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Best Medicare Advantage Plans in New Jersey for 2019

Having the best Medicare Advantage plan in New Jersey for your 2019 needs can help a local beneficiary manage copayments, deductibles, and coinsurance better than Original Medicare. Even though Medicare Part A and Part B provide very broad coverage, they won’t cover every medical bill. Most of the time, a Medicare Advantage plan, also called Medicare Part C, will also offer those who live along the Atlantic coast additional benefits that aren’t even included in Original Medicare. Many come with affordable monthly premiums, and some don’t require you to pay a premium at all!

For example, paying the Medicare Part B premium and even signing up for a Medigap plan will not provide you with Medicare Part D prescription drug coverage. Many Advantage health plans (although not all) do provide drug benefits on top of health care benefits, helping you reduce your out-of-pocket costs even more. This is just one example of how a Medicare Advantage plan can potentially help you best reduce your health care costs.

Best Time to Enroll in Medicare Advantage Plans in New Jersey for 2019

The main qualification for a New Jersey Medicare Advantage plan is to be enrolled in Medicare Part A and Part B. People who suffer from End Stage Renal Disease ESRD can’t enroll in Medicare Advantage plans but have specific plans they can join. Otherwise, Medicare Part C plans in New Jersey don’t do any health underwriting.

Aside from these qualifications, there are specific times to mark on the calendar as the best time to join, drop, or enroll in a Medicare Advantage plan:

  • Initial Coverage Election Period: A new Medicare beneficiary who is turning 65 gets to enroll for a few months before and after they would be enrolled in Medicare Part A and Part B.
  • Annual Election Period: Often called Open Enrollment, the government allows several weeks in the fall for a beneficiary to enroll in, drop, or switch a Medicare Advantage plan in New Jersey.
  • Special Election Periods: Certain circumstances may trigger Special Election Periods, like losing prior coverage or moving into a new service area.
  • Medicare Advantage Disenrollment Period: Beneficiaries get six weeks at the start of every year to drop a Medicare Advantage plan and resume Medicare Part A and Part B. People who only have Original Medicare may also enroll in Part D.

Once you enroll in the best Medicare Advantage plan in New Jersey for your specific needs for 2019, the insurance company will issue you an insurance card that you will typically present to medical providers instead of your Original Medicare card.

Best Types Medicare Advantage Plans in New Jersey for Different Needs

Don’t assume that all New Jersey Medicare Advantage plans are exactly alike. There are a lot of differences, including network differences. Some also include a Medicare prescription drug plan, while others do not. You can read a quick summary of the most common kinds of Medicare Advantage plans in New Jersey here:

  1. Health Maintenance Organization HMO plans:

    These Medicare Part C plans in New Jersey often do the best job of keeping rates modest, and they are the kind of Medicare Advantage plan most likely to have a $0 premium. About 54 percent of all New Jersey residents who enrolled in Medicare Advantage plans chose an HMO.

  2. Preferred Provider Organization PPO plans:

    About 46 percent of Medicare Advantage plan members in New Jersey chose a PPO Part C for 2019.  This plan type is often the best Medicare Advantage plan for offering network freedom and flexibility.

  3. Special Needs Plans SNPs:

    Insurance companies develop Special Needs Plans to assist people who need to cope with chronic health conditions and institutional conditions.

  4. Dual-Eligible:

    A beneficiary who qualifies for both Medicaid and Medicare might enroll in a Dual-Eligible plan.

  5. End Stage Renal Disease ESRD plans:

    People who suffer from ESRD are best-suited to enroll in a special type of plan.

Although less popular, there are also options like private fee-for-service (PFFS) plans (which don’t have networks for health care providers) and Medicare savings account (MSA) plans. Exploring all of these options is best so that you can make the right decision.

Enrollment Statistics for New Jersey Medicare Advantage Plans for 2019

These are some brief enrollment figures for people who enroll in a Medicare Advantage plan in New Jersey:

  • Percent of Medicare beneficiaries with Medicare Advantage plans: 21 percent
  • Number of enrollees: About 346,000

These are the biggest New Jersey counties by population:

  • Bergen County, New Jersey: 948,406
  • Middlesex County, New Jersey: 842,798
  • Essex County, New Jersey: 808,285
  • Hudson County, New Jersey:    691,643
  • Monmouth County, New Jersey: 626,351

Do Medicare Advantage Plans in New Jersey Cover Prescriptions in 2019

Most of the time, Medicare Part C comes with Medicare Advantage Prescription Drug plans. This means you can get Medicare Part C and Part D in the same plan. Sometimes, you can even get both Medicare Part C and D with a very low or a $0 premium. As a note, Medicare Part A and Part B don’t cover most prescription drugs, so you need either a stand-alone Part D plan or a Medicare Advantage Prescription Drug Plan.

Each plan will have its own formulary or list of covered prescription drugs for 2019. In addition, you will see Prescription Drug tiers that will assign different levels of benefits for various classes of prescription drugs. For instance, the plan may pay most of the cost for generic drugs and less for brand-name drugs and specialty drugs. Since some prescriptions cost quite a bit, it’s important to compare the drug lists and coverage to find the best prescription plan for your needs.

Network Restrictions for Medicare Advantage Plans in New Jersey

As mentioned above, most New Jersey beneficiaries will choose a Medicare Part C HMO or PPO for 2019. It’s important to understand how the network restrictions work. Original Medicare doesn’t use networks, so this works differently than Medicare Part A and Part B. With Medicare Part A and Part B, you just may want to make sure that your doctor or hospital accepts Medicare Assignment.

This list briefly highlights network restrictions for New Jersey MA plans:

  • HMO Medicare Advantage Plans: This kind of plan will usually only cover out-of-network costs in emergencies or in other unusual circumstances. You will also have a primary care doctor, and this PCP must give you a referral for a specialist.
  • PPO Medicare Advantage Plans: These Part C plans will cover in-network providers at a higher level, but you can still get covered at a lower level for out-of-network providers.

With either of these network options, you should make sure you can find your doctor or nearby hospital on this list of in-network service providers for 2019. You can find PPOs Medicare Part C plans in New Jersey with regional or national networks, but they usually have somewhat higher premium rates. If you intend to travel around the country, you might decide it’s best to pay more for this flexibility. As with any kind of insurance, you should compare the benefits and premiums to find the best option for your needs.

Top-Rated Companies Offering Medicare Advantage Plan in New Jersey for 2019

For your convenience as we approach 2019 Open Enrollment, we have compiled a list of several Medicare Advantage plan in New Jersey for 2019. Even though there are a lot of top providers out there, we have a few that we are partial to. These are some of our favorites:

Best New Jersey Medicare Resources

You probably want to maximize your Medicare benefits as a New Jersey resident. You can find a complete description of benefits of Medicare coverage, sign up for coverage and more with the help of these links:

If you live in Sussex, Somerset or any other area in New Jersey, we want to help you shop for Medicare plans. We’ll help you find the Best Medicare Advantage plan in New Jersey for 2019 that will reduce your costs for doctor’s visits, hospital care, skilled nursing facility care, temporary nursing home care and more by comparing options from companies with top star ratings. Not only can we help you find a Medicare Advantage plan, but we can help you look for Medicare Supplement plans, too. Give us a call today to find out more about your health insurance options!