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New Jersey Health Insurance Guide
Last updated: 2026 · Marketplace options, Medicaid eligibility, average costs, and enrollment tips for New Jersey residents.
Avg. Individual Premium
$505/mo
Avg. Family Premium
$1,445/mo
Avg. Deductible
$4,200
Medicaid Expansion
Yes
Marketplace
State-Based
Health Insurance Overview in New Jersey
New Jersey operates Get Covered NJ, a state-based marketplace. New Jersey expanded Medicaid in 2014 and has restored its own individual mandate (with state penalty) after the federal mandate was zeroed out. New Jersey also provides additional state subsidies beyond federal ACA subsidies, making coverage more affordable for middle-income residents. New Jersey has a highly competitive marketplace.
Average Health Insurance Costs in New Jersey
Health insurance premiums in New Jersey vary significantly based on age, plan type (Bronze, Silver, Gold, Platinum), insurer, and income-based subsidies. The figures below represent estimated 2026 benchmark premiums before ACA subsidies for a 40-year-old individual and family of four.
| Coverage Type | Monthly Premium | Annual Premium |
|---|---|---|
| Individual (benchmark Silver) | $505/mo | $6060/yr |
| Family of Four (benchmark Silver) | $1,445/mo | $17340/yr |
| Avg. Annual Deductible | $4,200 | |
Premiums shown are before ACA subsidies. Most marketplace enrollees receive premium tax credits that significantly reduce these costs. Use our Health Insurance Calculator to estimate your net premium after subsidies.
Marketplace Enrollment in New Jersey
New Jersey residents can enroll in individual and family health insurance plans through Get Covered NJ (State-Based). Open enrollment runs November 1 – January 31 (Get Covered NJ — extended deadline). Outside of open enrollment, a qualifying life event (job loss, marriage, birth of a child, move to a new state) triggers a Special Enrollment Period during which you can enroll or change plans.
Average Premiums by City in New Jersey
Health insurance premiums vary by location within New Jersey, reflecting local healthcare costs, provider availability, and insurer competition. The following estimated monthly individual premiums are based on a benchmark Silver plan for a 40-year-old non-smoker.
| City | Est. Monthly Premium (Silver, age 40) |
|---|---|
| Newark | $522/mo |
| Jersey City | $518/mo |
| Paterson | $515/mo |
| Elizabeth | $512/mo |
| Trenton | $495/mo |
| Camden | $505/mo |
| Cherry Hill | $488/mo |
Medicaid in New Jersey
NJ FamilyCare (New Jersey Medicaid) covers adults with incomes up to 138% of the federal poverty level. New Jersey has a strong Medicaid program with comprehensive benefits.
Children's Health Insurance (CHIP) in New Jersey
NJ FamilyCare covers children under 19 in families with incomes up to 350% of the federal poverty level.
What Makes New Jersey Unique
New Jersey restored its individual health insurance mandate in 2019 — one of a handful of states to do so after the federal mandate was effectively eliminated. New Jersey also provides state-funded subsidies for residents with incomes up to 600% of the federal poverty level, making New Jersey one of the most supportive states for middle-income marketplace enrollees.
ACA Subsidies: What New Jersey Residents Should Know
Premium tax credits (subsidies) are available for New Jersey residents who purchase coverage through the marketplace and have incomes between 100% and 400% of the federal poverty level (or higher in states with additional state subsidies). The subsidy amount is based on the cost of the benchmark Silver plan in your area and your income. For 2026, the enhanced subsidies first enacted in the American Rescue Plan have been extended, providing more substantial assistance across a broader income range than before.
Cost-sharing reductions (CSRs) provide additional savings on deductibles and copays for those who enroll in Silver plans with incomes between 100-250% of the federal poverty level. Silver plans with CSRs often provide Gold or Platinum-level value at Silver premiums, making them the best value for eligible enrollees.
Tips for Choosing Health Insurance in New Jersey
New Jersey residents should enroll through GetCoveredNJ.gov to access state subsidies for incomes up to 600% of the federal poverty level. New Jersey's extended open enrollment (through January 31) provides additional time. Note New Jersey's individual mandate — uninsured residents may owe a state penalty. Medicaid covers low-income adults.
- Enroll during open enrollment (November 1 – January 31 (Get Covered NJ — extended deadline)) — missing the deadline means waiting until the next open enrollment unless you have a qualifying life event.
- Check both Medicaid eligibility and marketplace subsidy eligibility — your income determines which program you qualify for.
- Don't just compare premiums — also compare deductibles, out-of-pocket maximums, and whether your doctors are in-network.
- Silver plans with cost-sharing reductions (for incomes 100-250% FPL) typically offer the best overall value despite higher premiums than Bronze plans.
- Use our Health Insurance Calculator to estimate your total annual cost (premium + expected out-of-pocket) for different plan options.
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The information on this page is provided for general informational purposes only and reflects estimated industry averages and program eligibility rules as of 2026. Health insurance premiums, Medicaid eligibility thresholds, marketplace options, and program rules change annually. Always verify current eligibility and enrollment options at the official Get Covered NJ (State-Based) or by contacting a certified navigator or broker. Premium figures shown are approximations before subsidies — actual net premiums depend on individual income, household size, and plan selection.