New Jersey Medicare Supplement Plans (Medigap)
New Jersey Medicare Supplement Plans work alongside Medicare to provide added coverage for the out of pocket (OOP) expenses. New Jersey residents who are currently enrolled in Original Medicare are eligible for a Medicare Supplement Plan.
Individual insurance companies carry these Medigap Plans to provide coverage for what’s not covered by Traditional Medicare, such as deductibles, copayments and coinsurance. Medicare and Medicare Supplement Plans are broken down into parts and plans and will be explained here.
- Traditional Medicare Part A provides hospitalization coverage and inpatient services.
- Medicare Part B includes outpatient coverage for services associated with doctor’s visits and other outpatient medical expenses.
- Part C or Medicare Advantage is considered a Medicare Replacement Plan. Providing the same benefits as straight Medicare and sometime more, but comes with certain policy limitations.
- Medicare Part D is a purchased prescription drug plan providing medication coverage.
To go along with the 4 parts of Original Medicare, there are ten Medicare Supplement letter plans. supplemental insurance provides assistance with OOP costs not covered by Traditional Medicare.
What Benefits Does Medicare Cover in New Jersey
Both Medicare Part A and B cover 80% of your inpatient and outpatient coverage. This leaves 20% remaining which the Medicare beneficiary is financially responsible for. Based on your individual healthcare needs, New Jersian’s can save a ton on OOP expenses with a Medicare Supplement Plan.
How to Qualify for New Jersey Medicare Supplement Plans
You must already be 65 years of age and currently enrolled in Medicare Part B. Your Open Enrollment Period (OEP) starts the three months prior to your 65th birthday and continues through your birthday month and then three months after. Giving you a total of 7 months for your OEP.
If you fail to enroll during your OEP it will result in a penalization.The Part B penalty increases your premium by 10% for each full 12-month period without coverage. This will be added onto the $134.00 a month premium, thus increasing your OOP expenses.
To be considered eligible for Medicare under the age of 65, you must 1st-be disabled, 2nd- currently receive Social Security Disability benefits, 3rd- have end stage renal disease, or 4th receive Railroad Retirement Benefits. You’re automatically enrolled in Medicare Parts A and B after 24 months.
Federal law doesn’t require private insurance carriers to offer Medicare Supplement plans. New Jersey’s state law however, does. The 10 Medicare Supplement Plans available can be further discussed and we can answer any questions you may have. Call today and one of our licensed insurance agents can help provide more information.
Sign Up for a Medicare Supplement Plans in New Jersey
As previously discussed, the 7 month OEP is the best time to enroll in a Medicare Supplement policy. The 1st day of the month after turning 65 and carrying Medicare Part B and the next 6 months is the OEP. For example, if your birthday was May 31st and your Medicare Part B effective date was June 5th, then your OEP begins July 1st.
During your OEP is when you are given what is called the Guaranteed Issue (GI) right. With your granted GI, you’re automatically eligible for supplemental insurance regardless of any pre-existing medical conditions.
Additionally, the insurance carrier’s are unable to increase your premium rate or perform underwriting. It is imperative to enroll during OEP to ensure GI so you can avoid the potential of more expensive insurance premiums or altogether coverage denial.
New Jersey Medicare Supplement Plan Prices
Your insurance premiums are determined by each state’s individual insurance providers. Determining factors for cost include your age, sex and location. So a gentleman living in Mount Laurel, NJ vs a lady living in Warren County, NJ will have different insurance premiums.
Additionally, there are 3 different pricing methods are used. Community rated pricing, issue-age rated pricing, or attained-age-rated pricing are the three different pricing methods and you can click here for more info.
The Best medicare Supplements in New Jersey
Regardless of which carrier you choose, the insurance benefits on the 10 letter plans will stay the same regardless of which state you live in. The monthly premium charge will be the only variation. Of the 10 Medicare Supplement Plans, the top 3 letter plans are Plans F, G and N.
Plan F is considered the most popular of all the letter plans as it provides the best overall, coverage. New Jersey Medicare Supplement Plan F provides 100% coverage of the deductible in both Medicare Parts A and B. Additionally, it covers the 20% of hospital and outpatient costs not covered by straight Medicare.
Medicare Part B coinsurance and copayments are another benefit with this plan. It also has the luxury of foreign travel coverage which not all plans include. There’s a Plan F High Deductible version that provides the same great benefits, but with a lower monthly premium and a higher deductible.
Similar to Plan F, Plan G has all the same benefits with the only difference being no Part B deductible coverage. It does however, have the added benefit of covering excess charges which New Jersey physicians are allowed to charge.
Considered a cost-sharing plan, Plan N is the most affordable of all the plans, but with less benefits. It covers the deductible of Medicare Part A and requires a small copayment for office and ER visits.
New Jersey Medicare Advantage Plans
Medicare Advantage Plans are also offered by the individual insurance companies. Also referred to as a Medicare Replacement Plan as it, “replaces” your Original Medicare Part A and Part B coverage.
An Advantage Plan cannot be combined with any of the Supplement Plans and also comes with restrictions. While premiums with Advantage Plans are typically cheaper than a Medicare Supplement Plan, overtime your OOP costs are higher.
Most seniors opt rather to have a Medicare Supplement Plan as they receive better benefits with less OOP cost.
With no prescription drug coverage offered by Traditional Medicare or any of the New Jersey Medicare Supplement Plans, you will want to look into obtaining a Medicare Part D Plan (PDP). A PDP provides coverage for any OOP expenses associated with prescription medications.
There is a Part D penalty that starts after your 7 month initial enrollment period. Once your IEP has expired, depending on how long you go without drug coverage, an added charge will be calculated into your monthly premiums.
For the most coverage benefits with the least OOP cost, New Jersey seniors should carry Traditional Medicare, a Medicare Supplement Plan and a Prescription Drug Plan combined.
How to Apply for Medicare Online in New Jersey
To apply for a Medicare Supplement Plan online, you can fill out our online form today! Our licensed insurance agents can help compare rates and plans and our services are always 100% free.
Resources for Medicare Help in New Jersey
OOP expenses associated with insurance benefits can get pricey. Being that most seniors are on a fixed income, there are state health insurance programs available to provide financial assistance for those that qualify. You can find New Jersey’s insurance assistance program here NJ-SHIP.
Medicare Fun Facts in New Jersey
Back in 2015, almost 1.5 million Medicare beneficiaries were enrolled in the state of New Jersey, which was 17% of the total population. In 2013, the distribution by eligibility was 13% disabled and the remaining 87% reached age 65. Also during that time frame, there was just under 14,000 Medicare beneficiaries in New Jersey that had ESRD, that’s 1.0% of the total beneficiaries.
New Jersey Medicare FAQs
- How do I get New Jersey Medicare Supplement Rates? By filling out our online rate form or calling our toll free number, we can assist with rate comparison for all of the Medicare Supplement Plans.
- How do I get vision and dental insurance in New Jersey? As dental and vision is not covered by Traditional Medicare, you would want to obtain a separate policy to obtain both types of coverage. Again, by calling or filling out the online form, we can help assist you in finding the best policy for all your individual healthcare needs.
- What are the Medicare Part B premiums in Florida vs New Jersey? The standard premium amount nationwide as of 2018 is $183.00. This can increase depending on income and possibly decrease if you receive social security benefits.