Medicare Advantage Plans in New Jersey

Learn about top companies, best plan types, price comparisons, and when to enroll in a New Jersey Medicare Advantage plan.

Medicare Advantage in New Jersey is one type of Medicare coverage available for Medicare beneficiaries. Original Medicare includes Part A and Part B, whereas a Medicare Advantage plan is Part C.

Medicare Part C is becoming increasingly more popular than original Medicare year after year because it is an “all in one” alternative Medicare additional coverage. A Medicare Advantage plan is a bundled plan that includes the following:

– Medicare Part A – Hospital Insurance

– Medicare Part B – Medical Insurance

– Medicare Part D – Medicare Prescription Drug Coverage

– Medicare Advantage plans specified as “MAPD” or Medicare Advantage Prescription Drug plans include the Part D plan prescription benefits built into the plan.

– Certain plans include the following coverage options for things such as:

  • Vision
  • Hearing
  • Dental
  • Gym memberships
  • Over-the-counter prescription allowances
  • Meal delivery
  • Transportation to medical appointments

Note: If you have End-Stage Renal Disease or disabilities, you still qualify for a New Jersey Medicare Advantage plan. You will still qualify even if you are under 65 and have End-Stage Renal Disease.

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Top-rated Medicare Advantage Companies in New Jersey

Popular Medicare Advantage Plan Types in New Jersey

Best network freedom: Medicare Advantage PPO

PPOs offer a more extensive network and no referrals for Medicare beneficiaries with their primary care physicians. Premiums for PPO plans range from $0 to $100 per month.

Best for lowest out-of-pocket: Medicare Advantage HMO Plan

HMO plans generally have premiums of $0 per month and lower out-of-pocket costs because it uses the HMO referral process.

Best for low-income or health conditions: Medicare Advantage D-SNIP

Best for those on minimal income or who have chronic health conditions. Medicare and Medicaid can be combined to help lower healthcare costs of copayments, coinsurance, monthly premiums, Part B premiums, etc.

New Jersey Enrollment Facts

1. Number of people enrolled in Medicare Advantage in New Jersey: 518,295

2. Number enrolled by plan, specifically the three plans below:

Local HMO – 172,536

Local PPO – 158,229

Regional PPO – 2,650

3. Percentage of Medicare beneficiaries enrolled in Medicare Advantage in New Jersey: 32%

4. Number of people enrolled in Medicare Advantage nationwide: 29.5 million in 2022

5. Percentage of Medicare beneficiaries enrolled in Medicare Advantage nationwide: 42%

How much does Medicare Advantage in New Jersey cost?

Although most states have an HMO available with a $0 per month premium and PPOs with $0 per month premiums, it’s becoming increasingly more common for a PPO to have a premium.

The average cost for a Medicare Advantage Prescription Drug Plan (MAPD) in New Jersey is about $27. Part D has average drug deductible of $200.

The standard monthly Medicare Part B premium for 2023 is $164.90. The annual Part B deducible for 2023 is $226.00.

How much do Advantage Plans cost in New Jersey?

PPO Plan $0.00 to $27.00

HMO Plan $0.00

When can I enroll in a Medicare Advantage plan?

Joining a Medicare Advantage plan can only be done at three particular points in the year.

Initial Enrollment Period

When you first have Medicare eligibility (becoming 65), you may join Medicare Part A and B.

Open Enrollment Period/Annual Election Period (AEP)

This period is open from October 15th through December 7th every year. You can join or drop a plan during this time and make changes. Coverage starts January 1st of the new year as long as the plan is completed by December 7th.

Open Enrollment for Medicare Advantage

The OEP period goes from January 1st through March 31st every year. You can switch to another plan or to Original Medicare and join a Medicare Supplement policy during this time.

Special Enrollment Periods (SEP)

When certain events happen in your life, you can make changes to your Medicare Advantage and Medicare prescription drug coverage. These times include:

  • Change of Address/Moving out of Service Area
  • Loss of Current Coverage
  • Opportunity to Get Other Coverage-Employer/TRICARE/VA/PACE
  • Your Plan Changes Its Contract with Medicare

Other special considerations may include eligibility for both Medicare and Medicaid, qualification for Extra Help, enrollment in the State Pharmaceutical Assistance Program, drop of a Medigap Policy, have a disability, or SNP (special needs).

5-star Special Enrollment Period

Satisfaction surveys are used to rate plans and help you compare plans based on quality and performance. A 5-Star rating is the highest rating. This star rating enrollment period can only be used once, from December 8th through November 30th. For more information about 5-Star enrollment, visit here.

Special Enrollment Periods if you get “Extra Help.”

If you get extra benefits, then special enrollment periods are available for the following:

– Eligibility for both Medicare and Medicaid

– Qualification for Extra Help

– Enrollment in State Pharmaceutical Assistance Program

Ready to learn more?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Call us today, or request a quote online to learn more about plan options.

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