Medicare Supplement Plans in New Jersey
For those who have Original Medicare, there is no annual out-of-pocket maximum. That's why so many beneficiaries choose to supplement their coverage in some way. Medicare Supplement plans in New Jersey help pay for a variety of healthcare costs
What Is Medigap in New Jersey?
There are 10 standardized Medicare Supplement plans available in New Jersey (A, B, C, D, F, G, K, L, M, and N). "Standardized" means that every Plan A (or D, G, etc.) provides the same benefits, no matter where you live or who your insurance provider is. Not every Medigap insurer offers all 10 plans. In addition, some provide high-deductible versions of one or more plans.
Although benefits are standardized, costs are not. Medigap insurers set their own premiums, working within state and federal guidelines.
Insurance companies only have to offer you a Supplement plan if you have a guaranteed issue right. At every other time, your application first goes through medical underwriting. The process starts with you answering a series of questions about age, tobacco use, and medical history. Insurance companies then use this information to decide whether to sell you a Medigap policy and at what rate.
Who Qualifies for Medicare Supplement Insurance in New Jersey?
Federal law states that anyone aged 65 or older AND enrolled in Original Medicare qualifies for Medicare Supplement Insurance. Most states also require Medigap insurers to offer plans to under-65 beneficiaries who qualify for Medicare due to a disability. This includes New Jersey, which requires insurance companies that sell Medicare Supplement Insurance to provide Medigap Plan C to under-65 applicants. As of 2020, this requirement changed to Medigap Plan D.
New Jersey also requires Medigap insurers to dedicate 65 percent of the premiums they collect to paying member claims. In the case of group policies, that number increases to 75 percent.
What Does Medigap Cover?
Medicare Supplement benefits vary according to the plan you choose. At a minimum, though, every Medigap plan covers the Medicare Part A coinsurance and provides an addition 365 lifetime reserve days for inpatient hospital care.
The following table helps compare Medigap plan benefits:
Please note that Medicare Supplement Insurance does not include prescription drug coverage. You get these benefits with a Medicare Part D prescription drug plan.
Medigap Plan C and Medigap Plan F in New Jersey
As of January 1, 2020, new Medicare beneficiaries may not enroll in either Medigap Plan C or Medigap Plan F. This is due to a new federal law barring Supplement plans from paying the Medicare Part B deductible.
We recommend Medigap Plan D or Medigap Plan G instead. These plans offer the same benefits as Plans C and F, respectively, minus the Part B deductible.
When Is the Best Time to Join a Medicare Supplement Plan in New Jersey?
The best time to join a New Jersey Medicare Supplement plan is during your 6-month Medigap Open Enrollment Period (OEP). It begins the day you enroll in both Medicare Part A and Medicare Part B and is one of the few times you have guaranteed issue rights. If you're age 65 or older, this means your application cannot be rejected and you cannot be charged more for the plan.
Beneficiaries who are under age 50 only get the same protections when they use Horizon Blue Cross Blue Shield of New Jersey, which is New Jersey's contracted carrier. Between the ages of 50 and 64, beneficiaries can use any New Jersey Medigap insurer.
Once you turn 65, you'll get a second Medigap Open Enrollment Period and the same protections as if you were a first-time Medicare enrollee.
How to Choose a Medigap Plan in New Jersey
Since New Jersey Medigap plans are standardized, the first step is deciding how much coverage you want. We recommend choosing the most comprehensive benefits you can afford, since medical underwriting may make that impossible if you don't have a guaranteed issue right.
The next concern is pricing. There are three pricing methods:
- Attained-age rated: Premiums start out low but go up as you age. These policies usually cost the most over your lifetime.
- Community rated: Also known as no-age rated, since premiums aren't based on your age. These are generally the least expensive option.
- Issue-age rated: Premiums are based on your age at the time you join the plan but do not go up because you get older. They may rise over time due to inflation, though.
Most New Jersey Medigap insurers use attained-age or issue-age pricing.
Our Find a Plan tool makes it easy to compare Medigap plans in New Jersey. Simply enter your location information and coverage start date to review Medicare plan options in your area.