Key takeaways
- New Jersey residents have access to a range of Medicare options, including Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Part D for prescription drug coverage.
- Medicare Advantage plans in New Jersey, administered by private insurers, provide the same coverage as Original Medicare, often with added benefits like prescription drug coverage, vision, or dental care.
- To help cover out-of-pocket costs associated with Original Medicare, individuals in New Jersey can purchase Medigap plans from private insurance companies.
Medicare plans in New Jersey follow all federal guidelines for healthcare coverage for people ages 65 years or older or who have qualifying disabilities or medical conditions.
However, coverage specifications, additional benefits, and plans may vary. It is important to review all the options that are available in New Jersey.
Snapshot of Medicare in New Jersey
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in New Jersey for the 2026 plan year:
- 20.12% of people with a stand-alone Part D plan get Extra Help.
- A total of 1,795,719 residents of New Jersey were enrolled in Medicare.
- The average monthly Medicare Advantage plan premium changed from $22.50 in 2025
- to $25.23 in 2026.
- There are 85 Medicare Advantage plans available in New Jersey for 2026, compared with 92 plans in 2025.
- All New Jersey residents with Medicare have access to buy a Medicare Advantage plan with a $0 premium.
- For 2026, there are 12 stand-alone Medicare Part D plans available in New Jersey.
- As in most states, 10 different Medigap plans are offered in New Jersey for 2026.
In New Jersey, as in other states, Medicare includes several types of coverage:
- Original Medicare: This plan is managed by the federal government and includes Part A (hospital insurance) and Part B (medical insurance). It doesn’t include prescription drug coverage.
- Medicare Advantage (Part C): These plans are offered by private insurers and include all Original Medicare benefits along with other perks such as vision, dental, and drug coverage. Some plans have limited provider networks, so beneficiaries should confirm their doctors are in-network before enrolling.
- Medicare Part D: This is a private, stand-alone plan for prescription drug coverage. People can pair Part D with Original Medicare or with a Part C plan that doesn’t include drug benefits.
- Medigap (Medicare Supplement): These are private plans that help pay for out-of-pocket costs under Original Medicare, such as copays and coinsurance. Medigap can’t be used with Medicare Advantage. A person can choose among 10 standardized plans.
Availability for private plans varies by county, and beneficiaries can check Medicare.gov for local options.
New Jersey residents can qualify for Medicare at age 65 if they’re U.S. citizens or legal residents for at least 5 years. People under 65 may also qualify through disability, or by living with end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).
When choosing a plan, a person may consider provider networks, costs, and quality ratings. A person has the option to:
- Initial Enrollment: Enroll 3 months before to 3 months after their 65th birthday.
- Open Enrollment: Join or change plans from October 15 to December 7
- Medicare Advantage Enrollment: Switch Advantage plans from January 1 to March 31
- Special enrollment period: Enroll after a qualifying life change, such as losing job-based coverage.
A person eligible for Medicare due to a disability will be automatically enrolled. If they are eligible based on age, they will need to enroll.
If a person delays enrolling in Medicare Part B or Part D and doesn’t have other coverage, they may have to pay a late enrollment penalty. This can add to their monthly premium for as long as they have Medicare.
All plans must cover the same benefits and services as Original Medicare. However, costs and other benefits under Medicare Advantage plans vary.
Before selecting a plan, individuals may wish to carefully consider:
- whether hospitals and doctors they prefer are in the plan’s network
- The services that the plans cover
- Centers for Medicare and Medicaid Services (CMS) star ratings that measure plans’ health and drug services and beneficiary satisfaction
Several resources are available to answer questions people may have or help with New Jersey Medicare plans.
- Division of Aging Services/State Health Insurance Assistance Program (SHIP): 800-792-8820
- Aging & Disability Resource Connection: 877-222-3737
- Medicare: 800-633-4227
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
New Jersey offers various Medicare options to its residents, including Original Medicare, Medicare Advantage, and Medigap.
Individuals with questions about Medicare can contact Medicare directly or the State Health Insurance Assistance Program (SHIP) for help with Medicare planning.