new opportunities offered by the New Jersey market: our agents will guide you to identify available subsidies, compare plan options, and find health coverage that protects both your health and your finances.
Don't let market changes or economic challenges prevent you from protecting your health and that of your family. Contact us today and discover how we can help you secure your well-being with the best health insurance in New Jersey.
