Need Advice on Last Day of Open Enrollment (NJ)

Hi all,

Today is the last day of open enrollment, and I need some advice. I’m a 26M who was recently dropped from my parents’ insurance policy. I was also laid off from my job, making it impossible to get employer-sponsored insurance.

I’m currently receiving unemployment benefits, but my income is significantly lower than before, and I’m struggling to cover my living expenses. The cheapest marketplace plan available to me is with Oscar, but it has a high deductible of $9,200. The agent I spoke with told me that, due to my unemployment benefits, I don’t qualify for financial assistance.

I’m torn between enrolling in this expensive plan or going without insurance and hoping I find a job with benefits soon. New Jersey has a penalty for being uninsured, but I’m not sure how much it is or how it works.

Would it be worth skipping insurance and taking the risk for now, or should I enroll just to avoid the penalty? Any advice or guidance would be greatly appreciated!

Did the marketplace actually say you’re ineligible for tax credits based on your income?

Koa said:
Did the marketplace actually say you’re ineligible for tax credits based on your income?

According to the agent, I don’t qualify. He mentioned that since I opted to have taxes withheld from my unemployment checks, there’s nothing else he can do.

@Mai
That doesn’t sound right. What’s your total income?

Koa said:
@Mai
That doesn’t sound right. What’s your total income?

Right now, my weekly unemployment benefit is $769, and I have about 8–9 weeks of benefits left for 2025.

Mai said:

Koa said:
@Mai
That doesn’t sound right. What’s your total income?

Right now, my weekly unemployment benefit is $769, and I have about 8–9 weeks of benefits left for 2025.

If that’s your only income, you should qualify for tax credits or even Medicaid. Go to the marketplace website, enter your projected income, and see what it says.

@Mai
I’d get a new broker. Better yet, apply directly on the marketplace website before midnight. You likely qualify for assistance.

When did your coverage under your parents’ plan officially end? You actually have a 60-day Special Enrollment Period (SEP) for losing coverage, so you might not need to rush today.

If you sign up today, your plan will start tomorrow. But if you delay a bit, the earliest your plan would start is March 1. That’s not necessarily a bad thing if you need more time to weigh your options. Also, if your parents’ plan offers COBRA, you might be able to elect that retroactively if you have a major medical event and need immediate coverage.

Have you tried entering your info at healthcare.gov or GetCoveredNJ? Based on your income, you should qualify for tax credits or even NJ FamilyCare (Medicaid).

Regarding the penalty, New Jersey allows a 3-month exemption for being uninsured. If you go without insurance for just January and February, you may not owe anything, as long as you enroll by March.

@Zephyr
My parents’ insurance ended on 12/31/24. Does the 60-day SEP apply from that date or from the end of open enrollment (1/31/25)?

My mother’s plan offers COBRA, but it costs about $1,000 per month for me. If I don’t sign up for a plan today and end up getting a job with a 90-day waiting period for employer benefits, would I have to pay for COBRA in the meantime or just take the tax penalty?

@Mai
Your SEP is 60 days from when your parents’ coverage ended (so until early March). But if you sign up during open enrollment today, your coverage starts tomorrow, whereas with an SEP, it wouldn’t begin until March 1.

Go to the official state exchange (GetCoveredNJ) and enter your income. You may actually qualify for Medicaid or tax credits.

If you get a job soon but need to wait 90 days for benefits, you could:

  1. Stay uninsured for up to 3 months and possibly qualify for the penalty exemption.
  2. Sign up for a marketplace plan for a few months and cancel when you get employer coverage.
  3. Use COBRA retroactively if you suddenly need care (but only for major medical events).

@Mai
Your SEP is based on when your parents’ coverage ended (12/31/24), so you have until early March to enroll. If you enroll today, your plan starts tomorrow. If you wait, your plan wouldn’t start until March.

COBRA is always an option, but it’s expensive. The key benefit is that you can elect it retroactively. So, if you remain uninsured but suddenly need care, you could pay for COBRA for those months and have it backdate to when you lost coverage. But it only makes sense for major medical events, not for routine care.

If you go uninsured for just Jan and Feb, you should qualify for the short-gap exemption and avoid the penalty. If you still don’t have employer coverage by March, you should enroll in a marketplace plan to stay covered.

You should qualify for either Medicaid or marketplace subsidies. Who told you unemployment makes you ineligible? That’s exactly the type of situation subsidies are designed for.