New Jersey (again) extends Special Enrollment Period for those losing Medicaid/CHIP

via the NJ Dept. of Banking & Insurance:

TRENTON — New Jersey Department of Banking and Insurance Acting Commissioner Justin Zimmerman today announced the department will continue and extend a previously announced Special Enrollment Period (SEP) to make it easier for qualified individuals who are no longer eligible for NJ FamilyCare coverage to enroll with Get Covered New Jersey.

As required by federal law, the Department of Human Services restarted eligibility reviews for NJ FamilyCare on April 1, 2023. Those who no longer qualify for NJ FamilyCare because their income is too high may be eligible to obtain health coverage through Get Covered New Jersey and may be able to get help paying for premiums.

The end date of this SEP will be extended from July 31, 2024, to November 30, 2024, which will help more individuals leaving NJ FamilyCare to find quality, affordable health insurance through the start of the next Open Enrollment Period. Any eligible consumer who attests to losing NJ FamilyCare (Medicaid/CHIP) coverage between that same time period will be eligible for the SEP.

“The Murphy Administration continues to make access to quality, affordable health coverage a priority, by breaking down these barriers New Jerseyans can better protect their health,” said Acting Commissioner Zimmerman. “The continuation of the expanded special enrollment for this population will provide additional time to enroll in health plans through Get Covered New Jersey and keep them connected to the health care they need.”

Get Covered New Jersey is a source of affordable health insurance for New Jersey residents who do not have health coverage from their employers or access to other health care programs. Nine out of 10 enrollees will qualify for financial help. Due to the substantial savings from the federal government and the State of New Jersey, many individuals will have access to a health plan at a cost of $10 a month or less. Typically, the Get Covered New Jersey Open Enrollment Period, November 1 to January 31, is the only time residents without health insurance through an employer, or other program such as NJ FamilyCare or Medicare, can enroll in coverage unless they have a qualifying life event or meet certain income levels. Residents at certain income levels (up to $29,160 for an individual or $60,000 for a family of four for 2024) are eligible for nearly free coverage year-round through the Expanded Access Special Enrollment Period. Consumers who lose NJ FamilyCare coverage can obtain coverage through GetCoveredNJ using the Loss of NJ FamilyCare, Medicaid, CHIP, and/or Medicare Special Enrollment Period qualifying life event.

“At Human Services we have worked diligently to connect individuals no longer eligible for NJ FamilyCare to the state exchange because we want them to stay covered. This extension will help ensure that people continue to have access to health coverage critical to their health, and I commend DOBI for giving people additional time to enroll. GetCoveredNJ provides affordable health care plans and most who apply will qualify for financial assistance, so I encourage anyone who no longer qualifies for NJ FamilyCare to visit the GetCoveredNJ website to review their options and find the plan that best meets their needs,” said Human Services Commissioner Sarah Adelman.

Consumers who are determined ineligible by NJ FamilyCare based on their income are automatically transferred to GetCoveredNJ and receive a welcome notice by mail or email with a unique access code from GetCoveredNJ that allows them to access their account, find out if they qualify for financial help and enroll in health insurance. Consumers who lose NJ FamilyCare coverage as a result of not completing their renewal form will not have their information transferred to GetCoveredNJ, but can enroll in coverage through GetCoveredNJ if eligible.​ Some consumers who are no longer eligible for NJ FamilyCare may be eligible for health insurance from an employer or may now be eligible for Medicare.

To avoid duplicate coverage and potential tax implications, consumers should apply for coverage through GetCoveredNJ after they have received notification from NJ FamilyCare that they are no longer eligible for NJ FamilyCare coverage. Once consumers receive confirmation that their coverage will not be renewed, residents can find free local assistance on the Get Covered New Jersey website, and browse plans and see if they qualify for financial help with the Shop and Compare Tool.

All plans sold through Get Covered New Jersey (GetCovered.NJ.gov) meet the high standards of the Affordable Care Act. While individuals are searching for new coverage options, the department advises them to be aware of plans with limited coverage that – unlike the health plans available at Get Covered New Jersey – do not cover basic services and pre-existing conditions. People who purchase these types of plans may only realize they are not comprehensive when they are denied coverage for a medical necessity. It should also be noted that short-term limited duration plans, sometimes referred to as junk plans, are prohibited in New Jersey. Health insurance plans available through Get Covered New Jersey offer comprehensive coverage and consumers cannot be denied due to a pre-existing condition.

For more information about Get Covered New Jersey, visit our Frequently Asked Questions (Loss of NJ FamilyCare) at GetCovered.NJ.gov

For more information about NJ FamilyCare eligibility reviews visit: www.nj.gov/StayCoveredNJ