New Jersey Health Insurance 2026: GetCoveredNJ Plans, Carriers & State Subsidies

New Jersey health insurance for 2026 looks different from almost every other state in two important ways. The Garden State runs its own marketplace — GetCoveredNJ — instead of using HealthCare.gov, and it funds a state premium subsidy program (NJ Health Plan Savings) that extends financial help up to 600 percent of the federal poverty level, well above the federal cutoff. New Jersey also maintains an individual mandate, requiring residents to carry minimum essential coverage or pay a Shared Responsibility Payment on their state tax return. This guide walks through the 2026 marketplace, all five participating carriers, NJ Health Plan Savings, NJ FamilyCare, and how to choose coverage for your household.

The New Jersey Health Insurance Marketplace for 2026

New Jersey residents buying individual coverage for 2026 do so through GetCoveredNJ, the state-based health insurance marketplace operated by the New Jersey Department of Banking and Insurance. New Jersey transitioned from HealthCare.gov to its own platform in November 2020, unlocking a longer open enrollment window, state-funded premium subsidies, and a tax-time enrollment program unavailable on the federal platform.

Open enrollment for 2026 ran from November 1, 2025 through January 31, 2026 — about two weeks longer than the federal default. New Jersey closed open enrollment with 509,192 residents enrolled, though approximately 70,000 dropped coverage by April 15, 2026 due to non-payment of higher premiums following the expiration of enhanced federal subsidies. The 2026 plan year is the most disrupted in NJ marketplace history, with average premiums up 16.6 percent and many enrollees shifting from Silver to Bronze plans to keep monthly costs manageable.

How NJ Health Plan Savings Work in 2026

New Jersey residents have access to a state-funded premium subsidy that no other state offers in quite the same way. NJ Health Plan Savings — known as NJHPS — provides $20 to $100 per person per month in additional premium assistance on top of any federal premium tax credit. Eligibility extends to households earning up to 600 percent of the federal poverty level, beyond the federal 400 percent ceiling. The state allocated approximately $215 million to fund NJHPS for 2026.

The 400-to-600 percent FPL bracket matters most in 2026. Federal premium tax credits phased back to their pre-2021 structure at the end of 2025, restoring the 400 percent FPL cliff for most households. For New Jersey residents in this income band, NJHPS is often the only subsidy available — a meaningful difference compared to residents in states without state-funded supplements. The state Department of Banking and Insurance has indicated NJHPS will continue at 600 percent FPL through 2026 regardless of federal action.

Health Insurance Carriers in New Jersey for 2026

GetCoveredNJ shoppers choose among five carriers for 2026 — down from six in 2025 after Aetna exited the New Jersey individual marketplace at the end of 2025. The remaining five carriers cover the state with varying plan portfolios and 2026 rate increases. Carrier choice matters significantly because provider networks, plan structures, and premium changes differ substantially between insurers.

Plan Types in New Jersey

New Jersey residents can choose among several plan structures, each balancing premium cost against network flexibility differently. The carrier mix and the geographic reach of each plan type affect which structure makes sense for a given household. North Jersey residents who frequently travel to New York City and South Jersey residents with Philadelphia provider relationships often weigh network breadth differently than residents in Central Jersey.

Horizon’s OMNIA Health Plans are unique to New Jersey and worth understanding. OMNIA uses a tiered network with three levels — Tier 1 (designated preferred providers and hospital systems), Tier 2 (standard network), and Tier 3 (out-of-network). Premiums are lower than traditional PPO, and out-of-pocket costs drop substantially when members use Tier 1 providers. The structure works well for households comfortable with Horizon’s preferred provider list — typically members of RWJBarnabas Health, Hackensack Meridian Health, and Atlantic Health System network hospitals.

Cost of Health Insurance in New Jersey for 2026

Health insurance costs in New Jersey rose substantially between 2025 and 2026. Average individual market premiums increased 16.6 percent year over year — driven largely by the expiration of enhanced federal premium tax credits at the end of 2025 and rising medical and pharmacy costs. Households eligible for both federal APTC and NJ Health Plan Savings absorbed much less of the increase than households above the 600 percent FPL subsidy cliff.

The shift from Silver to Bronze plans tells the story of 2026 affordability. In plan year 2025, 83 percent of active shoppers on GetCoveredNJ chose Silver. For 2026, that dropped to 68 percent while Bronze selections nearly doubled from 16 percent to 31 percent. Households facing higher premiums traded richer benefits for lower monthly costs — a trade that often costs more annually if any meaningful care is needed because Bronze deductibles run $7,000-9,000 single and $14,000-18,000 family compared to Silver’s $4,500-6,000 and $9,000-12,000.

NJ FamilyCare for Children and Low-Income Adults

NJ FamilyCare is New Jersey’s Medicaid and Children’s Health Insurance Program (CHIP), covering approximately 1.8 million state residents — roughly 20 percent of the population. Eligibility runs through the same GetCoveredNJ application as marketplace plans, so applicants are routed to FamilyCare automatically when household income qualifies. The NJ FamilyCare program covers comprehensive medical, dental, vision, mental health, prescription drug, and hospital care with minimal or no copays depending on category.

New Jersey children qualify for FamilyCare up to 355 percent of FPL regardless of immigration status — one of the most expansive children’s coverage thresholds in the country. Undocumented children of any household income up to the 355 percent ceiling are eligible. This makes the split-coverage approach common: children on NJ FamilyCare while parents enroll in a GetCoveredNJ marketplace plan with NJ Health Plan Savings. Most households with income below approximately $111,000 see children automatically routed to FamilyCare when applying through the marketplace.

The NJ Individual Mandate and Shared Responsibility Payment

New Jersey is one of a handful of states that maintains an individual health insurance mandate. The NJ Health Insurance Market Preservation Act of 2018 requires most state residents to carry minimum essential coverage each month or pay a Shared Responsibility Payment on the state income tax return. The mandate applies to children and adults, with the family penalty capped at three times the annual adult amount, and the total penalty capped at the statewide average annual bronze plan premium.

The SRP is the greater of the flat-dollar amount or the percentage-of-income calculation. Residents report coverage status on Schedule NJ-HCC, attached to Form NJ-1040. Acceptable coverage includes GetCoveredNJ marketplace plans, employer-sponsored plans meeting minimum essential coverage standards, NJ FamilyCare, Medicare, military coverage, and individual market plans purchased off-marketplace that meet the ACA’s December 2017 minimum essential coverage definition. Short-term health insurance does NOT satisfy the mandate and does not exempt buyers from the SRP.

Special Enrollment and the NJ Easy Enrollment Program

Open enrollment for NJ coverage runs annually from November 1 through January 31 — two weeks longer than the federal default of November 1 through January 15. Outside that window, residents need a qualifying life event for a Special Enrollment Period, with one exception unique to New Jersey: the NJ Easy Enrollment Health Insurance Program, which lets uninsured residents trigger enrollment by completing the NJ-EZ Enroll Form on the state income tax return.

Pregnancy as a qualifying event is specific to New Jersey — most state marketplaces and the federal platform do not include pregnancy itself as an SEP trigger. NJ residents who become pregnant outside open enrollment can apply within 60 days of conception, with coverage starting the first day of the month following plan selection. The NJ Easy Enrollment Program, launched in 2022, has connected tens of thousands of uninsured residents to marketplace coverage by automating the SEP process from the state tax return.

How to Choose New Jersey Health Insurance for Your Situation

Marketplace shoppers do better when household profile drives plan selection rather than the other way around. Income band, household composition, network preferences, and how the household actually uses healthcare each shift the right answer. Five household profiles cover most situations encountered on GetCoveredNJ.

Frequently Asked Questions About NJ Coverage

Common questions New Jersey residents ask about health insurance — including how GetCoveredNJ differs from HealthCare.gov, what NJ Health Plan Savings pays, which 2026 carriers are available, how the individual mandate works, and who qualifies for NJ FamilyCare.