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.
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.
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.
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.