Medicare Advantage in New Jersey

Looking for New Jersey Medicare Advantage Plans? Enter your ZIP below to compare affordable or $0 premium plans in your area.

New Jersey state

Information about Medicare Advantage Plans in New Jersey

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28 percent of Medicare beneficiaries in New Jersey were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.1

There are 375 different New Jersey Medicare Advantage plans in 2019.1 Not every plan is available in each county, so it's important to find out which ones are offered where you live.

A licensed insurance agent can help you compare the availability, benefits and costs of Medicare Advantage plans in your area of New Jersey. Read below to learn more about Medicare in your state.

You can also learn more about other types of Medicare plans:

Average costs of Medicare Advantage in New Jersey

The average premium for a 2019 New Jersey Medicare Advantage plan was $24 per month.

That average was affected by the 181 available plans that feature $0 monthly premiums.

  • Average monthly premium cost in 2019 (weighted): $24
  • Average in-network out-of-pocket spending limit: $6,613
  • Average deductible in 2019 (weighted): $186.551

Individual plan premiums, deductibles and out-of-pocket costs may vary greatly depending on where you live and the plan you have.

You can view the 2019 average New Jersey Medicare Advantage plan monthly premiums by county listed below in this guide.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Compare New Jersey Medicare Advantage plan costs

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

If you want to enroll in Medicare Advantage in New Jersey, you must first be enrolled in Medicare Part A and Part B, often referred to as Original Medicare.

To be eligible for Original Medicare at age 65, you must meet the following requirements:

  • You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.

  • You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.

  • You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

You may also be eligible for Medicare benefits under 65 if:

  • You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.

  • You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).

  • You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

It’s important to note that if you have ESRD, you may not qualify for most Medicare Advantage plans. If you have ESRD, you may be able to enroll in a New Jersey Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in New Jersey

The first time you may be able to enroll in a New Jersey Medicare Part C plan is during your Medicare Initial Enrollment Period (IEP).

Medicare Initial Enrollment Period graphic

Your Medicare IEP starts three months before your 65th birthday. It includes the month of your 65th birthday and then continues for another three months after your birthday.

Additional times at which you may sign up for a Medicare Advantage plan include:

Medicare Advantage Open Enrollment Period graphic

Medicare Advantage Open Enrollment Period: January 1 – March 31

If you're already enrolled in a Part C plan, from January 1 to March 31 every year, you may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare.

If you return to Original Medicare during this period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare AEP graphic

Medicare Annual Enrollment Period (AEP): October 15 – December 7

From October 15 to December 7 every year, you may enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another.

You may also drop your existing Medicare Advantage plan and return to Original Medicare.

During AEP, you may also join, switch or drop a Medicare Part D plan. 

Medicare Special Enrollment Periods (SEP)

You may potentially be granted a Medicare Special Enrollment Period (SEP) at any time throughout the year for qualifying circumstances.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Find a New Jersey Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in New Jersey 2019

Each year, the Centers for Medicare & Medicaid Services (CMS) issues Star Ratings for all Medicare Advantage plans using a system of one to five stars.2

In order for a Medicare Advantage plan to be considered a top-rated plan, it must have four or more stars out of five stars.

There are 79 top-rated 2019 Medicare Advantage plans in New Jersey that are rated four stars or higher.

Medicare Star Ratings
Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

Medicare Advantage plans are rated in the following five categories:

  • Preventive care and health maintenance (screenings, tests, vaccines, etc.)
  • Management of chronic conditions
  • Member experiences and ratings of the plan
  • Member complaints, problems receiving services and member retention
  • Customer service

The information for the star ratings is gathered from information that is submitted to Medicare, Medicare’s regular monitoring activities and member surveys.

List of Medicare Advantage Plans Available in New Jersey in 2019

To view a list of plans offered in your area within New Jersey, use our plan comparison tool.

Find a New Jersey Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in New Jersey

Multiple insurance carriers may offer Medicare Advantage plans in New Jersey, depending on where you live.

Private insurance companies offer Medicare Advantage plans that may be unique to the plan area they serve.

Call to speak with a licensed insurance agent who can help you compare the Medicare Advantage plans that are sold by insurance companies in your area.

When you’re shopping for Medicare Advantage plans in New Jersey, you can compare plans from several different carriers by using some of the following information:

  • The Medicare Star Ratings can give you an idea of a plan’s overall quality.

  • Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.

  • Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.

  • You can read through Medicare Advantage plan reviews and testimonials from customers.

New Jersey Medicare Advantage plans by county

The chart below provides some more information about 2019 New Jersey Medicare Advantage plans by county.1

  • Bergen County and Hudson County each had 13 $0 premium plans available in 2019, which was the most out of any county in the state.

  • Morris County was home to 9 top-rated Medicare Advantage plans (4 stars or higher) in 2019.
2019 NJ Medicare Advantage by County
County Total of County MA Enrollees % of Medicare Beneficiaries Enrolled in MA Number of Plans Available Number of $0 Premium Plans Available % Enrolled in a $0 Premium Plan
Atlantic 14932 25% 16 7 41.0%
Bergen 42463 24% 23 13 63.0%
Burlington 27396 29% 22 10 41.6%
Camden 28479 28% 19 9 63.4%
Cape May 5915 20% 8 3 25.3%
Cumberland 8793 30% 13 5 43.8%
Essex 45357 36% 20 11 85.3%
Gloucester 16199 28% 18 8 59.7%
Hudson 30692 35% 25 13 63.6%
Hunterdon 6699 25% 13 7 68.7%
Mercer 23455 34% 19 10 59.5%
Middlesex 38951 27% 18 9 64.5%
Monmouth 29429 22% 18 8 78.5%
Morris 21784 23% 27 12 49.3%
Ocean 45432 28% 15 8 88.7%
Passaic 29529 33% 20 10 60.6%
Salem 3376 22% 8 3 36.3%
Somerset 13770 23% 19 10 57.5%
Sussex 6730 22% 14 7 86.6%
Union 30587 33% 26 11 53.8%
Warren 5302 22% 14 7 66.6%

NJ Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 New Jersey Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.1

Plan type Percentage of New Jersey enrollees (2019)
HMO 99.9%
Local PPO <1%
Regional PPO <1%
Other Plans <1%

The major types of Medicare Advantage plans include:

  • HMO
    Health Maintenance Organization (HMO) usually requires patients to use health care providers and pharmacies that are part of the plan’s network (except in the case of emergencies) while also typically requiring a referral from a primary care doctor in order to see a specialist.

  • PPO
    Medicare Advantage beneficiaries in a Preferred Provider Organization (PPO) are able to see providers outside of their plan’s network, often at a higher cost.

    Beneficiaries in this type of plan typically pay less out of pocket if they choose to receive medical services from providers within their plan’s network.

    PPO plans typically do not require patients to acquire a referral before visiting with a specialist.

  • PFFS
    A Private Fee-For-Service (PFFS) plan determines how much it will pay to health care providers and how much the patient will pay when care is received.

    With a PFFS plan, you can typically receive care from any doctor, hospital or health care provider that accepts your plan’s terms. Not all providers will accept these terms, however.

  • SNP
    A Special Needs Plan (SNP) is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics.

    Typically, you must receive care from health care providers and hospitals within your SNP network, except for in cases when you need emergency or urgent care and when someone who has End-Stage Renal Disease (ESRD) needs out-of-area kidney dialysis.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 New Jersey Medicare Advantage plans that are available where you live.

Local health insurance resources in New Jersey

  • New Jersey’s State Health Improvement Plan offers free assistance to the state’s Medicare beneficiaries who have questions about their insurance.

    Counseling is free of charge and administered by a group of trained volunteers. The program may be reached at 800-792-8820.

  • You can also explore more information about the insurance industry in New Jersey by visiting the state’s Department of Insurance website.

  • New Jersey Prescription Drug Assistance Programs
    The state of New Jersey has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.