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Medicare in New Jersey

April 7, 2022

Medicare in New Jersey

If you call New Jersey home and you are approaching the age of 65, you might be thinking about retirement and how to handle health coverage. Medicare can be complex, but it’s important to understand it so you can choose the plan that’s best for your needs.

This guide will answer many of the most commonly-asked questions about Medicare in New Jersey. If you have specific concerns about your unique situation, we’re available to help as well!

Does New Jersey Have Medicare?

Medicare is a nationally-available health plan that aims to help Americans without employer insurance coverage pay for medical care. It’s available in New Jersey and every other U.S. state.

Eligibility for Medicare is based on age and/or specific medical conditions. To enroll in Medicare, you have to be a U.S. citizen or permanent resident who has lived in the US for at least five years, and one of the following conditions must also apply:

  • Age 65 or older
  • Under 65 but disabled and receiving disability benefits from Social Security or the Railroad Retirement Board
  • Having Amyotrophic Lateral Sclerosis (ALS), better known as Lou Gehrig’s disease
  • Having end-stage renal disease (ESRD)

Your initial enrollment period is an important time. You’ll have additional benefits, such as automatic approval for Medigap plans, that don’t happen again. That’s why it’s important to understand this coverage and choose the right plan from the beginning.

How Do I Get Medicare in NJ?

When you’re eligible for Medicare, you may be automatically enrolled in Original Medicare Parts A and B. However, that leaves important gaps in your coverage — like prescription drugs — and may not be the best option for your needs.

To answer “What’s the best Medicare plan in NJ?” you’ll need to compare the available plans based on costs and benefits. When you do, you’ll be sure to end up with the coverage you need.

If you want Original Medicare, you’ll want to look at Part D plans for prescription medications. Each plan will have its own costs and a list of covered drugs, so you’ll want to compare carefully before making your choice. You may also want to look at Medigap plans to help you cover out-of-pocket expenses.

Another option for Medicare is to choose a Medicare Advantage plan. These are offered by private insurers and may give you additional coverage that Original Medicare doesn’t offer. Again, these plans vary, so be sure to compare the details before making your decision.

Is Medicare Advantage Available in NJ?

Medicare Advantage, or Medicare Part C, is a full replacement plan for Original Medicare. There are more than 5.7 million people with a Medicare Advantage plan in New Jersey. These plans are sold by private insurance companies and have many of the same benefits and limitations as regular health insurance.

For example, you’ll get at least as much coverage as Original Medicare but in most cases will get more. Your Advantage plan will likely include prescription drug coverage and may also offer benefits like vision or dental care.

However, you’ll also have a limited medical network that’s focused on your local area. It may be difficult or impossible to get non-emergency care covered at an out-of-network provider. As a result, if you travel often you might find that Original Medicare is a better choice.

What is the Best Medicare Advantage Plan in NJ?

Every Medicare Advantage plan is different and has its own benefits and limitations. The right Advantage plan for you starts with finding a plan that covers your preferred medical providers, hospitals, and specialists.

Then, look at the prescription drug coverage to make sure your medications are listed and the price is reasonable. Finally, look for extra benefits and compare the monthly premiums along with other costs like deductibles, copayments, and coinsurance.

Finding an affordable plan is one that has the benefits that are important to you — for example, vision care if you have glasses — is the best way to pick an Advantage plan.

Contact Us to Learn More About Medicare in New Jersey

Understanding your Medicare options and choosing your plan can be challenging. This guide answered many of the questions we hear about Medicare in New Jersey, but it’s likely you have additional concerns as well. Talking to a licensed agent can help. Contact us today to speak to a professional about your Medicare options.

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