Medicare is a health insurance program that is offered through the federal government for people age 65 and older. You may also qualify if you’re under 65 and meet certain qualifications. If you live in New Jersey, you have several options for Medicare plans.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in New Jersey for the 2021 plan year:
- A total of 1,633,826 residents of New Jersey are enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased in New Jersey compared to last year — from $24.50 in 2020 to $23.26 in 2021.
- There are 84 Medicare Advantage plans available in New Jersey for 2021, compared to 74 plans in 2020.
- All New Jersey residents with Medicare have access to buy a Medicare Advantage plan, including plans with $0 premiums.
- There are 12 different Medigap plans offered in New Jersey for 2021.
There are a few Medicare coverage options in New Jersey. You can choose from original Medicare, Medicare Advantage, or other supplemental plans.
Part A covers:
- care during hospital stays
- limited stays at skilled nursing facilities
- limited home healthcare
- hospice services
Part B covers:
Medicare Advantage in New Jersey
You may prefer to get coverage through private insurers that bundle Part A, Part B, and sometimes prescription drug coverage into a single Medicare Advantage (Part C) plan. These private insurers contract with CMS and their plans must cover the same things that are covered under original Medicare.
Some Medicare Advantage plans cover things like dental and vision care, nonemergency medical transportation, home meal delivery, and more. These plans may have additional premiums for the extra coverage.
One benefit of choosing a Medicare Advantage plan is the annual out-of-pocket spending limits. Once you reach the limit, the plan pays 100 percent of covered expenses for the rest of the year. Original Medicare does not have an out-of-pocket limit.
Medicare New Jersey plans are available from the followingcarriers:
- Aetna Medicare
- Braven Health
- Clover Health
- Horizon Blue Cross Blue Shield of New Jersey
- United Healthcare
These companies offer plans in many counties in New Jersey. However, Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live.
Medicare supplement plans in New Jersey
Medicare supplement (Medigap) plans are offered through private insurers to cover some out-of-pocket costs for Medicare services. These plans can help pay for Medicare copayments, coinsurance, and deductibles.
Many companies offer Medigap plans in New Jersey. In 2021, some of the companies offering Medigap plans throughout the state include:
If you’re eligible for Medicare, you can sign up at certain times during the year. These times include:
- Initial enrollment period. If you’re first eligible when you turn age 65, you can sign up during this 7-month period. It starts 3 months before the month you turn age 65 and ends 3 months after the month of your 65th birthday.
- Medicare open enrollment period. The annual open enrollment period happens between October 15 and December 7. At this time, you can join a Medicare Advantage plan or switch to a new plan.
- Medicare Advantage open enrollment period. If you’re already in a Medicare Advantage plan, you can switch to another one between January 1 and March 31 every year.
Certain life events, such as losing a job that provides you with health coverage, will trigger a special enrollment period. This gives you an opportunity to sign up for Medicare outside of the standard enrollment periods.
In some cases, you may be signed up for Medicare automatically. If you’re eligible because of a disability, you’ll get Medicare after you’ve received 24 months of Social Security Disability Insurance. You’ll also be signed up automatically when you turn age 65 if you’re already getting Social Security retirement benefits.
Tips for enrolling in Medicare in New Jersey
All plans must cover the same benefits and services as original Medicare, but costs and other benefits under Medicare Advantage plans vary.
Before selecting a plan, carefully consider:
- what services are covered
- CMS star ratings that measure plans’ health and drug services, and beneficiary satisfaction
- whether hospitals and doctors you prefer are in the plan’s network
Several resources are available to answer yourquestions or help with New Jersey Medicare plans.
- Medicare Information & Referral Service/SHIP (800-792-8820): free, unbiased Medicare counseling for New Jersey seniors.
- Aging & Disability Resource Connection (877-222-3737): helps New Jersey residents who are older, people who have physical disabilities, and caregivers find healthcare resources.
- Area Agency on Aging (AAA): offices in all 21 New Jersey counties to help seniors and adults with disabilities connect to local resources for comprehensive, coordinated services. Find locations and phone numbers online or call 1-877-222-3737 to connect to your local AAA.
- NJ Save: online application for low-income seniors and people with disabilities who cannot afford Medicare premiums and prescription costs.
- Medicare (800-633-4227): contact Medicare directly with questions.
- More than 1.6 million New Jersey residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have decreased for 2021 Medicare Advantage plans in New Jersey.
- There are also several Medigap plan options if you live in New Jersey and are looking for additional coverage.