Looking to get more out of your Medicare enrollment? Continue reading to find some of the highest-rated Medicare Advantage plans in New Jersey.
Original Medicare is a great foundational source of health insurance, but if you need more than just inpatient and outpatient coverage, Medicare Advantage might be right for you. Offering virtually the same cover coverage as Original Medicare, Medicare Advantage can offer a wide variety of additional benefits, such as vision, dental, hearing, mental health, and prescription drug coverage. If you’re looking for an idea of what Medicare Advantage can do for you, then you’re in the right place!
Eager to get your Medicare Advantage search started? Check out Insurify’s plan-comparison tool! With a free and easy-to-use format, it will allow you to review detailed plan information and find the right plan for you!
Though the following list of MA plans has some of the highest-rated plans in New Jersey, it’s important to note that they might not be the best specific plan for you. To get a much more solid sense of what plan best fits your situation, take stock of your specific medical needs, financial limitations, and county of residence.
1. Erickson Advantage Signature with Drugs (HMO-POS) - Score: 74.31
2. Cigna Preferred Medicare (HMO) - Score: 72.38
3. Erickson Advantage Liberty with Drugs (HMO-POS) - Score: 72.22
4. Erickson Advantage Freedom (HMO-POS) - Score: 72.22
5. HumanaChoice H5216-186 (PPO) - Score: 71.34
6. Erickson Advantage Liberty without Drugs (HMO-POS) - Score: 70.14
7. Cigna Preferred Plus Medicare (HMO) - Score: 69.72
8. Humana Gold Plus (HMO) - Score: 69.26
We compiled the best plans in the state and ranked them based on several factors. Those factors including the entire cost of the plan, the variety of services offered, and the CMS rating– based on user-reported quality of care. For more information on our ranking procedure, see our methodology page.
As a disclaimer, please note that the following list is not intended as an endorsement of healthcare providers but is instead as a presentation of information regarding the most highly rated plans in New Jersey.
- Monthly Premium: $199
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $2,600
Counties: Monmouth, Morris, Union
Though the monthly premium may through you off, this is a low-cost plan. Just take a look at the low out-of-pocket maximum. Plus you’ll pay very little for routine vision, preventive dental, and hearing visits. And $0 copays for preventive and primary care office visits.
As an added bonus, you get access to out-of-network benefits as well. Out-of-network care will be more expensive. But for some, having the added flexibility will come in handy for the treatment of certain conditions.
Monthly Premium: $0
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $7,200
Counties: Gloucester, Cumberland, Atlantic, Camden, Burlington, Mercer, Monmouth, Ocean
This Cigna plan comes with a ton of low-cost coverage. Low-cost Tier 1 and Tier 2 drug deductibles, preventive and primary care visits, health plan deductible and diagnostics. Plus mostly $0 copays for hearing, preventive dental, comprehensive dental, routine vision, and mental health care. This is a comprehensive and low-cost plan.
In Monmouth and Ocean counties, your out-of-pocket limit is set a little lower at $7,100 annually.
Monthly Premium: $0
Prescription Drug Plan Deductible: $400
Out-of-Pocket Maximum: $6,700
Counties: Monmouth, Morris, Union
With a premium of $0 and a somewhat moderate prescription drug deductible, this plan looks to be a great option for those seeking solid prescription drug coverage. The prescription co-pay rates are fairly competitive, and with great coinsurance rates for medical supplies, this plan could be a great option if prescription drugs are your concern.
Also, for a monthly premium of $40, you can add preventive and comprehensive dental. Even though this plan has a relatively small service area, it earns five stars out of five.
Monthly Premium: $70
Prescription Drug Plan Deductible: $200
Out-of-Pocket Maximum: $4,300
Counties: Monmouth, Morris, Union
Though this plan may seem expensive out of the gate, with a monthly premium of $70, a moderate prescription drug deductible of $200, and a moderate out-of-pocket maximum, it offers optional supplemental benefits, great primary and specialist co-pays, and low emergency co-pays.
Additional benefits include preventive dental, some vision coverage, hearing, and mental health. With a solid core of health coverage and a fairly expansive suite of benefits, this plan earns five stars out of five.
Monthly Premium: $0
Prescription Drug Plan Deductible: $275
Out-of-Pocket Maximum: $7,400
Counties: Atlantic, Bergen, Essex, Hudson, Hunterdon, Monmouth, Somerset, Morris, Warren, Union, Sussex, Burlington, Camden, Cumberland, Salem, Mercer, Gloucester
This plan keeps most of its copays low so long as you stay in-netwrok. You’ll even get $0 copays for preventive dental and routine vision. Plus low cost hearing care. As an added advantage, you ar allowed covered care outside of your network. Costs will be higher, typically you pay at least 20 percent in coinsurance. But for some, this flexibility makes this plan worth it.
On a final note, costs for this plan will vary depending on your county.
Monthly Premium: $0
Health Plan Deductible: $800
Out-of-Pocket Maximum: $6,700
Counties: Monmouth, Morris, Union
While this plan doesn’t cover prescriptions, it still offers a lot to love. Not the least of which is extensive coverage for extended hospital stays. You also get low-cost doctors visits, diagnostics, hearing, preventive dental, and routine vision care.
You’ll also get the added bonus of access to premium out-of-network benefits. In most cases, you’ll pay a percentage of costs in coinsurance. But you also get out-of-network dental care with a $0 copay!
Monthly Premium: $59
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $6,200
Counties: Mercer, Burlington, Gloucester, Camden, Cumberland, Atlantic
If there’s one thing Cigna Medicare should be known for, it’s comprehensive low-cost health plans. While you can’t get everything for next-to-nothing, you still have a ton of $0 copays. That includes routine vision, preventive dental, comprehensive dental, and most hearing needs (including hearing aids!)
You also get $0 copays for preventive and primary care office visits,. Beyond that, fairly low costs for specialists, diagnostic services, and institutional stays are also advantageous.
Monthly Premium: $0
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $6,700
Counties: Warren, Bergen, Essex, Somerset, Union, Sussex, Monmouth, Morris, Hunterdon, Hudson, Cumberland, Gloucester, Camden, Burlington
Here’s another Humana plan with a lot of perks. You’ll get $0 copays for preventive and primary care visits. Plus, $0 for preventive dental and routine vision. But you’ll also get low-cost care for comprehensive dental, hearing, and mental health services. This plan is truly comprehensive.
Depending on your county, you could end up paying a little more. That can include a $275 drug deductible and an increased out-of-pocket limit set at $7,200.
Interested in seeing more plans available in New Jersey? Give Insurify’s plan-comparison tool a try! With the ability to compare plans side by side, you’ll be able to make informed healthcare decisions in no time!
For 2021, the average premium for Medicare Advantage plans in New Jersey is $23.26 a month. Annually, this would cost $279.12. While this may seem fairly low, it does not necessarily take into consideration a number of different factors, such as:
The varying co-pays and coinsurances for both covered medical services and additional benefits
Service area coverage, which could zone you out of more affordable plans
Additional plan benefits, which could increase the overall cost of a plan
A plan’s actual network of healthcare providers, which can vary in size and costs for medical services
Medicare Part B premiums, which you are still required to pay in addition to regular MA plan costs
Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare. Offered by approved private insurance companies, Medicare Advantage plans are bundled policies that include Original Medicare coverage.
They can also include various additional benefits, like Medicare Part D prescription drug, vision, hearing, and dental coverage, among many others. Some health plans might also tailor their coverage to benefit people suffering from specific chronic illnesses, such as diabetes or end-stage renal disease (ESRD).
Given that these plan options come from private insurers, their overall cost, coverage, and service areas can vary. The baseline portions of Medicare Parts A and B will always be included in an MA plan, but everything beyond that is not standardized and will require closer research to ensure that a plan can work for you.
For more information on Medicare Advantage, please visit www.medicare.gov or call 1 (800) 633-4227; TTY users can call 1 (877) 486-2048.
Health Maintenance Organization ( HMO ): HMO plans provide coverage for doctors, hospitals, and other healthcare providers in your plan’s network. Any visits outside your provider network will generally not receive coverage (unless those visits are for emergency or urgent care). For specialist services, you will need a doctor’s referral.
Preferred Provider Organization ( PPO ): A PPO plan is more flexible than an HMO, allowing you to visit doctors or other healthcare providers out of your network (albeit at a higher cost). For in-network providers, you can expect to pay less in coinsurance and co-payments.
Private Fee-for-Service ( PFFS ): PFFS plans generally have few limits on which medical service providers you can visit. However, these plans also reserve the right to decide how much they will cover for doctor visits, hospital visits, and other medical services.
Special Needs Plan ( SNP ): SNP insurance policies restrict eligibility to individuals who live in an institution (such as a nursing home ) or suffer from a chronic health condition (such as HIV/AIDS, end-stage renal disease, or diabetes). Dual special needs plans (D- SNPs ) exist for individuals who qualify for both Medicare and Medicaid.
Medicare Advantage Prescription Drug Plan (MA-PD): MA-PD plans roll health and prescription drug coverage into one plan. This type of plan serves as an alternative to the Medicare Part D plans you would have to enroll in if you had Original Medicare and needed prescription drug coverage.
Medical Savings Account ( MSA ): Medicare MSA plans deposit money into a special savings account. You can use money from this savings account to pay for your healthcare costs before you meet the deductible. Once you meet the deductible, you’ll receive expanded coverage.
There are a few different ways to enroll in a Medicare Advantage plan. The first is through your Initial Enrollment Period, which begins three months prior to your 65th birth month and ends three months after. During this time, you will be able to enroll in a Medicare Advantage plan, provided that you first enroll in Original Medicare to obtain your Medicare number.
Alternatively, you can enroll during the Open Enrollment Period, which lasts from October 15 to December 7 of each year. During this time, you can switch from Original Medicare to Medicare Advantage or switch between different MA plans.
If you experience a qualifying life event, you can participate in a Special Enrollment Period. To find out if you qualify for special enrollment, you can find more information at www.medicare.gov.
While Medicare Advantage does have a lot to offer, there are definitely some downsides.
MA plans are almost always more expensive than Original Medicare. Things like variable co-pays and coinsurance rates, optional benefits, and monthly premiums have a significant impact on how much you can expect to pay.
Also, unlike Original Medicare, MA plans have service areas that can severely limit the number of plans available to you. If you live out of a plan’s service area, you simply cannot enroll in the plan, even if it would provide you with needed healthcare services at affordable rates.
If you’re looking for a much more stripped-down, more affordable, and more basic plan, the standardized nature of Original Medicare might be more your speed.
Provided that you are eligible for both, yes, you can enroll in both Medicare Advantage and Medicaid services. You cannot, however, be simultaneously enrolled in Medicare Advantage and Medicare Supplement Insurance (also known as Medigap or Medicare Supplement plans). Please check www.medicare.gov to see which assistance programs are compatible with Medicare Advantage.
Highly rated plans are definitely a great starting point for finding the right MA plan for you, but an even better starting point is reviewing your own situation. By taking your specific medical needs and your financial limitations into consideration, you’ll be able to find a plan that covers all needed medical services without overextending your finances. With those two aspects in mind, you’ll definitely be ready to get your search started.
Ready to take charge of your Medicare Advantage enrollment? Try out Insurify’s plan comparison tool! It’s free and will provide you with everything you need to find the plan that’s right for you!
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