Best Medicare Advantage Plans New Jersey 2025

When searching for the best Medicare Advantage plans, clarity is key. This article strips away the complexity, revealing the top Medicare Advantage Plans in New Jersey for 2025 by summarizing their benefits, costs, and networks.

It’s your straightforward guide to making an educated decision on your Medicare Advantage plan that offers optimal coverage for the year ahead.

 

Key Takeaways

  • In the past, New Jersey has offered a diverse range of dozens of Medicare Advantage plans from more than 10 different insurance companies, often with benefits surpassing those of Original Medicare, including annual caps on out-of-pocket expenses and added services like dental, vision, and hearing plans.

 

  • In the past, top-rated providers such as UnitedHealthcare, Humana, and Aetna have offered high-quality Medicare Advantage plans that have been noted for their comprehensive coverage and customer service, with UnitedHealthcare leading with a 5-star CMS rating.

 

  • Cost considerations are pivotal when selecting a Medicare Advantage plan; enrollees must pay attention to deductibles, copays, and coinsurance during enrollment periods to avoid penalties and ensure optimal coverage.

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Overview of Medicare Advantage Plans in New Jersey 2025

In recent years, New Jersey has offered almost 100 Medicare Advantage plans from a dozen esteemed insurance companies, including AmeriHealth and Jefferson Health Plans.

 

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These plans are designed to provide comprehensive coverage and additional benefits above and beyond what Original Medicare offers, making some of them among the best Medicare Advantage plans available.

More than 1.7 million New Jersey residents were enrolled in Medicare in previous years, making it crucial to comprehend the various plan types and their benefits. So, we will probe further into the different Medicare Advantage Plans and examine their advantages.

 

Types of Medicare Advantage Plans

Medicare Advantage plans in New Jersey come in various types, each with its network restrictions and cost-sharing structures. One of these types is the Medicare Advantage HMO, which usually requires members to use healthcare providers within the plan’s network and typically involves a primary care physician who directs referrals.

Consulting one of our licensed insurance agents can help you navigate these options. They’re available at 1-844-709-9937 (TTY user 711), from Monday to Friday, 8 AM to 9 PM EST.

On the other hand, Preferred Provider Organization (PPO) plans aim to offer flexibility, often allowing members to choose between in-network and out-of-network healthcare providers, including outpatient services, thus affecting cost-sharing amounts.

Private Fee-For-Service (PFFS) plans usually set their own payment rates, often permitting members to receive care from any provider who agrees to the plan’s payment terms.

Lastly, Special Needs Plans (SNPs) are designed specifically for individuals with certain diseases, usually offering tailored benefits, provider choices, and drug formularies.

 

Benefits of Choosing a Medicare Advantage Plan

A significant benefit of many Medicare Advantage plans is the annual cap on out-of-pocket expenses. Once this limit is reached, most plans cover 100% of additional qualifying health services. This safety net is especially beneficial for beneficiaries who require frequent medical services.

Beyond this, some Medicare Advantage plans in New Jersey may offer routine coverage for vision, dental, and hearing needs, enhancing traditional Medicare coverage.

For instance, in previous years some of Aetna’s Medicare Advantage plans focused on benefits like more choices, added value, and the flexibility to help manage everyday expenses, highlighting the varied benefits available across different plans.

 

Top-Rated Medicare Advantage Providers in New Jersey

As the Medicare landscape in New Jersey evolves, so do the providers who offer these plans.

 

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Among these providers, UnitedHealthcare, Humana, and Aetna have often stood out, each earning high CMS Star Ratings in previous years based on the quality of care, management of chronic conditions, and customer service.

 

UnitedHealthcare

UnitedHealthcare, with its impressive 5-star rating for their Medicare Advantage plans in New Jersey, stands tall among the providers.

Their vast network of healthcare providers, including a wide range of doctors and hospitals, likely means that members have ample choice when selecting their healthcare professionals.

In addition to a comprehensive network, many UnitedHealthcare’s Medicare Advantage plans often offer a slew of extra benefits as part of their health insurance package.

 

Humana

Humana is another top-rated provider in New Jersey, which has historically offered high-quality care and customer service with low average costs. With a 4.5-star rating, Humana has been recognized for its commitment to customer satisfaction, ranking second nationwide for customer satisfaction for Medicare Advantage in 2022.

Many of Humana’s plans aim to offer a broad spectrum of benefits tailored to the diverse needs of their members.

 

Aetna

Aetna, with its 4-star rating, often provides comprehensive care with essential health services, preventive services, health and wellness programs, and robust customer service.

In addition to standard medical coverage, Aetna’s plans historically often provided:

 

  • Preventive services, such as screenings and vaccines, at no extra cost
  • Robust customer service and care coordination efforts to enhance member experience

 

Cost Considerations for New Jersey Medicare Advantage Plans

Evaluating your Medicare Advantage plan options requires careful consideration of the associated costs. In previous years, the average monthly premium for Medicare Advantage plans in New Jersey was less than $20.

 

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These costs may include varying premiums, deductibles, coinsurance, and copayments, all of which likely require careful evaluation.

 

Comparing Costs Across Providers

Given the variety of Medicare Advantage plans offered by multiple providers, comparing costs across these providers is a necessary step before making a decision. This involves understanding and considering factors such as:

 

  • Premiums
  • Deductibles
  • Copays
  • Coinsurance

Annual health deductibles, which is the amount paid out-of-pocket before the plan starts to pay, and varying copays and coinsurance across plans, are critical costs to compare when selecting a Medicare Advantage plan.

Our online plan comparison tool can help you make sense of the plans available in your local area. Enter your ZIP code in the box on this page to get started comparing the plans available to you.

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Enrollment Periods and Eligibility for New Jersey Medicare Advantage Plans

Enrollment in Medicare Advantage plans is time-bound and follows specific periods set out by Medicare.

Comprehending these enrollment periods—the Initial Enrollment Period, Annual Open Enrollment Period, and Medicare Advantage Open Enrollment Period 2025 — is vital to ensuring that Medicare Advantage plan benefits are not missed.

 

Initial Enrollment Period

The Initial Enrollment Period in New Jersey for Medicare Advantage plans is a 7-month timeframe, starting three months before one’s 65th birthday and extending until three months after. This period holds significance as it often offers the first opportunity for individuals to enroll in Medicare Advantage plans.

Missing the Initial Enrollment Period can lead to potential late enrollment penalties, requiring enrollment during the General Enrollment Period. Therefore, it’s important to act promptly and enroll during the Initial Enrollment Period to avoid any penalties.

 

Annual Open Enrollment Period

For Medicare Advantage plans in New Jersey, the annual open enrollment period occurs from October 15 to December 7. Any modifications to the Medicare Advantage plans during this timeframe become effective on the first day of the succeeding year.

During the Annual Open Enrollment Period, Medicare enrollees likely can:

 

  • Switch from Original Medicare to a Medicare Advantage plan
  • Change from one Medicare Advantage plan to another
  • Drop a Medicare Advantage plan and return to Original Medicare

 

If you’re not satisfied with your current plan, this period provides an opportunity to switch to another plan that better suits your needs. However, if you miss the open enrollment period, you may have to wait until the next year to make changes to your plans, unless you qualify for a Special Enrollment Period.

 

Additional Coverage Options with New Jersey Medicare Advantage Plans

Some Medicare Advantage plans in New Jersey may offer a range of additional coverage options that can enhance the value and convenience of your healthcare journey.

 

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These may include prescription drug coverage and dental and vision coverage.

 

Prescription Drug Coverage

In New Jersey, many Medicare Advantage plans have historically incorporated Medicare Part D prescription drug coverage, merging health and drug coverage into a single plan. It is essential to understand the drug coverage of your Medicare Advantage plan, which entails knowing specifics like the drug tier placements, the plan’s formulary, and any applicable coverage rules.

Prescription drug coverage in Medicare Advantage plans can affect the total cost, with some plans often requiring a separate drug deductible.

However, additional perks such as prescription mail-order delivery service have historically been available with some Medicare Advantage plans in New Jersey, providing more convenience in managing prescriptions. It’s essential to research and choose the right Medicare prescription drug plan that aligns with your needs.

 

Dental and Vision Coverage

Many Medicare Advantage plans in New Jersey differentiate from Original Medicare by offering additional benefits like dental, vision, and hearing coverage. The level of dental and vision care can range from basic routine exams to more comprehensive coverage, such as major dental work.

Medicare Advantage plans can vary significantly; some may offer basic routine coverage for dental and vision, while others may provide more extensive benefits.

When choosing a Medicare Advantage plan, it’s crucial to compare based on individual healthcare priorities, especially for routine vision, dental, and hearing needs.

New Jersey Medicare Resources and Assistance

The Medicare landscape can be complex to navigate, and that’s why a plethora of resources and assistance are available for guidance.

 

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For example, you can reach out to one of our licensed insurance agents at 1-844-709-9937 (TTY user 711). Lines are open from Monday to Friday, 8 AM to 9 PM EST.

Summary

Understanding the Medicare Advantage plans in New Jersey for the year 2025 can seem daunting, but with the right information and resources, it doesn’t have to be.

With various types of plans, comprehensive benefits, top-rated providers, and additional coverage options, choosing the right Medicare Advantage plan can significantly enhance your healthcare journey.

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Frequently Asked Questions

 

What is the highest-rated Medicare Advantage plan?

Humana is ranked as the no. 1 nationally for Medicare Advantage plan offerings, making it the highest-rated Medicare Advantage plan.

AARP/UnitedHealthcare and Kaiser Permanente are also good choices for their popular plans and outstanding customer service.

 

What are the types of Medicare Advantage plans available in New Jersey?

In New Jersey, the types of Medicare Advantage plans available usually include HMO, PPO, PFFS, and SNP. Choose the one that best meets your needs.

 

When can I enroll in a Medicare Advantage plan in New Jersey?

You can enroll in a Medicare Advantage plan in New Jersey during the Initial Enrollment Period around your 65th birthday, the Annual Open Enrollment Period from October 15 to December 7, or the Medicare Advantage Open Enrollment Period from January 1 to March 31.

Get Started Now

We can help make the process of finding the right Medicare Advantage plan easy.

To get started enter your zip code above to compare plans in your area, and even enroll online yourself!

Or, call us today to speak to one of our licensed insurance agents who can answer your questions and help find the best plan to fit your needs.

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Compare Medicare Plans

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Speak with a licensed insurance agent

1-844-709-9937
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Mon-Fri : 8am-9pm ET