Medicare Advantage in New Jersey

Medicare Advantage (Medicare Part C) is an alternative health insurance option for Medicare beneficiaries enrolled in Original Medicare, Part A and Part B. Medicare Advantage is private insurance required by law to offer at least the same benefits as Original Medicare. Like residents of other states, New Jersey residents enrolled in Medicare Advantage are covered through their individual health plans and not directly through Medicare. Health plan options depend on the zip code in which the Medicare beneficiary resides.

How Medicare Advantage works in New Jersey

Original Medicare consists of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). If you're seeking additional benefits that aren't available under Original Medicare, you may want to consider signing up for a New Jersey Medicare Advantage plan. Offered by private insurance companies in New Jersey, Medicare Advantage plans cover the hospitalization and medical benefits offered by Original Medicare, usually with extra benefits like dental, hearing, and vision services.

You can sign up for a New Jersey Medicare Advantage plan if you:

Your first opportunity to enroll in a Medicare Advantage plan is during your Initial Coverage Election Period (ICEP):

Another opportunity to join a Medicare Advantage plan is during the Annual Election Period, also called the Open Enrollment Period, which runs from October 15 to December 7 each year. If you're already enrolled in a Medicare Advantage plan and wish to switch plans, you can make the change during the Annual Enrollment Period. Your new coverage begins on January 1 of the following year if you join or switch Medicare Advantage plans during the Annual Election Period.

Sometimes, circumstances may effectively force you to change Medicare plans. Examples of these events include moving to a new address, losing your current coverage, qualifying for other coverage, or changes in your current plan that affect your health benefits. If you find that you have to change plans, you may qualify for a Special Enrollment Period; call your plan or contact Medicare and ask for assistance.

If you're enrolled in a New Jersey Medicare Advantage plan and decide to switch back to Original Medicare, Part A and Part B, you're allowed to do so during the Medicare Advantage Disenrollment Period, which runs from January 1 to February 14 each year. Original Medicare doesn't include prescription drug coverage, so you can add an optional stand-alone Medicare Prescription Drug Plan (Part D) during this period.

Types of Medicare Advantage plans in New Jersey

New Jersey Medicare Advantage plan options vary in New Jersey, and they include, among others, Health Maintenance Organizations (HMOs), Preferred Provider Organization (PPO) plans, Special Needs Plans (SNPs), Private Fee-for-Service (PFFS) plans, and Medical Savings Account (MSA) plans.

You may decide you need prescription drug coverage with your health insurance. If so, you can select a New Jersey Medicare Advantage plan that includes such coverage. These insurance plans are known as Medicare Advantage Prescription Drug plans, and they combine health and prescription drug coverage into a single plan. Most Medicare Advantage plans include this coverage, but check the plan's policy before you sign up to make sure it covers your medications if you want this benefit.

Remember that if you enroll in a Medicare Advantage plan, you have to stay enrolled in Original Medicare and continue paying your Medicare Part B premium.

Comparing Medicare Advantage plans in New Jersey

Medicare Advantage plans in New Jersey may have different services and details depending on the insurance companies that offer these plans. In addition, these details may change on a yearly basis, so it's always a good idea to keep up with any policy changes and how they may affect your specific health needs

The availability and costs of Medicare Advantage plans varies depending on where you live and on what companies offer the plans. Some plans may offer premiums as low as $0, but do keep in mind that you must continue paying your Medicare Part B premium, no matter which Medicare Advantage plan you choose.

You also need to decide whether or not you want prescription drug coverage with your Medicare Advantage policy, and whether the plan covers the medications you take and the other benefits you may need, such as dental services. With all these options, you can see why it can be important to compare plans with the benefits and costs best suited to your specific health needs.

To start comparing plans or learn more about Medicare Advantage:

Medicare has neither reviewed nor endorsed this information.

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