Are You Uninsured?

The State of New Jersey and the federal government are now providing new and expanded financial help to eligible consumers who purchase plans through Get Covered New Jersey.

The federal government recently passed a COVID-19 relief bill, the American Rescue Plan Act of 2021, which was signed into law by President Biden on March 11, 2021. The new law will reduce health insurance premiums by providing more financial help to eligible consumers who purchase a plan through Get Covered New Jersey. The State of New Jersey is also providing more financial help to lower health insurance costs for residents enrolling at Get Covered New Jersey.

New Federal and State Savings

Here are more details on what you can expect:


  • Increases in financial help for all eligible consumers. The amount of financial help is based on household income just like before, but has increased at every income level due to more financial help provided by both the state and federal government.
  • New Benefits from American Rescue Plan Act. Premium tax credits help lower your monthly premium payments. Eligibility for the premium tax credit is based on several things including income and household size.

Under the new American Rescue Plan Act changes, more people now qualify for more financial help. Previously, premium tax credits were only available up to certain income levels ($51,040 for an individual or $104,800 for a family of four). Effective May 1, 2021 through 2022, there are no longer income limits for consumers to qualify for financial help through Get Covered New Jersey.

Your premium tax credit amount is based on a sliding scale. Those with a lower income get a larger credit to help cover the cost of their insurance. Premium tax credits will apply at every income level to ensure that no household pays more than 8.5% of income for a benchmark plan (the second-lowest cost Silver plan in a consumer’s area that is used to calculate federal premiums tax credits) purchased through the Marketplace. Some households will qualify for nearly free coverage.

You can apply some or all of your premium tax credit to your monthly insurance premium payment. The Marketplace will send your tax credit directly to your insurance company. You will pay less each month. This is called taking an “advance payment of the premium tax credit” or APTC. 

If you use advance payment of the premium tax credit to lower your monthly premium payment, you will have to “reconcile” when you file your federal income taxes the following year using IRS Form 8962.

This means you will compare:

  1. the amount of premium tax credit you used during the tax year to lower premiums and
  2. the amount of premium tax credit you qualify for based on your final annual income for that year on your tax return.

The difference between these two numbers is what you may owe in your taxes if your income was higher than what you put on your application, or what you may be refunded if your income is lower than what you put on your application. You will get a 1095-A form from Get Covered New Jersey by January 31st so you can fill out federal tax Form 8962.

When Can I Buy Health Insurance?

Open Enrollment happens once a year, from November 1 to January 31. It is typically the only time you can enroll in coverage unless you have a major life event. 

Certain life-changing events such as getting married, moving, or losing job-based health coverage qualify you for a Special Enrollment Period (SEP). Some life events, such as pregnancy, having a baby, or adoption qualify you for an SEP and allow you to enroll in coverage with an earlier effective date. Certain life-changing events also allow consumers to make changes to their current coverage.

A new Special Enrollment Period is available for consumers based on yearly household income. Consumers with an annual income up to 200% of the Federal Poverty Level ($25,760 for an individual or $53,000 for a family of four) can now qualify for a Special Enrollment Period and can access nearly free health plans throughout the year. If you qualify for an SEP, you usually have up to 60 days after the event to enroll or change your plan.

(Note: You can enroll in NJ FamilyCare, the state’s publicly funded health insurance program with free or low-cost health coverage, any time of year.)


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Contact Us

Pathways Insurance Agency
707 Alexander Rd, Bldg 2 Suite 208
Princeton, NJ 08540

Office: (609) 337-4411
Direct/Cell: (908) 285-5946


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