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Medicare in New Jersey

As a New Jersey Medicare beneficiary, it’s important for you to familiarize yourself with the various parts of Medicare to get a better understanding of what your health insurance benefits entail. In brief, New Jersey Medicare encompasses Original Medicare, Part A and Part B, as well as private health insurance through Medicare Advantage (Medicare Part C), and prescription drug coverage under Medicare Part D.

Original Medicare for New Jersey beneficiaries

Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) together form Original Medicare. Original Medicare is available to US citizens 65 and older and certain people under 65 with qualifying disabilities. New Jersey Medicare beneficiaries are eligible to join Original Medicare during the Initial Enrollment Period, which begins three months before a person turns 65 and ends four months after that date. Medicare beneficiaries in New Jersey can also join Medicare during the General Enrollment Period, which takes place every year from January 1 to March 31. However, if you miss your seven-month Initial Enrollment Period and end up joining Medicare at a later date, you will probably have to pay a late-enrollment penalty.

New Jersey Medicare beneficiaries, like those in other states, are generally eligible to enroll in Medicare Part A premium-free, even though there are some exceptions to this rule. Medicare Part A in New Jersey offers the following health coverage:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care
  • Hospice care
  • Home health services

Medicare Part B, also part of Original Medicare, offers medical insurance with a monthly premium. As a New Jersey Medicare Part B beneficiary, you’re eligible to receive the services and supplies listed below:

  • Clinical research
  • Ambulance services
  • Durable medical equipment
  • Mental health (inpatient, outpatient, and partial hospitalization)
  • Getting a second opinion before surgery
  • Limited outpatient prescription drugs

Medicare private insurance in New Jersey

Medicare Advantage is private health insurance, and it is required by the government to offer at least the same coverage as Original Medicare, Part A and Part B. As a New Jersey Medicare beneficiary, you can also add extra coverage to your Medicare Advantage plan, like dental, vision, and hearing benefits.

If you’re a New Jersey Medicare beneficiary seeking private health and prescription drug coverage through a single health plan, you can enroll in a Medicare Advantage Prescription Drug plan. But note that even if you join a Medicare Advantage plan or a Medicare Advantage Prescription Drug plan, you have to stay enrolled in Original Medicare and continue paying the Medicare Part B premium to keep your health insurance coverage.

As a New Jersey Medicare beneficiary, you will incur various out-of-pocket expenses associated with Original Medicare, like coinsurance, copayments, and deductibles. To get help paying for such expenses, you can enroll in a Medicare Supplement plan (also known as Medigap), available through private insurance companies.

In New Jersey, as in other states, you can also sign up for separate prescription drug coverage through Medicare Part D, which is also offered by private insurance companies. New Jersey Medicare Part D Prescription Drug Plans have different costs, depending on the extent of the coverage you select, but most plans require payment of a monthly premium, annual deductible, and copayment or coinsurance.

As a New Jersey resident, you can choose from various Medicare Advantage plans, depending on the county in which you live. If you live in Newark, in Essex County, for example, you may have different Medicare plan offerings than someone living in Jersey City, in Hudson County. Considering the big choice of New Jersey Medicare Advantage plans, it’s essential to customize your search for plans based on your individual health and prescription needs.

For more information about private Medicare insurance for New Jersey beneficiaries, please see:

New Jersey resources for Medicare beneficiaries

There are a number of resources designed to help New Jersey Medicare beneficiaries with Medicare-related issues and concerns. Here are some of the resources that may be helpful to you: