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New Jersey Medicare Supplement (Medigap)

Last Updated on

October 6, 2016

If you’re a Medicare beneficiary in New Jersey and need help with your Medicare out-of-pocket costs, you want to consider getting a Medicare Supplement (Medigap) plan. Medigap plans in New Jersey (as in the other states) can help you pay for expenses associated with Original Medicare, Part A and Part B, such as copayments, coinsurance, and deductibles.

How Medigap plans work in New Jersey

There are 10 standardized Medicare Supplement plans available in 47 states, including New Jersey. Each Medigap plan is identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), with plans of the same letter offering the same benefits. For example, a Medigap Plan D in Newark has the same benefits as a Medigap Plan D in Woodbury – or even in other states where Medigap Plan D is available. Please note, however, that Medigap Plan D is distinct from Medicare Part D (prescription drug coverage), although their names sound similar.

Three states have their own standardized Medicare Supplement plans: Massachusetts, Minnesota, and Wisconsin.

If you’re interested in a Medigap plan, you can sign up during the six-month Medigap Open Enrollment Period, which begins the first day you are both at least 65 years old and enrolled in Medicare Part B. During these six months, you can sign up for any Medigap plan available in your area, without being denied coverage for pre-existing conditions or medical underwriting. There may be a waiting period for certain coverage in some cases.

However, if you decide to join a Medicare Supplement plan in New Jersey after your Medigap Open Enrollment Period has ended, the health insurance company may consider your health status and history. As a result, you may be charged more for your insurance plan or even be denied coverage altogether. Keep in mind that you must already be enrolled in Original Medicare, Part A and Part B, to sign up for a Medigap plan in New Jersey (or in any state).

Since Medigap plans are designed to supplement Original Medicare (and not replace it), you must stay enrolled in Original Medicare, and keep paying your Medicare Part B premium, to retain your health insurance coverage. You may also want to sign up for a stand-alone Medicare Part D Prescription Drug Plan to help cover your medication costs –Medigap plans sold currently don’t offer such coverage.

Types of Medigap plans in New Jersey

Familiarize yourself with Medigap by taking a look at the 10 types of standardized Medicare Supplement plans available in the state. Not every plan is necessarily available in all parts of New Jersey. In the table below, please note that an X indicates that the Medigap plan covers the service or item, while a blank cell means the plan doesn’t cover it.

 

Medicare Supplement Plans
Medicare Supplement Benefits A B C D F* G K L M N
Medicare Part A coinsurance and hospital costs up to an additional
365 days after Medicare benefits are exhausted
X X X X X X X X X X
Medicare Part B copayment or coinsurance X X X X X X 50% 75% X X***
First three pints of blood X X X X X X 50% 75% X X
Medicare Part A hospice care coinsurance or copayment X X X X X X 50% 75% X X
Skilled nursing facility (SNF) care coinsurance X X X X 50% 75% X X
Medicare Part A deductible X X X X X 50% 75% 50% X
Medicare Part B deductible X X
Medicare Part B ‘excess charges’ X X
Foreign travel emergency coverage (up to plan limits) 80% 80% 80% 80% 80% 80%
Medicare Part B preventive care coinsurance X X X X X X X X X X
Out-of-pocket limits apply**

 

For the most comprehensive coverage, you may want to consider Medicare Supplement Plan F, which covers almost all of the Medicare out-of-pocket costs listed above. Like other Medigap plans, Plan F doesn’t cover the Medicare Part B premium.

Also note that Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for copayments up to $20 on some office visits and up to $50 on emergency room visits. Medicare Supplement Plan K and Plan L have out-of-pocket limits that are subject to change each year. 

Choosing a suitable Medigap plan in New Jersey

Medicare Supplement plans named with the same letter have the same coverage, as explained earlier. However, each insurance company that offers Medicare Supplement plans can determine its own monthly premium structure. This means that if you live in Princeton in Mercer County, you may pay more or less than a resident of Newark in Essex County for an identical Medicare Supplement plan. Keeping in mind the possible differences in costs, it may be smart to compare all Medicare Supplement plans available in your area in order to choose a Medigap plan that may suit your budget and health requirements.

You can start comparing Medigap plans in New Jersey right now —  just enter your zip code in the box on this page.

For more information about Medicare coverage options in New Jersey, see Medicare Advantage in New Jersey.

 

 

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.