Health Insurance Marketplace

The new Health Insurance Marketplace helps uninsured people find health coverage. When you fill out the Marketplace application we’ll tell you if you qualify for:

 Private health insurance plans. We’ll tell you whether you qualify for lower costs based on your household size and income. Plans cover essential health benefits, pre-existing conditions, and preventive care. If you don’t qualify for lower costs, you can still use the Marketplace to buy insurance at the standard price.

 NJ FamilyCare/ Medicaid: These programs provide coverage to millions of families with limited income. If it looks like you qualify, we’ll share information with the state agency and they’ll contact you. The state of New Jersey expanded Medicaid which will allow covering more people in 2014.

Some states operate their own Marketplace. In some states, like New Jersey, the Marketplace is run by the Federal government.

 Most people must have health coverage in 2014 or pay a fee. If you don’t have coverage in 2014, you’ll have to pay a penalty of $95 per adult, $47.50 per child, or 1% of your income (whichever is higher). The fee increases every year. Some people may qualify for an exemption to this fee (see sample of exemptions). If you enroll by March 31, 2014, you won’t have to pay the fee for any month before your coverage began.

 You’re considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage.

 If you’re eligible for job-based insurance, you can consider switching to a Marketplace plan. But you won’t qualify for lower costs based on your income unless the job-based insurance is unaffordable or doesn’t meet minimum requirements. You also may lose any contribution your employer makes to your premiums.

 If you have Medicare, you’re considered covered and don’t have to make any changes. You can’t use the Marketplace to buy a supplemental or dental plan.

 Enrollment deadlines

Open enrollment ends March 31, 2014.

If you miss the March 31, 2014, open enrollment deadline for coverage in 2014, you may not be able to enroll in a health insurance plan through the Marketplace until the next open enrollment period unless you qualify for a special enrollment period.

You and anyone in your household who doesn’t have qualifying health coverage for 3 months or more out of the year could owe a penalty. But if you enroll by March 31, 2014, you won’t have to pay the penalty, even if you were uninsured for the entire year before your coverage starts.

You can call the Health Insurance Marketplace 24 hours a day, 7 days a week: 1-800-318-2596 (TTY: 1-855-889-4325)


SJFMC’s Certified Application Counselors are ready to assist you today!

Contact us at: (609) 567-0200 Ext. 4227 or


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Basic Health Insurance Terms
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