If you live in New Jersey and need health insurance, the Affordable Care Act (ACA) marketplace remains one of the best options for finding affordable coverage in 2026. But this year comes with significant changes. The enhanced federal premium tax credits that kept costs low from 2021 through 2025 expired at the end of 2025. That means many New Jersey residents will pay more for coverage than they did last year.
The good news? New Jersey is one of a handful of states that offers its own state-funded subsidies on top of federal assistance. The New Jersey Health Plan Savings program continues in 2026, helping households with incomes up to 600% of the federal poverty level (FPL). This puts New Jersey residents in a better position than people in most other states.
Whether you are looking at marketplace plans for the first time or trying to understand how 2026 changes affect your costs, this guide covers everything you need to know about ACA eligibility in New Jersey.
Check your eligibility for all available benefits in minutes with our free screener.
What Changed for 2026
The biggest shift for 2026 is the expiration of enhanced federal premium tax credits. From 2021 through 2025, Congress temporarily expanded subsidies through the American Rescue Plan and Inflation Reduction Act. Those enhancements did two key things:
- Removed the income cap for federal subsidies, so even people above 400% FPL could receive help
- Lowered the percentage of income that households had to pay toward their benchmark plan premium
Starting in 2026, the original ACA subsidy rules are back. Federal premium tax credits are now limited to households earning between 138% and 400% of FPL in Medicaid expansion states like New Jersey. If your income exceeds 400% FPL, you no longer qualify for federal premium assistance.
During the 2026 open enrollment period, about 80% of Get Covered New Jersey enrollees qualified for federal and/or state subsidies averaging $604 per person per month. That is down from 90% during the previous year, reflecting the reduced federal assistance.
New Jersey ACA Income Limits for 2026
ACA eligibility in New Jersey is based on your household income as a percentage of the federal poverty level. For 2026 coverage, eligibility uses the 2025 FPL guidelines. Here are the key income thresholds:
2026 Federal Poverty Level Thresholds by Household Size
| Household Size | 100% FPL | 138% FPL (Medicaid Cap) | 250% FPL (CSR Cap) | 400% FPL (Federal Subsidy Cap) | 600% FPL (NJ Subsidy Cap) |
|---|---|---|---|---|---|
| 1 | $15,650 | $21,597 | $39,125 | $62,600 | $93,900 |
| 2 | $21,150 | $29,187 | $52,875 | $84,600 | $126,900 |
| 3 | $26,650 | $36,777 | $66,625 | $106,600 | $159,900 |
| 4 | $32,150 | $44,367 | $80,375 | $128,600 | $192,900 |
| 5 | $37,650 | $51,957 | $94,125 | $150,600 | $225,900 |
| 6 | $43,150 | $59,547 | $107,875 | $172,600 | $258,900 |
These figures use the 2025 federal poverty guidelines, which determine eligibility for 2026 coverage.
What Your Income Level Means for Coverage
Your income determines which type of financial help you can receive:
Below 138% FPL: You likely qualify for NJ FamilyCare (New Jersey's Medicaid program). This provides free or very low cost health coverage. An individual earning up to approximately $1,800 per month, or a family of two earning up to $2,433 per month, falls in this range.
138% to 250% FPL: You qualify for federal premium tax credits, NJ Health Plan Savings, and cost-sharing reductions (CSRs). CSRs lower your deductibles, copays, and out-of-pocket costs but are only available if you choose a Silver plan.
250% to 400% FPL: You qualify for federal premium tax credits and NJ Health Plan Savings, but not for cost-sharing reductions.
400% to 600% FPL: You do not qualify for federal subsidies in 2026 (this is where the "subsidy cliff" hits). However, New Jersey Health Plan Savings are still available to help lower your premiums. For a single person, that covers incomes up to $93,900. For a family of four, up to $192,900.
Above 600% FPL: No federal or state subsidies are available. You pay the full premium.
New Jersey Health Plan Savings: A State Advantage
New Jersey stands out nationally because of its state-funded subsidy program. Since 2021, the New Jersey Health Plan Savings program has provided additional premium assistance to marketplace enrollees. In 2026, this program is especially valuable because it fills part of the gap left by expired federal enhancements.
Key facts about NJ Health Plan Savings:
- Available to households earning up to 600% of FPL
- Applied automatically when you enroll through Get Covered New Jersey
- Can be combined with federal premium tax credits and cost-sharing reductions
- Works with plans at any metal level (Bronze, Silver, or Gold)
While state officials have acknowledged that state subsidies cannot fully replace the lost federal enhancements, they still provide meaningful savings for many households, particularly those earning between 400% and 600% FPL who no longer receive any federal help.
Who Is Eligible for ACA Coverage in New Jersey
To enroll in a marketplace plan through Get Covered New Jersey, you must:
- Live in New Jersey and be lawfully present in the United States
- Not be incarcerated
- Not be enrolled in Medicare
To qualify for financial assistance (subsidies), you must also meet these conditions:
- You are not eligible for affordable employer-sponsored coverage
- You are not eligible for NJ FamilyCare (Medicaid), CHIP, or premium-free Medicare Part A
- If married, you file a joint tax return (with very limited exceptions)
- You cannot be claimed as a tax dependent by someone else
New Jersey's Individual Mandate
Unlike the federal level, New Jersey enforces its own individual mandate requiring residents to maintain health insurance. If you go without qualifying coverage, you may face a Shared Responsibility Payment on your New Jersey state tax return.
The penalty is the greater of:
- $695 per adult ($347.50 per child under 18), up to a family maximum of $2,085, or
- 2.5% of household income above the filing threshold
The penalty is capped at the cost of the statewide average annual Bronze plan premium. Exemptions are available for financial hardship, certain religious beliefs, and other qualifying circumstances.
How to Apply for ACA Coverage in New Jersey
Step 1: Gather Your Information
Before starting your application, collect the following:
- Social Security numbers for everyone in your household
- Immigration documents (if applicable)
- Employer and income information (pay stubs, W-2s, tax returns)
- Information about any employer-sponsored health coverage available to you
- Policy numbers for any current health insurance
Step 2: Visit Get Covered New Jersey
Go to GetCoveredNJ.com to create an account and start your application. You can also call their customer service center at 1-833-677-1010 (TTY 711) for phone assistance.
Step 3: Complete the Application
The application asks about your household size, income, and other factors to determine what subsidies you qualify for. Be as accurate as possible with income estimates, since you will need to reconcile premium tax credits when you file taxes.
Step 4: Compare Plans and Enroll
After your eligibility is determined, you can compare Bronze, Silver, and Gold plans from up to five insurance carriers in New Jersey for 2026. If you qualify for cost-sharing reductions, remember that those savings only apply to Silver plans.
Step 5: Pay Your First Premium
Your coverage begins once you pay your first monthly premium. Make sure to pay on time to avoid a gap in coverage.
Getting In-Person Help
New Jersey has a network of trained navigators and certified application counselors who can help you at no cost. Visit the Get Covered New Jersey website to find local assistance near you.
Qualifying Life Events and Special Enrollment
The 2026 open enrollment period ran from November 1, 2025, through January 31, 2026. If you missed it, you can still enroll during a Special Enrollment Period (SEP) if you experience a qualifying life event, such as:
- Losing other health coverage (job loss, aging off a parent's plan)
- Getting married or divorced
- Having or adopting a baby
- Moving to New Jersey from another state
- Becoming pregnant (New Jersey is one of the few states where pregnancy qualifies as a life event)
You typically have 60 days from the qualifying event to enroll. NJ FamilyCare (Medicaid) enrollment is available year-round regardless of open enrollment periods.
Also note that starting in fall 2026, a new federal rule will shorten the open enrollment window. Future enrollment periods will end by December 31 instead of January 31.
Not sure which programs you qualify for? Use our free benefits screener to check your eligibility.
NJ FamilyCare (Medicaid and CHIP)
If your income falls below 138% FPL, you may qualify for NJ FamilyCare rather than marketplace coverage. NJ FamilyCare is New Jersey's Medicaid and Children's Health Insurance Program, providing free or very low cost coverage to eligible residents.
NJ FamilyCare covers:
- Adults with income up to 138% FPL
- Children in households with higher income thresholds
- Pregnant women with expanded eligibility
- Seniors and individuals with disabilities (with different income and asset rules)
You can apply for NJ FamilyCare at any time during the year. When you apply through Get Covered New Jersey, the system automatically checks whether you qualify for Medicaid before showing you marketplace plans.
Note that changes to NJ FamilyCare eligibility rules are expected starting in fall 2026, so check with the program directly for the latest information.
Five Insurance Carriers for 2026
For the 2026 plan year, Get Covered New Jersey offers plans from five insurance carriers (down from six in 2025). Plan availability varies by county, so not all carriers may be available in your area. When comparing plans, pay attention to:
- Monthly premium after subsidies
- Deductible amounts
- Provider networks (make sure your doctors are in-network)
- Prescription drug coverage
- Out-of-pocket maximums
Frequently Asked Questions
Can I still get ACA subsidies in New Jersey if I earn over 400% FPL?
You cannot receive federal premium tax credits above 400% FPL in 2026. However, New Jersey offers its own Health Plan Savings subsidies for households earning up to 600% FPL. A single person earning up to $93,900 or a family of four earning up to $192,900 can still receive state premium assistance.
What if I missed open enrollment?
If you missed the January 31, 2026 deadline, you can still enroll through a Special Enrollment Period if you have a qualifying life event. In New Jersey, pregnancy counts as a qualifying event. NJ FamilyCare enrollment is open year-round.
How much will I pay for a marketplace plan in 2026?
Your cost depends on your income, household size, age, and location. Federal premium tax credits ensure that eligible households (138% to 400% FPL) pay no more than approximately 9.96% of their income for a benchmark Silver plan. NJ Health Plan Savings provide additional discounts for eligible households up to 600% FPL.
What is the penalty for not having health insurance in New Jersey?
New Jersey has an individual mandate. The penalty is the greater of $695 per adult (up to $2,085 per family) or 2.5% of household income above the tax filing threshold. It is capped at the average Bronze plan premium cost.
Can undocumented immigrants get ACA coverage in New Jersey?
ACA marketplace coverage requires lawful presence in the United States. Undocumented immigrants are not eligible for marketplace plans or federal subsidies. However, emergency Medicaid may be available regardless of immigration status for certain medical emergencies.
What is the difference between NJ FamilyCare and marketplace plans?
NJ FamilyCare is Medicaid, offering free or very low cost coverage for lower income residents (generally below 138% FPL). Marketplace plans are private health insurance available through Get Covered New Jersey, with subsidies to reduce costs for eligible households. If you qualify for NJ FamilyCare, you are generally not eligible for marketplace subsidies.
Will I need to pay back subsidies when I file taxes?
If your actual annual income differs from what you estimated on your application, you may owe money or receive a refund when you file your federal taxes. Starting in 2026, there is no cap on repayment amounts for excess advance premium tax credits, so it is important to report income changes to Get Covered New Jersey within 30 days.
Next Steps
Understanding your ACA eligibility is the first step toward getting affordable health coverage in New Jersey. Even with the expiration of enhanced federal subsidies, the combination of remaining federal tax credits and New Jersey's own Health Plan Savings program means that many residents can still find affordable options.
Take a few minutes to check what benefits you may qualify for using our free eligibility screener. You can also explore more programs and resources on our New Jersey Benefits Overview page.
If you need personalized help, Get Covered New Jersey offers free assistance through trained navigators and counselors across the state. Call 1-833-677-1010 or visit GetCoveredNJ.com to get started.
