New Jersey Medigap Basics

New Jersey Supplemental Medicare Insurance, or “Medigap,” helps ease the costs of hospital and outpatient services and fees not covered under Medicare insurance. This can include remaining balances of co-pays, deductibles, and services.

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New Jersey offers ten Medigap policies. These Medigap policies are “standardized” which means you will get the exact same coverage no matter which insurance carrier you choose. However, different companies offer different rates so it’s essential to shop around. To find companies in your area that offer Medigap insurance, fill out the zip code form to compare rates immediately.

Prescription Coverage

If you’re interested in any of the Medigap plans, you must already be enrolled in Medicare coverage. Prescription drug costs can be very expensive and are not covered, or fully covered, under all Medigap policies. A Stand-Alone Prescription Drug Plan has monthly premiums and deductibles ranging from just a few dollars to several hundred dollars a month depending on the prescription coverage you require.

Medicare Advantage Plans

One way to save money on Medicare costs in New Jersey is to opt into a Medicare Advantage Plan. You can select a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), or Private Fee-for-Service (PFFS). Many of these programs include prescription drug coverage.

The premiums, deductibles, and co-pays for Advantage Plans are usually much lower than traditional Medicare. However, keep in mind that just like when you had company or private health insurance, you are restricted to only seeing doctors and visiting health facilities within the network. If you see a doctor outside of the network, the fees can be very expensive.

Medicare Advantage plans replace the coverage provided by Medicare Parts A and B. Advantage plans are cheaper than Medicare, but provide the same services. The reason they are cheaper is because they have “in-network” providers that you are limited to choosing from when selecting health providers. The cost of the services provided by Medicare Advantage plans are reimbursed by Medicare, thus lowering the cost passed on to you. To find out how much a Medicare Advantage plan will cost, fill out the zip code form to compare rates.

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What A – N Covers

Fill out the zip code form to compare plans and to speak to a qualified insurance agent to discuss the details of each plan. Below is a basic overview of Medigap coverages. Note that these are Plans A – N. When mentioning “Part A” and “Part B,” it is concerning original Medicare Parts A and B, not Plans A or B.

  • Plan A: Provides an additional 20% of Part B co-insurance, hospital co-insurance, an additional 365 days of hospital coverage, and a blood deductible coverage.
  • Plan B: All of A and skilled nursing co-insurance.
  • Plan C: All of A and B and Part A deductible, Part B deductible, and health-related foreign travel.
  • Plan D: All of C (excepting Part B deductible) and at home recovery
  • Plan F: All of C and Part B excess.
  • Plan G: All of C and Part B excess at 80%.
  • Plan K: Completely covers the cost sharing for Part B preventative services, Part A hospital co-insurance, 365 days of additional hospital coverage, 100% of cost sharing for Parts A and B after a $4,000 deductible, and 50% of the following services: Part A and Part B blood deductibles, Part B co-insurance, skilled nursing facility co-insurance, cost sharing at hospices, and Part A hospital deductible.
  • Plan L: A low monthly premium option that includes 100% coverage for Part A hospitalization co-insurance, an additional 365 hospitalization days, 75% of hospice cost sharing, 75% of Medicare-approved expenses for the first three pints of blood, 75% of part B co-insurance, 100% of Part B preventative care services, 75% for skilled nursing co-insurance, 75% coverage for Part A deductibles, and a $2,310 out-of-pocket limit per year.
  • Plan M: This cost sharing plan requires higher out of pocket expenses in exchange for lower monthly premiums and includes all Medicare basic benefits being fully covered, no co-payments for ER and office visits, and 50% of Part A deductible.
  • Plan N: The same as Plan D but with $20 doctor visit co-pays and $50 ER visit co-pays.

Fill out the zip code form to get specific costs for plans in your area and to compare rates instantly.

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