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Medicare Advantage Plans in New Jersey

If you have Original Medicare (Part A and Part B) and are not completely satisfied with the benefits, a Medicare Advantage (Medicare Part C) plan may be right for you. Private insurance companies offer these plans instead of the federal government, and many offer additional benefits you cannot get with Original Medicare. Learn more about Medicare Advantage plans in New Jersey.

Medicare Advantage Plan Benefits

Medicare Advantage plans in New Jersey are required to provide the same benefits as Original Medicare, but many offer extras, such as dental, vision, and hearing benefits, as well as wellness programs.

Many of the Medicare Advantage plans also provide prescription drug coverage. While you have the option of purchasing prescription drug coverage (Medicare Part D) if you have Original Medicare, Medicare Part D operates separately from your medical and hospital insurance. Medicare Advantage plans are bundled, meaning all your benefits are provided in a single plan, simplifying the process.

Types of Medicare Advantage Plans in New Jersey

You have a variety of options when purchasing a Medicare Advantage plan. All options are not available across the entire state. When you get a quote for Medicare Advantage, you will find out which options are available to you.

Health Maintenance Organization (HMO) Plans

HMOs are very popular in the state of New Jersey. If your Medicare Advantage plan is an HMO, you will pick your providers from an extensive network. You’ll need to get a primary care provider first since he or she will refer you to specialists inside of the network when needed.

You must stay in the network to get coverage unless you need emergency care.

Preferred Provider Organization (PPO) Plans

If you prefer more flexibility, you might want to consider a PPO Medicare Advantage plan. You’ll still have access to a network of providers, but you can also receive care outside of the network. Look at the out-of-pocket costs before getting care outside of the network, though. You will pay more for care when you go outside of the network.

Special Needs Plans (SNP)

If you have Medicare and Medicaid, live inside of a nursing home, or have a chronic condition, you might qualify for a Special Needs Plan. These plans will help you get the care necessary for your special need, from proper medication to a network of providers who specialize in the treatment of a specific condition or disease.

Private Fee-for-Service (PFFS) Plans

If you don’t want to deal with a specific network of providers, a PFFS plan might be the right choice. While some of these plans have networks, many do not. Instead, you can go to any provider, as long as he or she agrees to the plan’s terms.

Medicare Savings Account (MSA)

MSA plans are essentially health savings accounts. The plan will put money in your account that you can use for healthcare expenses. These plans are paired with high-deductible health insurance coverage.

Prescription Drug Coverage

If you want prescription drug coverage, you need to get a Medicare Advantage Prescription Drug Plan. These plans combine health insurance with prescription drug coverage. Look at the formulary before purchasing a plan to ensure the medications you use are covered.

How to Choose a Medicare Advantage Plan

It’s important to do some research before choosing one of the Medicare Advantage plans in New Jersey. First, look at the benefits provided by the plan. Make sure the plan has the coverage you want, such as prescription drug benefits.

Then, look at the costs. Insurance companies set the price of these plans, so it’s critical to get quotes. As you do this, keep in mind that you’re responsible for your Medicare Part B premium.

You also need to consider the out-of-pocket costs. Some of the Medicare Advantage plans that don’t charge premiums make up for it with high out-of-pocket costs. Do your homework before purchasing a plan to determine which is the best one for you.

Get Help Selecting a Medicare Advantage Plan

With so much to consider when buying a Medicare Advantage plan, it’s a good idea to get help. Call 844-903-4406 to speak to a licensed insurance agent. The agent will help you compare plans and find one that offers the benefits you need at an affordable price.

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