Medicare plays a key role in providing health and financial security to beneficiaries residing in New Jersey. With more than 1.6 million New Jersey beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in New Jersey. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in New Jersey?

Medicare covers most New Jersey residents who are 65 or older, and it also covers disabled New Jersey residents. In general, Medicare enrollment in New Jersey works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, it will help cover 80% of your health care costs.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

New Jersey Medicare Enrollments

1,103,915

Original Medicare Plans
(Part A and B)

524,272

Medicare Advantage & Other Health Plans

898,408

Stand-alone Medicare
Part D (Drug plans)

1,628,187

Total Medicare Beneficiaries
in New Jersey

New Jersey Medicare Advantage Plans (Part C)

More than 30% of New Jersey Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in New Jersey who already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare.

As of 2020, 74 Medicare Advantage plans are available in New Jersey. The average monthly Medicare Advantage premium changed from $27.82 in 2019 to $26.73 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in New Jersey.

According to the Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 524,272 beneficiaries enrolled in Medicare Advantage and other plans in New Jersey. More than 30% of New Jersey Medicare beneficiaries were enrolled in a private Medicare Advantage plan in 2019. 100% of people with Medicare have access to a Medicare Advantage plan.

Depending on your county, New Jersey Medicare beneficiaries can select from between nine and 36 Medicare Advantage plans.

New Jersey Medicare Supplement (Medigap) Insurance Plans

New Jersey guarantees at least some access to Medigap plans for enrollees under the age of 65.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

New Jersey Medigap insurance is available to everyone with Medicare in the state, including those who are under 65 and are enrolled in Medicare. Often, Medigap plans in New Jersey can be more expensive if you don’t enroll during your Initial Enrollment Period and wait for an Annual Open Enrollment Period. 

There are two initial times to enroll in a Medigap plan before and after you turn 65:

  • 6 months prior to turning 65
  • Once you turn 65, your 6 month period begins the month you enroll in Part B

During this period, an insurance company can’t use medical underwriting. 

Similar to the majority of states, New Jersey guarantees at least some access to Medigap plans for enrollees under the age of 65. New Jersey also ensures that people under age 65 aren’t required to pay higher premiums for their Medigap coverage.

New Jersey Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of May 2020, There are 898,408 Medicare beneficiaries in New Jersey enrolled in stand-alone Part D prescription drug plans and 334,673 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 28 stand-alone Part D plans available in New Jersey, with premiums ranging from about $12 to $102 per month. About 23% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS). When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in New Jersey

  • Senior Health Insurance Assistance Program (SHIP): SHIP provides free help to New Jersey Medicare beneficiaries who have problems with or questions about their health insurance. SHIP is a statewide program administered by the New Jersey Department of Human Services with financial assistance through a grant from the U.S. Administration for Community Living.
    Contact: Call 1-800-792-8820 or search for your local SHIP office online.

  • Aging & Disability Resource Connection: The Aging and Disability Resource Connection serves as a visible and trusted source of information on long term services and supports for persons of all incomes. ADRC professional staff assists seniors, adults, and their caregivers in finding benefits and services they need. The ADRC goal is to improve the experience of consumers and their families when seeking access to information, supports, and services. The ADRC initiative is part of a nationwide effort to empower people to make informed decisions about their long term services and supports and to help people more easily access services.
    Contact: Call 1-877-222-3737 or search for your local Area Agency on Aging online.

  • The Passaic County Department of Senior Services, Disabilities and Veterans’ Affairs in Totowa, New Jersey, acts as the county’s State Health Insurance Plan Coordinator and operates the Aging & Disability Resource Connection that assists Medicare beneficiaries in and around Passaic County. ADRC lead agencies in their county, ensuring seniors, adults with disabilities, and their caregivers have easy access to information and long term services and supports.
    Contact: Call 973-569-4060 or email [email protected].

  • Sussex County Division of Senior Services, also known as an “Area Agency on Aging” as mandated by the federal government under the Older Americans Act, is your connection to services and programs designed to support seniors’ independence and quality of life. ADRC helps connect people with the services they need to continue living independently in the community for as long as possible. Your ADRC is administered locally by the 21 County Offices on Aging.
    Contact: Call 973-579-0555 or email [email protected].

  • Cape May County Department of Aging & Disability Services: Cape May County Department of Aging and Disability Services has experienced State Health Insurance Assistance Program (SHIP) counselors who offer free and confidential one-on-one counseling and assistance making health care choices for people with Medicare. We are here to educate, advocate, counsel, and empower Medicare beneficiaries to make informed health care decisions in choosing health insurance to meet your needs. SHIP counselors also provide information and assistance for beneficiaries with limited income and resources in applying for extra help paying for prescriptions and Medicare Part B premiums and special benefits programs. If you are a Medicare beneficiary who feels overwhelmed by health and prescription insurance plan choices, need assistance in choosing the right coverage, have questions about a claim, SHIP counselors are ready and willing to provide free and personalized help answering your questions.
    Contact: Call 609-886-2784

  • Middlesex County Office of Aging & Disabled Services: Middlesex County seniors with questions about Medicare insurance plans, benefits, claims, supplemental policies, or long-term care insurance can receive assistance and counseling through the Middlesex County Office of Aging & Disabled Services’ State Health Insurance Program. Volunteer counselors do not provide legal advice, sell, recommend, or endorse any specific insurance product, agent, insurance company, Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), or Private Fee-for-Service (PFFS) plan. They provide information and assistance so that you can make your own decisions. Counseling is free of charge.
    Contact: Call 732-745-3295

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of New Jersey. Our process makes it easier for you to access your Medicare eligibility in New Jersey so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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