How to Find the Best New Jersey Medicare Advantage Plans

The best Medicare Advantage Plan in New Jersey is the one that provides the coverage the buyer needs. MoneyGeek evaluated different plans in order to determine the highest-rated options in the state that provide broad benefits and are widely available. According to our research, the best PPO plan in New Jersey is the Aetna Medicare Explorer Premier Plus plan, while the top HMO plan is the Humana Gold Plus H6622-063 plan.

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Last Updated: 9/23/2022
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MoneyGeek researched Medicare Advantage Plans that are widely available in New Jersey and have the highest rating based on the Centers for Medicare & Medicaid Services (CMS) five-star quality rating system. We broke down the best plans based on plan type, whether or not they have drug coverage and out-of-pocket costs.

These recommendations are generalized, so you should shop for a plan that fits your needs the best. Also, make sure the plans you are considering have your preferred hospitals and providers in their network.

MoneyGeek also analyzed the best medicare supplement plans in New Jersey for those focused on covering out-of-pocket expenses.

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Best Medicare Advantage Plans in New Jersey

Best Medicare Advantage Plan in New Jersey - Overall

To find the best Medicare Advantage Plan, you should evaluate your healthcare needs and preferences. For instance, if you want a PPO plan that ranks well according to the CMS rating system, provides six-core benefits and drug coverage, MoneyGeek’s research found that the Aetna Medicare Explorer Premier Plus plan by Aetna Medicare is the top option.

PPO or Preferred Provider Organization plans have a wider network of treatment centers, doctors and hospitals. These plans come with an array of benefits and provide great flexibility to the policyholders. You also won’t need a referral to see a specialist with this type of plan. However, the premiums can be a bit higher compared to other plans.

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MoneyGeek Top Pick
Aetna Medicare

As per MoneyGeek’s findings, Aetna Medicare Explorer Premier Plus from Aetna Medicare is the best PPO plan in New Jersey. However, the right plan for you may vary based on your needs.

The details of the plan include:

  • Monthly premium of $37
  • Drug coverage with a deductible of $300 yearly
  • It has an in-network max-out-of-pocket limit of $7,550
  • As per CMS ratings, it received 4.5 stars out of 5

This plan includes all the six core benefits like vision, hearing, dental, worldwide emergency, fitness and telehealth. For frequent travelers, the worldwide emergency benefit can be a great relief for paying medical bills when they are traveling. This plan also earned a high rating from the CMS and provides Part D drug coverage.

Best HMO Medicare Advantage Plan in New Jersey

Based on your unique healthcare needs, you should shop around to determine which HMO plan is best for you. MoneyGeek researched the best HMO plan in New Jersey that has drug coverage, six core benefits and a high rating from CMS. The top option is the Humana Gold Plus H6622-063 plan offered by Humana.

An HMO or Health Maintenance Organization plan is the most popular type of healthcare plan. It is usually cheaper compared to other plans like PPO, PFFS and others. However, the network of hospitals is more restricted compared to a PPO plan. That said, you can seek out-of-network care during an emergency. This type of plan requires a referral if you want to see a specialist.

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MoneyGeek Top Pick
Humana

MoneyGeek found that the Humana Gold Plus H6622-063 offered by Humana is the best HMO plan in New Jersey. However, the best plan depends on individual preferences and needs.

The details of the plan include:

  • Monthly premium $0
  • Drug coverage offered with a deductible amount of $225
  • 4.5 stars out of 5 on CMS rating systems
  • In-network max-out-of-pocket limit is $6,500

Humana Gold Plus plan offers all the six core benefits like vision, dental, hearing, fitness, worldwide emergency and Telehealth benefits. It is highly rated on CMS rating systems and offers Part D drug coverage.

Best Medicare Advantage Plan in New Jersey Without Drug Coverage

There are more Medicare Advantage Plans available for people who don’t need Part D drug coverage.

MoneyGeek found that in New Jersey, the best plan with or without drug coverage, six-core benefits and high ratings on CMS is Humana Gold Plus H6622-063 plan offered by Humana. This is also the top HMO plan in the state based on MoneyGeek’s research.

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MoneyGeek Top Pick
Humana

We found that the Humana Gold Plus H6622-063 plan (HMO) could be the best in New Jersey for those looking for a plan with or without drug coverage. This plan provides drug coverage with an annual deductible of $225.

Here are the plan details:

  • Monthly premium of $0
  • In-network max-out-of-pocket limit is $6,500
  • Overall star rating of 4.5 out of 5 from the CMS

Humana Gold Plus H6622-063 plan has all the six common additional benefits, including vision, dental, hearing, fitness, worldwide emergency and telehealth. It also has a high rating from CMS.

Best Medicare Advantage Plan in New Jersey for Low Max Out-of-Pocket Costs

In New Jersey, you will find that most healthcare plans charge no or low monthly premiums. While this may seem great financially, these plans may not be completely helpful when paying expensive bills associated with medical emergencies. To avoid paying hefty medical bills, you should consider plans that have a low in-network max-out-of-pocket limit.

As per our findings, the best Medicare Advantage Plan in New Jersey with a low in-network max-out-of-pocket limit is Humana Choice H5216-170 (PPO) plan offered by Humana. It offers all the six core benefits and is rated highly by CMS.

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MoneyGeek Top Pick
Humana

MoneyGeek found that the Humana Choice H-5216-170 plan could be the best in New Jersey if you are looking for a plan with or without drug coverage. However, the right plan for you could vary based on your needs.

The plan details details include:

  • Monthly premium of $33
  • Drug coverage with $250 annual deductible
  • CMS rating of 4 stars out of 5 stars
  • MOOP of $6,500

If your healthcare plan has a lower max-out-of-pocket limit for in-network hospitals, then you will not have to pay large medical charges if you have a very expensive year for health payments. With plan Humana Choice H5216-170, the max-out-of-pocket limit for in-network expenses is $6,500. Once you reach this limit, you do not have to pay anything from your pockets. However, the out-of-network MOOP will be different when it comes to PPO plans. For out-of-network costs within this plan, the max-out-of-pocket limit is $11,000.

Medicare Advantage Plan in New Jersey - Statistics

A total of 10 healthcare organizations in New Jersey offer Medicare Advantage plans. The following statistics will help you learn more about plan types, costs and benefits offered in the state.

1

New Jersey Medicare Advantage Plans are a mix of HMO and PPO plans, with 87.10% of the plans offering drug coverage

Health Maintenance Organization plans constitute 52.30% of the total plans in New Jersey, while the remaining 47.70% are Preferred Provider Organization plans. Drug coverage is provided by most of the plans in the state, with around 87.10% of the total plans offering this benefit.

2

57% of Medicare Advantage Plans in New Jersey have a $0 premium

In New Jersey, 57% of Medicare Advantage Plans have no premiums. The remaining plans have an average premium of $57.40.

3

Vision, hearing, dental, fitness and telehealth benefits are common in New Jersey, with most plans offering them.

In New Jersey, you will find that all the Medicare Advantage Plans offer vision, dental, hearing, telehealth and fitness benefits. The most uncommon benefits in the state include in-home support, home safety devices & modifications and emergency response devices.

Methodology

MoneyGeek collected data from the Centers for Medicare & Medicaid Services 2022 MA Landscape Source Files released in October 2021. Plans in New Jersey were filtered down to those that offer drug coverage (unless otherwise noted), offer six of the most common Medicare Advantage coverage benefits and are available to at least 50% of the population of New Jersey based on county availability.

About the Author


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Mark Fitzpatrick is a senior content manager with MoneyGeek specializing in insurance. Mark has years of experience analyzing the insurance market and creating original research and content. He graduated from Boston College with a Bachelor of Arts and Johns Hopkins University with a Master of Arts.