Medicare Advantage Plans in New Jersey
Key Takeaways
- Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plans are available throughout New Jersey as an alternative for those who have Parts A and B of Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). .
- Medicare Advantage plans substitute for Original Medicare, providing at least the same coverage as Parts A and B and often additional benefits.
- Medicare Advantage plans offer the protection of an out-of-pocket maximumThe maximum amount of money an individual will pay towards out of pocket expenses like deductibles, copayments, and coinsurance. .
- New Jersey residents seeking drug coverage can either switch to a Medicare Advantage plan with Part DMedicare Part D is prescription drug coverage for people enrolled in Medicare. Part D is optional and is offered by private insurance companies. coverage or add a standalone Part D plan to Original Medicare.
New Jersey Medicare Advantage Plan Coverage
If you live in New Jersey and have Parts A and B of Original Medicare, you qualify for coverage from a Medicare Advantage plan in New Jersey. In 2024, 100% of people with Medicare in New Jersey had access to a Medicare Advantage plan.
While Original Medicare is administered by the federal government, Medicare Advantage provides an alternative from private insurance companies. Plans must offer at least the same coverage as Parts A and B, and many feature additional benefits, such as dental and vision care.
- Part A of Original Medicare, commonly referred to as hospital insurance, covers inpatient hospital stays.
- Part B of Original Medicare, commonly known as medical insurance, covers outpatient services like doctor visits and durable medical equipment.
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NJ Medicare Advantage Plan Costs
Some Medicare Advantage plans in New Jersey help pay your Part B premium.
In 2024:
- The average monthly premium for a Medicare Advantage plan in New Jersey was $19.22.
- 100% of Medicare-eligible New Jerseyans had access to at least one Medicare Advantage plan with a $0 monthly premium.
One thing that is universal about Medicare Advantage plans is the presence of an out-of-pocket maximum, a feature that tells you the most you’ll have to pay out of pocket over the benefit year. Original Medicare doesn’t offer the protection of an out-of-pocket maximum.
Medicare Advantage Plan Eligibility and Enrollment in New Jersey
Want to enroll in Medicare Advantage in NJ?
The state of New Jersey had 96 Medicare Advantage plans in 2024. According to the Centers for Medicare and Medicaid Services (CMS), 15 of the plans offered reduced cost-sharing and other innovative benefits for people who receive Extra Help, also called low-income subsidies, or who live with chronic illnesses.
Your first chance to enroll in a Medicare Advantage plan aligns with when you first enroll in Medicare Part A and B. This is called your Initial Coverage Election Period (ICEP).
- If you enroll in Parts A and B of Original Medicare when you turn 65, you have the option at the same time to switch to a Medicare Advantage plan that replaces Original Medicare. This option extends to three months after the month you turn 65.
- If you don’t enroll in Parts A and B when you turn 65, then you’ll still get an ICEP once you do. Whatever date you will first be in both Parts A and B, the three months leading up to that date provide a window to switch to a Medicare Advantage plan that will take effect on the date you were set to have both Parts A and B for the first time.
If you utilize this period, which runs from January 1 to March 31 each year, then you’ll be covered by both Parts A and B for the first time on July 1. Then, from April 1 to June 30, you’ll have an ICEP that allows you to switch to Medicare Advantage (with that same July 1 start date).
If you didn’t utilize an ICEP to enroll in Medicare Advantage, you still have the option to do so during the Annual Enrollment Period that runs from October 15 to December 7 each year.
Now that you know when you can enroll in Medicare Advantage, you need to know how.
One simple approach: Reach out to a GoHealth licensed insurance agent to check your eligibility and begin your enrollment.
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Find My Ideal Plan Are There New Jersey Medicare Advantage Plans With Prescription Drug Coverage?
The large majority of Medicare Advantage plans in New Jersey offer prescription drug coverage. This is among the reasons why some people prefer Medicare Advantage: It often bundles Part A and B coverage with Part D drug coverage (among other services), while with Original Medicare you must add a standalone Part D plan if you want drug coverage.
For those who prefer Original Medicare, private insurance companies offer stand-alone Part D plans in New Jersey. A GoHealth licensed insurance agent can help you find the right drug coverage for you, whether it’s stand-alone or part of a Medicare Advantage plan.
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
- FACT SHEET. CMS.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.