Who is the Marketplace for?

The New Jersey Health Insurance Marketplace is where eligible residents can shop for and buy insurance in person, online, or by phone. In New Jersey, the Marketplace is run by the federal government. The Marketplace, also called an Exchange, is mainly for people who:

  • Don’t have insurance
  • Aren’t insured by their employer
  • Don’t have Medicare
  • Aren’t included in their spouse’s employer insurance
  • Have pre-existing conditions and may have had trouble getting insurance before
  • Have private insurance but want to look at other options
  • Own a small business


The Affordable Care Act requires most Americans to sign up for health insurance or pay a penalty at income tax time. 

If you have a life-changing event -- such as the birth of a child, losing your job, or moving to a new state -- you don't have to wait for the next enrollment period. You can sign up or change coverage within 60 days of the event. You can also sign up for Medicaid at any time, if you are eligible.

You’ll need to provide information about you and your family members when you apply. Here’s a checklist of what you’ll need:

  • Social Security number (or document number if you are a legal immigrant)
  • W-2 forms: Wage and tax statements or pay stubs for all employed members of the household; for people who are self-employed or do not have a regular salary, include an estimate of household income.
  • Policy numbers of health insurance plans covering any members of the household
  • Immigration/citizenship status
  • Tobacco use

What’s Covered: All approved plans in the state must cover the same package of benefits, called essential health benefits. They include:

  1. Outpatient services, such as doctor visits or tests done outside a hospital
  2. Emergency services
  3. Hospital stays
  4. Pregnancy and baby care
  5. Mental health and substance abuse services, including behavioral health treatment
  6. Prescription drugs, including generic and certain brand-name drugs
  7. Lab tests
  8. Rehabilitative services, such as those that help people recover from an accident or injury, and habilitative services, which help people with developmental issues.
  9. Preventive and wellness services, along with those that help people manage chronic conditions; these are covered at no additional cost.
  10. Services for children, including dental and eye care

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Posted 8:25 AM  View Comments

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