Individual and ACA
Written By Patrick Brenner 10/2/2025
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What is the ACA?
How Does the ACA Lower Costs?
Key Points
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The Affordable Care Act (ACA) is a government program designed to help people with their monthly health insurance costs
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Many people refer to it as "Obamacare"
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In New Jersey, our health insurance marketplace is known as Get Covered NJ
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Many of these policies have high out-of-pocket costs, which can be combatted with ancillary policies like Hospital Indemnity and Critical Illness
What is the Affordable Care Act?
The Affordable Care Act (ACA) is a federal law passed in 2010 designed to help people get more affordable health insurance and expand access to healthcare.
In New Jersey, ACA policies are administered through the state marketplace Get Covered NJ.
How does the ACA lower costs?
The ACA helps lower monthly health insurance premiums by providing tax credits proportional to your income. The lower your income, the more tax credits you will receive to help lower your health insurance premiums.
Let's say you are looking at a policy that has a premium of $400/month. The government may say based on your income they will give you a $300/month tax credit, lowering your premium to $100/month.
It is incredibly important that you are as accurate as possible with your income when applying for a policy. If you lie or your income changes, you may face a large tax bill for receiving inaccurate tax credits.
When Can I Sign Up For An ACA Policy?
Open Enrollment for ACA policies is November 1st to January 31st. Enrolling November 1st to Dec 31st will start your policy January 1st. January 1st to January 31st will start your policy Feb 1st.
There are also Special Enrollment Periods you may qualify for that are tied to major life events. These can include things such as losing your work health insurance, getting married, or losing Medicaid.
Should I Have Just an ACA Policy?
While many ACA policies have low monthly premiums, they may have high out-of-pocket costs. To combat this, we recommend getting Hospital Indemnity Plans and Critical Illness plans.
Hospital Indemnity plans give you a lump sum when you're admitted to the hospital and help pay your daily copays.
Critical Illness polices in most cases provide a lump sum if you are diagnosed with a serious condition like cancer or a heart attack.
These ancilliary policies are incredibly affordable, especially if you are young!
What is NJ Family Care?
In some cases, your income level will be deemed too low for Get Covered NJ subsidies. In this instance, you will instead qualify for Medicaid. In NJ, Medicaid is known as NJ Family Care.
NJ Family Care provides health insurance with no monthly premium and no out-of-pocket costs. That being said, the provider network may be smaller.
NJ Life and Health currently DOES NOT help with NJ Family Care applications. You will have to apply online or call their phone number.
About the Author
Patrick Brenner is a licensed health insurance broker. He has personally helped hundreds of people with their Medicare and is NJ Life and Health's ACA specialist.