New Jersey Medicare insurance offers more affordable health insurance for those who are at least 65 years old, although younger, working individuals with specific disabilities may be eligible as well. The cost of Medicare is much more manageable, as the premiums are much lower than other health insurance plans in the state.
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New Jersey Medicare Insurance Trends
The Centers for Medicare & Medicaid Services (CMS) reported the following information on 2024 Medicare trends in New Jersey:
- There are 1,711,287 Medicare enrollees in New Jersey.
- The average Medicare Advantage monthly premium increased in New Jersey from $15.64 in 2023 to $19.22 in 2024.
- There are 96 Medicare Advantage plans available in New Jersey for 2022.
- All New Jersey residents with Medicare can buy a Medicare Advantage plan, including those with $0 premiums.
- In 2024, there are 21 different Medicare prescription drug plans offered in New Jersey.
- The lowest monthly premium for a Medicare prescription drug plan is $0.
Medicare Offered in New Jersey
Medicare is a government-sponsored health care program that offers financial assistance to American citizens ages 65 and over or those with disabilities.
Original Medicare
The basic coverage comes from Original Medicare, with its two parts. Medicare Part A covers inpatient care and other hospital services, while Medicare Part B covers medically necessary treatments, supplies, and preventive screenings.
Medicare Part A does not usually require the payment of a premium, though there are exceptions. Medicare Part B generally requires a premium, but this depends on the beneficiary’s annual income.
Both Part A and Part B also require beneficiaries to cover out-of-pocket expenses. These include deductibles, copays, and coinsurance costs.
Medicare Advantage
Medicare Advantage coverage offers a comprehensive plan from private insurers that bundle Part A, Part B, and sometimes prescription drug coverage into a single Medicare Advantage (Part C) plan. CMS contracts these plans to cover the same things as original Medicare.
Some Medicare Advantage plans offer a wide range of coverage, including dental and vision care, non-emergency medical transportation, home meal delivery. These extra benefits come at an additional cost to the plan’s premium price.
One major benefit of Medicare Advantage is that it has annual out-of-pocket spending limits. Once you reach this limit, your coverage will pay 100% of covered expenses. There is no cost associated with additional care that may appear during any month in which the annual benefit has been exhausted.
New Jersey Medicare Advantage options include plans from the following private insurance companies, with ratings:
- United Healthcare – 4/5 stars
- Aetna – 4/5 stars
- WellCare – 3.5/5 stars
- Clover Health – 3.5/5 stars
- Amerigroup Community Care – 3.5/5 stars
- Braven Health
Note that Medicare Advantage plans vary in price, and their plan offerings vary by location.
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Medicare Supplement Plans
Original Medicare coverage may not be comprehensive enough for some Medicare beneficiaries. To cover these gaps, they can obtain supplemental plans for additional coverage that also cover Medicare copayments, coinsurance, and deductibles. These plans are available from private health insurance companies with Medicare approval. Like Medicare Advantage, These plans will also require an additional premium.
New Jersey Supplement options include plans from the following private insurance companies:
- AARP – UnitedHealthcare
- Aetna
- Cigna
- Colonial Penn
- Horizon Blue Cross Blue Shield of New Jersey
- Lumico
- Royal Arcanum
New Jersey Medicare Enrollment
New Jersey citizens are eligible for Medicare if they are a U.S. citizen and above 65 years old or are under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis. Use Medicare’s online eligibility tool if you are unsure if you qualify.
Requirements
- You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
- You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
- You have ESRD or ALS.
Enrollment Period Dates
Initial Enrollment Period
This is a seven-month window that allows you to sign up for a plan
- Begins 3 months before the month you turn 65
- Ends 3 months after the month you turn 65
Medicare Open Enrollment Period
This is when you can sign up for a plan, switch a plan or leave a plan
- Begins Starts October 15th
- Ends December 7th
Special Enrollment Period
Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances.
General Enrollment Period
This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.
- Starts January 1st
- Ends March 31st
Medicare Advantage Open Enrollment Period
This is when you can switch or leave a Medicare Advantage Plan
- Starts January 1st
- Ends March 31st
New Jersey Enrollment Tips & Advice
In New Jersey, qualifying for the MSPs also automatically enrolls the beneficiary in the Low-Income Subsidy (LIS) program. This can pay some or all of the costs of Medicare Part D.
New Jersey also funds a prescription assistance program called Pharmaceutical Assistance to the Aged and Disabled (PAAD). This program pays for the Medicare Part D premium and all the “wrap-around” costs during the Part D deductible, coinsurance, and “donut-hole” phases.
Additional resources:
- Medicare Information & Referral Service/SHIP
- Aging & Disability Resource Connection
- Area Agency on Aging (AAA)
- NJ Save
How Do I Enroll in a Medicare Plan?
If you have any questions about New Jersey Medicare and your eligibility for supplement or advantage plans, speak to one of our licensed agents today. Our agents will discuss your Medicare options and help find a plan that works for you.
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