Nov. 1 marks the beginning of open enrollment, the roughly two-month period when Americans without employer-sponsored health insurance or Medicaid can choose plans on the marketplace. And this year, shoppers should steel themselves for a financial hit.
Monthly premiums are expected to climb largely across the board. KFF, a nonprofit that researches health policy, reported a nationwide 6.3% increase in premiums for the average bronze plan, which is the cheapest tier of Affordable Care Act plans. Pennsylvanians will see an average 3.9% spike in premiums, state officials announced in September.
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Most people qualify for financial assistance. Pennie, the state marketplace for Pennsylvania, and Get Covered NJ, the marketplace for New Jersey, both say that 9 out of 10 customers are eligible for savings that lower their monthly payments. These credits can be calculated online on the state marketplaces or, for residents of states without their own systems, on healthcare.gov.
Pennsylvania residents will also have more options for 2024, as both Jefferson Health Plans and Highmark are participating in the state marketplace for the first time. And Independence Blue Cross is launching a new portfolio of dental plans alongside its health plans in the Philadelphia region.
What else do you need to know to enroll? Here’s a guide to the deadlines, qualifications and assistance options in New Jersey and Pennsylvania:
How do I sign up for a plan?
Both Pennie and Get Covered NJ offer users the option to browse plans before they register. But to proceed, you’ll eventually need to create an online account, providing information like your birthday, social security number and household income. You can then start an application and select a health insurance plan.
Do I qualify for a marketplace plan?
In Pennsylvania, state residents who are U.S. citizens or nationals, or have qualified immigration status, can enroll in a Pennie plan. Incarcerated individuals are ineligible, unless they are pending the disposition of charges.
In New Jersey, you must be a state resident and U.S. citizen or national to enroll in a Get Covered NJ marketplace plan. “Qualified” immigrants — such as refugees, aslyees and green card holders — also can enroll. Anyone currently incarcerated is not eligible.
Can I get help choosing or enrolling in a plan?
Brokers and assisters are available to help Pennsylvania and New Jersey residents. While both receive training, there are a few key differences in their services.
Assisters generally help enrollees navigate the marketplace and application process. Their assistance is free, but they cannot make specific recommendations on health insurance plans. You can search for assisters by zip code on Pennie or Get Covered NJ. Additionally, Pennie is offering in-person assister events across Philadelphia, Montgomery, Allegheny, Dauphin, Lehigh, Lancaster, Northampton, Greene and Washington counties every day in November and December.
Brokers, conversely, can make recommendations, but they may only be able to sell plans from specific insurance companies. Brokers are typically paid a commission by insurance carriers, making their assistance free to customers, unless they request additional, specialized services. You can search for local brokers on Pennie and Get Covered NJ.
Customer service representatives are also available to help in either state. For Pennie, the number is 1-844-844-8040. For Get Covered NJ, it’s 1-833-677-1010.
How long do I have to enroll?
Pennsylvania residents have until Dec. 15 to apply for insurance coverage that will begin on Jan. 1. Open enrollment then ends on Jan. 15.
New Jersey residents have a little more time. Dec. 31 is the deadline to enroll for coverage beginning on Jan. 1, while Jan. 31 is the hard deadline for open enrollment.
Once open enrollment ends, only those who experience “qualifying life events” — such as getting married or losing a job — may enroll in an ACA plan at a date outside that period. Low-income residents also may obtain an exception. In New Jersey, those with an annual income up to 200% of the federal poverty level can enroll at any time of the year. In Pennsylvania, the threshold is at or below 150% of the federal poverty level.
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