New Jersey residents are entering a critical period for securing health coverage as the 2026 Open Enrollment window officially opened on November 1, 2025, running through January 31, 2026. With significant premium increases and evolving marketplace dynamics, this year’s enrollment season demands careful attention from individuals and families seeking coverage. Residents can explore, compare, and enroll in plans through the state’s official marketplace, Get Covered New Jersey, ensuring compliance with the state’s individual mandate, which still requires most residents to maintain minimum essential health coverage.
The New Jersey Department of Banking and Insurance has announced an average 16.6% increase in individual market premiums for 2026, a sharp rise driven largely by the anticipated expiration of enhanced federal premium tax credits at the end of 2025. For enrollees who currently benefit from these subsidies, this could mean their effective costs rise by nearly 175%, potentially pricing many out of the marketplace and increasing the state’s uninsured rate after years of progress during the pandemic.
In addition to rising premiums, changes in marketplace carriers are influencing consumer options. Nationwide, Aetna has withdrawn from state marketplaces and will not offer plans in New Jersey for 2026. This leaves five carriers on the Get Covered New Jersey platform: Ambetter from WellCare of New Jersey, AmeriHealth, Horizon Blue Cross Blue Shield of New Jersey, Oscar, and UnitedHealthcare. Notably, AmeriHealth has updated its offerings to align with federal mental health parity requirements, ensuring balanced coverage for mental health services across all plans.
Understanding the factors driving premium increases is essential for residents navigating open enrollment. Systemic pressures such as rising medical costs, high-priced prescription drugs, advanced medical technology, an aging population, and the prevalence of chronic diseases contribute heavily to higher premiums. Administrative overhead, hospital consolidation, and insurers’ claims experiences further compound the financial burden, while individual factors like age, location, tobacco use, and plan selection also play a significant role in determining out-of-pocket costs.
The upcoming enrollment period is critical for residents to shop, compare, and update their information. Those receiving financial assistance should pay particular attention to plan changes, subsidy availability, and total costs. Free, unbiased enrollment assistance is available across the state for individuals and families who need guidance in selecting the best coverage for their needs. Keeping account details current—including income, household size, and mailing address—is essential to ensure accurate subsidy calculations and seamless plan enrollment.
Experts warn that without proactive engagement during open enrollment, many New Jersey residents could face substantial coverage gaps in 2026. The combination of premium increases, subsidy expirations, and market adjustments may make it challenging for some households to maintain consistent coverage. Yet, timely participation in the state’s marketplace offers the opportunity to secure affordable, comprehensive health insurance while remaining compliant with the state mandate.
For up-to-date information on plans, enrollment assistance, and resources to navigate the 2026 Open Enrollment period, residents can visit Explore New Jersey’s Open Enrollment coverage page for guidance, tips, and official marketplace details.
As New Jersey heads into 2026, awareness and preparation will be key for individuals and families seeking to manage rising healthcare costs while ensuring access to essential medical care. The decisions made during this open enrollment window will have a profound impact on coverage, affordability, and peace of mind throughout the year ahead.
