Many New Jersey residents have switched from Original Medicare to Medicare Advantage plans. According to New Jersey’s enrollment data, there are 485,468 active enrollees with a participation rate of 34%.
New Jersey Medicare Advantage plans, or Medicare Part C plans, offer benefits beyond Medicare Part A and B. These plans pay for costs not covered by Medicare. However, before enrolling in a plan, you must understand how Medicare Advantage coverage works and the types of plans available.
Medicare Advantage plans can offer a comprehensive plan by combining Medicare Part A, Part B, and Part D into one. Unlike Original Medicare, private insurance providers offer Medicare Advantage plans, and there are over 50 plans available in New Jersey. It’s essential to read the summary of benefits carefully before enrolling in any of these plans because they differ from carrier to carrier.
The federal government standardizes Medicare Advantage plans since they must offer at least what Original Medicare does. All the information and data shown below are from one zip code in New Jersey. There may be slight variations between zip codes.
The Medicare Advantage plans below offer zero-dollar premium rates, zero-dollar drug deductibles, 1 to 5-star ratings, and Medicare Part B reductions.
Typically, Medicare Advantage plans with no premiums will have higher out-of-pocket expenses. Plans can have copayments, coinsurance, and deductibles. These costs may be your responsibility, depending on the plan you choose.
If you’re looking for zero-dollar premiums, Aetna PPO plans have a maximum out-of-pocket (MOOP) limit of $7,550, with no monthly premiums and a 4-star rating. Plus, Aetna lets you visit outside providers that accept Medicare.
HMO plans by Cigna have a MOOP limit of $7,200, with zero-dollar premiums and a 4-star rating. Cigna offers a vast network of doctors.
Another plan to consider is Amerigroup’s HMO, which has a MOOP limit of $6,950, with zero-dollar premiums and a 3-star rating. Amerigroup allows you to choose the primary care provider for your regular care.
Lastly, PPO plans offer direct access to specialists without a referral. This plan has zero-dollar premiums, with a MOOP limit of $7,550 and a 4-star rating.
PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
Aetna | $0 | $7,550 | LOCAL PPO | 4 |
Cigna | $0 | $7,200 | HMO | 4 |
Amerigroup | $0 | $6,950 | HMO | 3 |
$0 | $7,550 | LOCAL PPO | 4 | |
Clover Health | $0 | $7,550 | LOCAL PPO | 3 |
Medicare Part D is a plan for prescription drugs. New Jersey Medicare Advantage plans with a zero-dollar drug deductible might be right for you if you require frequent medication.
Cigna offers an HMO plan with no monthly premiums, a 4-star rating, and a $7,200 MOOP limit. PPO plan has a MOOP limit of $7,550, zero monthly premiums, and a 4-star rating. Lastly, the Humana PPO plan has zero monthly premiums, a 4-star rating, and a MOOP limit of $6,700.
PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
Cigna | $0 | $7,200 | HMO | 4 |
$0 | $7,550 | LOCAL PPO | 4 | |
Humana | $0 | $6,700 | LOCAL PPO | 4 |
Cigna | $30.00 | $7,300 | LOCAL PPO | 3 |
Cigna | $$60.00 | $6,200 | HMO | 4 |
Notably, these plans vary by zip code, and not all areas offer programs with Part B reductions. Therefore, even if Part B reductions are available in some parts of New Jersey, they may not be available everywhere.
PLAN | PREMIUM | MOOP | PART B REDUCTION | STAR RATINGS |
Aetna | $0 | $7,550 | $40.00 | 4 |
Wellcare | $0 | $7,550 | $60.00 | N/A |
Clover Health | $0 | $7,550 | $70.00 | 3 |
Humana | $0 | $6,700 | $60.00 | 4 |
$0 | $6,700 | $35.00 | 4 |
Medicare Advantage plans are a viable alternative to Original Medicare. Unlike Medicare Supplement and prescription drug insurance, these policies have zero or low premiums. Medicare Advantage offers an all-in-one plan with ancillary coverage for dental, vision, hearing, and prescription drug benefits.
The following cities in New Jersey have helpful charts created to show estimated premiums for Medicare Supplemental coverage:
The benefits of your Medicare Advantage plan may differ depending on your zip code. But don’t worry, there are a few plans out there that even include a grocery allowance! Fill out the form below and to find details about the NJ grocery allowance for seniors in your area.
Over 50 Medicare Advantage plans are available throughout New Jersey. Star ratings are crucial for assessing coverage, customer satisfaction, and overall performance before choosing a Medicare Advantage plan. Additionally, you need to factor in your medical needs and pick the plan that best suits you.
is the most popular Medicare Advantage plan in New Jersey. plans are excellent for those seeking a balance between benefits and costs.
Aetna offers the cheapest Medicare Advantage plan in New Jersey. Plans have affordable rates, good coverage, and substantial benefits. Some plans are available for $0, so there is no extra cost over what you pay for Original Medicare. Aetna also offers several plans with low deductibles, which helps you avoid significant medical expenses.
Yes. The Social Security Administration automatically deducts the premium from your monthly benefit if you enroll in Social Security and Medicare Part B. Additionally, Social Security can also automatically deduct Medicare Advantage plan premiums. Contact your provider and ask them to make the payment arrangements.
Yes. The State of New Jersey will pay your Part B premium if your household income in 2022 does not exceed $18,348 (for singles) or $24,720 (for married couples) and you have no more than $8,400 in assets, including a home and car. Healthcare expenses will save you at least $1,800 yearly, and lower-income individuals could save even more.
Every person’s health needs and budget differ, so you will want to research Medicare Advantage plans carefully.
Remember that plan costs, benefits, and provider networks vary, so you should review your coverage yearly to ensure it meets your needs. Our licensed insurance agents will compare New Jersey Medicare Advantage plans to find the right plan that works for you.
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Written By:
Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
Reviewed By:Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.
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