New Jersey Health Insurance Guide

From the sandy shores of the Jersey Shore to bustling cities and historic landscapes, New Jersey remains a desirable place to live — and understanding your health insurance options here is key to protecting your health and finances.

As of 2025, the uninsured rate in New Jersey reflects strong progress, with consistent enrollment improvements driven by Medicaid expansion and state-based mandates. If you’re currently without coverage, here’s what you need to know about getting insured in New Jersey.

Health Insurance Options in New Jersey

New Jersey offers a range of health insurance options tailored to råesidents’ needs, depending on age, income, employment, and family size. Here are the most common coverage types available:

Employer-Sponsored Insurance

Many New Jersey residents receive health insurance through their employer. If your workplace offers coverage, this is usually the most cost-effective and convenient option.

ACA Marketplace Plans

The Affordable Care Act (ACA) allows individuals and families to buy health insurance through federal or state Marketplaces. These plans offer essential health benefits, free preventive care, and protection for preexisting conditions.

If you don’t have employer coverage, you may qualify for subsidies to lower your premiums. Use our ACA Subsidy Calculator to check your eligibility.

Starting this year, the Centers for Medicare & Medicaid Services (CMS) is requiring income verification to confirm eligibility for premium subsidies.

ACA Plan Types

ACA marketplace plans are available in four tiers: Bronze, Silver, Gold, and Platinum. Each tier provides different levels of coverage and cost-sharing:

• Bronze: Low monthly premiums, higher out-of-pocket costs; ideal for minimal healthcare usage.
• Silver: Moderate costs; eligible for cost-sharing reductions (CSRs).
• Gold: Higher monthly premiums with lower out-of-pocket costs; best for frequent healthcare users.
• Platinum: Highest premiums, lowest out-of-pocket costs.

Metal Tier Breakdown:

Medicaid

New Jersey’s Medicaid program, part of NJ FamilyCare, provides free or low-cost coverage to eligible low-income residents. Medicaid plan benefits include preventive services, hospital visits, mental health support, prescriptions, and more.

Residents may qualify based on income, age, disability status, or other factors. NJ FamilyCare also administers the state’s Medicaid expansion program and CHIP coverage.

Short-Term Plans

Short-term medical (STM) plans are not available in New Jersey. The state prohibits the sale of Short-term medical (STM) plans due to concerns that they do not meet the minimum essential coverage standards required by New Jersey’s Individual Health Coverage (IHC) Program.
Instead, residents are encouraged to obtain comprehensive coverage through the ACA Marketplace or NJ FamilyCare.

Children’s Health Insurance Program (CHIP)

New Jersey’s CHIP program is part of NJ FamilyCare. It provides low-cost or no-cost health insurance to children and pregnant women in families who earn too much for Medicaid but need affordable care. Learn more through the NJ FamilyCare website.

Student Health Insurance

College students in any state have multiple health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic or short-term plans, making New Jersey student health insurance accessible and flexible for a wide range of needs.

Medicare

Medicare provides health coverage for people aged 65+ and younger individuals with qualifying disabilities. New Jersey residents can explore these options:

• Medicare Advantage Plans (Part C): Private plans that combine Parts A and B and may offer additional benefits such as vision or dental coverage.
• Medicare Part D: Standalone plans for prescription drug coverage, which can be paired with Original Medicare.
• Medicare Supplement plans (Medigap): Help cover deductibles, coinsurance, and other out-of-pocket costs not paid by Original Medicare.

New Jersey also offers broader access to Medigap plans for beneficiaries under age 65 with disabilities.

COBRA Coverage

If you’ve recently lost job-based insurance, COBRA allows you to continue your employer-sponsored health plan for a limited time. This can be a helpful option while transitioning to new coverage.

Enrollment Periods in New Jersey

• Open Enrollment for 2026 Coverage: November 1, 2025 – January 31, 2026
  During this time, all eligible residents can apply for, renew, or change their health insurance plans.
• Special Enrollment Period: Available year-round for residents who experience qualifying life events, including:
  • Loss of coverage
  • Marriage or divorce
  • Birth or adoption of a child
  • Relocation
  • Major change in income

You typically have 60 days from the event to enroll in a new plan.

Health Insurance Providers in New Jersey

As of 2025, these insurers typically offer individual and family plans through New Jersey’s state-based Marketplace, Get Covered NJ:

• AmeriHealth
• Horizon Healthcare of NJ
• Oscar Garden State Insurance Corporation
• Oxford Health Insurance (off-exchange)

Plan availability may vary by county. Some carriers may also offer off-Marketplace plans directly to consumers.

Understanding Health Insurance Costs

When selecting a plan, be sure to understand these key cost terms:

• Premium: Your monthly payment to keep your health insurance active.
• Deductible: The amount you pay before your insurance starts covering care.
• Copayment (Copay): A fixed cost for services like doctor visits or prescriptions.
• Coinsurance: Your share of the cost after the deductible is met.
• Out-of-Pocket Maximum: The most you’ll pay in a year for covered care.
• In-Network vs. Out-of-Network: Using in-network providers can save you money.

Use this helpful glossary to understand these and other key insurance terms.

Bottom Line

Health insurance in New Jersey comes with many choices—whether through an employer, the ACA Marketplace, or public programs like NJ FamilyCare and Medicare. By staying informed and comparing your options during the right enrollment windows, you can secure quality coverage that meets your needs.

Need help finding the right plan? Use our ACA Subsidy Calculator to determine if you qualify for financial aid, or speak with a licensed agent for personalized assistance.