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Individual Health Insurance Open Enrollment 2021

“Open enrollment” is basically a household word now, but there is still lots of confusion, especially this year with all the changes going on. Here’s a recap of why the next month is critical for which healthcare you’ll be enrolling in for 2021.

Individual health insurance is a health policy that you can purchase for just yourself or for your family. Individual policies are also called personal health plans. Open enrollment is the period every year when individuals and families can enroll in a health insurance plan. This is the opportunity to switch plans, add family members and apply for financial aid. In most states, open enrollment runs from November 1 to December 15, but in New Jersey, the deadline isn’t until January 31. You don’t want to miss this because you will not be able to upgrade or switch plans unless you have a qualifying event.

Get Covered NJ—New Marketplace

The good news is New Jersey is on a new marketplace, and it’s called Get Covered NJ. Cosmo is your preferred local assistance for Get Covered NJ. There is an array of good individual health care options available for you from various reputable carriers. We at Cosmo know these options inside out and will guide you towards the best one for you.

Also, keep in mind if you have an existing plan from healthcare.gov and are typically auto-renewed in coverage, you will be auto-enrolled in the same or similar plan for 2021 on Get Covered NJ. This is the only place where you can apply for financial help (subsidy) to lower the cost of your health insurance monthly premiums. Eligibility for a subsidy is based on the applicant’s household income.

What Information Is Needed to Enroll in a Health Insurance Plan?

Cosmo provides a safe way to enroll for health insurance this year. You can enroll online or over the phone.

Name, social security number, birthday, address and email address.

Household size and income, only if you’re planning to apply for premium subsidies. You can use pay stubs, W2s and your most recent tax return to prove your income.

Payment information that will be used to charge your insurance premiums.

Your doctors’ names and zip codes so that you can make sure they’re in-network with the health plans you’re considering.

A list of medications taken by anyone who will be covered under the policy, so that you can check to see which one will best cover the medications you need.

If you want to enroll in a catastrophic plan and you’re 30 or older, you’ll need a hardship exemption.

Special Enrollment Period—Qualifying Events

The special enrollment period (SEP) is a time outside the yearly open enrollment period when you can either modify your current plan or enroll in a new one. There are a few requirements that allow you to be eligible for special enrollment. They include losing your previous health plan, moving to a different state, getting married, giving birth or adopting a child. You are eligible for special enrollment for up to 60 days after the event, and you must wait until the next open enrollment if you don’t enroll in the specified time period.

Events that qualify:

Loss of coverage

Gaining/becoming a dependent

Gaining access to new plans due to a permanent move to New Jersey

Recently getting married or separated/divorced

Loss of eligibility for APTC or CSR

Medicaid/NJ Family Care denial

Experiencing domestic violence or the desertion of spouse and offspring

Bottom Line

There are two dates that your health insurance plan can take effect, either January 1, 2021, or February 1, 2021. For your insurance to take effect on January 1you would have to have enrolled by December 31, 2020, and to be effective for February 1 you need to enroll by January 31, 2021.

Plans and rates change each year, so you could be saving money. Make sure you compare plans during open enrollment. A little time and effort now can make a great difference throughout the next year, both financially and with your healthcare quality. We are proud to share that we have representatives fluent in Spanish, Mandarin and Cantonese.

Just give Cosmo Insurance Agency a call. We will simplify the process for you!


Mark Herschlag is CEO of Cosmo Insurance Agency, which is based in Ocean County. Cosmo Insurance Agency offers personalized solutions for individuals and businesses looking to obtain health, life, dental, long-term care or disability insurance. For more information or for a free, no-obligation quote, please call 201-817-1388 or email [email protected].

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