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About State-Run Health Insurance Plans in New Jersey

New Jersey has a robust and competitive private health insurance market, and many New Jersey residents obtain coverage through employer group plans as well. Some residents, however, fall through the cracks. Thus, the state has implemented other programs to address the needs of residents who have pre-existing health conditions that make it impossible for them to find private coverage, and programs to provide coverage to pregnant women, children, low-income familes, the elderly and the handicapped.

  1. NJ Protect

    • NJ Protect is the state of New Jersey's health insurance pool for high-risk individuals. New Jersey residents who have certain health risk factors or pre-existing conditions that make it impossible for them to obtain coverage from private health insurers can apply to NJ Protect. Generally, you cannot apply at NJ Protect unless you have been declined for coverage in the private market. Premiums range from $212 to $768 per month as of 2011, and are subsidized by the federal government.

    NJ Family Care

    • The NJ FamilyCare program exists to help make health coverage affordable for families with children. Eligible New Jersey families with low incomes can qualify for free or reduced-price coverage through NJ FamilyCare. The plan covers children from families with incomes of up to 350 percent of the federal poverty level. NJ FamilyCare also covers parents with incomes of up to 133 percent of the federal poverty line. The poverty line is different for families of different sizes. The more family members, the more money the family can earn and still qualify for benefits.

    New Jersey Medicaid

    • New Jersey Medicaid is a federally-subsidized, state-administered program to provide basic medical coverage to children, the very poor, the elderly, disabled and blind. Generally, to qualify for New Jersey Medicaid, applicants must have low incomes, little in the way of personally owned assets, and be uninsured.

    Programs for Pregnant Women

    • NJ Medicaid also provides special programs to assist pregnant women and mothers of young children. If a mother is eligible for Medicaid at the time of a child's birth, Medicaid also covers that child for a period of one year, regardless of other insurability factors. To be eligible for Medicaid, the pregnant woman must show a household income of 200 percent of the federal poverty line or less. For single pregnant women with no other children, that translates to a monthly income of $2,429. Note that this guideline is more lenient than for parents in the NJ FamilyCare program who are not pregnant.

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