12:41 PM

Buying Your Own Health Insurance: 5 Things to Know



Enrollment for individual coverage features lower prices, higher subsidies, one-on-one assistance and more for 2021.

Consumers shopping for individual health coverage as the open enrollment period begins on November 1 are in for a pleasant surprise: their Affordable Care Act (ACA) policy from Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) has become, well, more affordable.

Here are the five things that all consumers should know about this year’s plans for the 2021 individual market.

1. Premiums for Horizon BCBSNJ’s most popular plans are down or largely unchanged.

If you’re in an OMNIA Silver or Bronze plan with Horizon BCBSNJ the new enrollment period brings good news and, for some, lower costs. OMNIA Silver plans – chosen by nearly 80% of Horizon BCBSNJ individual members – have premium changes that range from a 2.3% decrease to a 1.4% increase for 2021. And for the roughly 30,000 Horizon members with the OMNIA Bronze plan, average premiums are down by more than 2% compared to last year.

2. The vast majority of consumers qualify for financial assistance.

In 2020, 87% of consumers who bought their coverage through the federal marketplace received some amount of financial assistance that lowered their premium. For those getting help, the average premium was less than $100 a month.

3. There are more ways than ever to get financial help to lower or eliminate premiums.

The Affordable Care Act provides a federal subsidy to single individuals earning $51,040 or a family of four with income up to $104,800. On top of that, this year, thanks to a new law enacted by Governor Murphy in 2019, these same consumers may be eligible for additional financial assistance from the State.

4. Coverage (still) isn’t optional.

In 2018, New Jersey enacted an “individual mandate” – requiring almost every state resident to have health insurance in 2020. This requirement remains in place, so if you don’t get coverage from your employer or qualify for Medicare or Medicaid, you need to select a health plan during open enrollment. If you don’t, you will pay a penalty when you pay your state taxes.

5. Horizon BCBSNJ offers personalized, virtual 1-on-1 counseling.

Whether you are a first-time shopper or have experience buying an individual health plan, there are bound to be questions. To help you safely get the answers to all your questions, Horizon BCBSNJ is offering personalized virtual or in-person appointments with plan experts who can answer your questions. In-person, on the phone, or virtually during a web-based consult, you’ll be able to learn about the enrollment process, what new benefits and services are available for 2021, how the new state subsidy program can mean an even lower monthly premium, find the right coverage for less, and new benefits and services.

By visiting www.HorizonBlue.com/MeetOnline or calling 1-800-224-1234 consumers can schedule a one-on-one web-based consult, speak to an expert to set up a plan review or find locations near them for a face-to-face consultation. As always, Horizon BCBSNJ plan experts will be available at:

  • Horizon Connect locations in Moorestown and Union City
  • Hola Doctor offices in Perth Amboy and Jersey City
  • Sanitas Medical Centers in Union City, Belleville and Elizabeth
  • Blue to You kiosks at the Bergen Town Center (Paramus), Willowbrook Mall, (Wayne), and Menlo Park Mall (Edison)

The individual market enrollment period begins on November 1, 2020, and ends on January 30, 2021.