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COVID-19 and Health Insurance FAQS

Will my insurance cover testing for COVID-19?
The State of New Jersey has instructed state-regulated health insurance companies to waive consumer cost-sharing (co-payments, deductibles or co-insurance) for medically necessary COVID-19 testing. This means that consumers may not be charged out of pockets costs for medically necessary COVID-19 testing.

This waiver covers emergency room, urgent care, and office visits related to COVID-19 testing for the following groups:

  • the state’s individual, small and large group markets;
  • the State Health Benefits and School Employee Health Benefits Plans;
  • NJ FamilyCare populations; and
  • those eligible for the Charity Care program. 

Additionally, to ensure that individuals who are uninsured have access to testing for COVID-19, the Murphy Administration required hospitals and Federally Qualified Health Centers (FQHCs) to waive patient fees for testing and related diagnostic services for those who lack health insurance.

What do I do if my health coverage is through a self-funded plan, a federal health plan (military or veteran), or a health-sharing ministry?
The Department does not regulate self-funded plans, federal health plans or health-sharing ministries. However, note that the Families First Coronavirus Response Act establishes requirements for providing coronavirus diagnostic testing at no cost to consumers in certain plans not regulated by the Department.  Contact your employer or health insurer to find out what is covered by your health plan.

What should I do if I don't have health insurance or if I lose coverage?
As part of the state’s overall response to the coronavirus pandemic, New Jersey opened a new COVID-19 Special Enrollment Period for New Jerseyans who need coverage to enroll in a health plan until May 15, 2021. All eligible residents can enroll now through Get Covered New Jersey, the state’s official health insurance marketplace, and coverage will start on the first day of the month following your plan selection.

Start now at GetCovered.NJ.gov

The press release announcing the COVID-19 SEP may be found here.

If you do not have health insurance, or lose coverage, you may be eligible for free or low-cost coverage (www.njfamilycare.org) through NJ FamilyCare, New Jersey's publicly funded health insurance program. NJ Family Care includes CHIP, Medicaid and Medicaid expansion populations and covers doctor visits, prescriptions, vision, dental care, mental health and substance use services and even hospitalization.

Visit GetCoveredNJ (www.getcovered.nj.gov) for more information.

Note: State and federal law also require that most employees and dependents who lose health coverage under an employer’s group health plan be given the opportunity to continue coverage for a period of time. Under the federal law (COBRA) and state law, the person electing to continue coverage can be required to pay the full premium plus a 2% administrative fee. You can contact your employer or benefits administrator for more information.

Who should I contact if I need assistance with information about my health coverage options?
Health insurance can be confusing, and sometimes it’s hard to choose between all the plans that are available. GetCoveredNJ, the state’s official health insurance marketplace, has a network of trained professionals who can help you enroll at no cost. You can find a certified Assister or Broker in your area who can guide you through the application and help you find the right plan on the Get Covered New Jersey website: https://nj.gov/getcoverednj/help/local/

Who should I contact about my health insurance complaints?
Residents who have questions or concerns about insurance or any entity regulated by the Department may contact the our Consumer Hotline at 1-800-446-7467 (8:30 am to 5:00 pm EST Monday-Friday), or go to the department website and click on Consumer Assistance - Inquiries/Complaints, at https://www.dobi.nj.gov

Where can I go to learn more about the spread of COVID-19 and the measures I can take to protect myself and my family?
Residents may visit the New Jersey Department of Health website (www.nj.gov/health) for COVID-19 updates and information on how to prevent the spread of the virus. For more information on the coronavirus, including testing and vaccine locations, visit the New Jersey COVID-19 Information Hub at https://covid19.nj.gov/

 
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