We researched the best Medicare Advantage plans in New Jersey to identify top providers by plan type, focusing on CMS star ratings, premium costs and maximum out-of-pocket (MOOP) limits to highlight the best value. Clover Health leads the state for HMO coverage and PPO plans, while Wellcare is the top choice for HMO-POS options.
Best Medicare Advantage Plans in New Jersey (2026)
Updated: April 30, 2026
Advertising & Editorial Disclosure
Key Takeaways
New Jersey residents have access to nine Medicare Advantage providers with 49 plans to choose from. Monthly premiums range from $0 to $182, while maximum out-of-pocket (MOOP) limits range from $2,900 to $9,250 annually.
Clover Health is the best Medicare Advantage provider in New Jersey for both HMO and PPO plans in New Jersey, while Wellcare leads for HMO-POS plans.
When choosing a Medicare Advantage plan in New Jersey, it’s important to consider the doctors and hospitals you want to access, your prescription drug requirements and your overall budget.
Best Medicare Advantage Providers in New Jersey
| HMO | Clover Health | 4.00 | $0 | $6,000 | Clover Health Classic (HMO) |
| HMO-POS | Wellcare | 3.50 | $45 | $9,250 | Wellcare Low Premium (HMO-POS) |
| PPO | Clover Health | 3.50 | $0 | $8,500 | Clover Health Choice Giveback (PPO) |
Medicare Advantage Plans Explained
Medicare Advantage plans cover everything Original Medicare includes, plus benefits it doesn't: dental, vision and prescription drug coverage. Private insurers administer these plans, bundling Part A and Part B services into a single policy.
- CMS Star Ratings: Scores run from 1 to 5 stars, with 4- and 5-star plans showing stronger customer service and care coordination.
- Monthly premiums: Many plans in New Jersey charge $0 beyond your standard Part B premium, though your total monthly cost varies by plan and location.
- Maximum out-of-pocket (MOOP) limits: Once you hit your annual limit, your plan covers 100% of remaining costs for covered services.
- Prescription drug coverage: Most plans bundle Part D medication benefits into your coverage, giving you access to necessary prescriptions at lower costs than paying out of pocket.
Clover Health
Best HMO
MoneyGeek Rating
5/ 5
5/5Affordability
5/5Quality
5/5Availability
CMS Star Rating
4.0Plan Types
HMO, PPO
WellCare
Best HMO-POS
MoneyGeek Rating
5/ 5
5/5Affordability
5/5Quality
5/5Availability
CMS Star Rating
3.5Plan Types
HMO-POS
Best New Jersey HMO Medicare Advantage Providers
New Jersey seniors have a range of HMO Medicare Advantage options that balance cost, coverage, and network access. Out-of-pocket limits for these plans range from $4,500 to $9,250, averaging $7,550 annually. Across 10 plans from five providers, seven charge $0 monthly premiums. The average CMS star rating is 3.7, with five plans earning 4 stars or higher. All include enhanced Part D drug coverage.
- Clover Health offers two plans with a 4-star rating, including one $0-premium option and an average $6,000 MOOP.
- Humana provides two plans averaging $0 monthly, earning 3.5 stars, though maximum out-of-pocket costs are higher at $8,643.
- Aetna delivers three 4-star plans, charging $44 per month with $9,250 average MOOP limits.
| Clover Health | 4.00 | $0 | $6,000 | 2 | 5 |
| Humana | 3.50 | $0 | $8,643 | 2 | 4.27 |
| Aetna | 4.00 | $44 | $9,250 | 3 | 3.98 |
| Cigna HealthCare | 3.00 | $0 | $7,500 | 1 | 3.98 |
| Jefferson Health Plans | 3.50 | $0 | $6,250 | 2 | 3.75 |
HMO PROS AND CONS
HMO Medicare Advantage plans require you to stay within a provider network and get referrals for specialist care. You'll benefit from lower premiums, reduced out-of-pocket costs, and coordinated care that makes managing your health care easier. These plans work well if you're comfortable having a primary care doctor coordinate your treatment and don't need out-of-network specialists.
Best New Jersey HMO-POS Medicare Advantage Providers
New Jersey has 13 HMO-POS plans from three providers, averaging $46 per month, with five plans charging $0 premiums. MOOP limits run from $2,900 to $9,250, averaging $7,434. That's higher than traditional HMOs, but these plans include out-of-network access that standard HMOs don't cover.
- Wellcare offers four plans, including two $0-premium options, averaging $45 monthly with a $9,250 MOOP and a 3.5-star CMS rating.
- UnitedHealthcare has the most choices with seven plans averaging $46 per month, a 3.68-star rating and a $6,440 average MOOP.
- Aetna's two plans earn the highest CMS rating at 4 stars, averaging $37 per month with a $9,250 average MOOP.
| Wellcare | 3.50 | $45 | $9,250 | 4 | 5 |
| UnitedHealthcare | 3.68 | $46 | $6,440 | 7 | 4.1 |
| Aetna | 4.00 | $37 | $9,250 | 2 | 3.99 |
HMO-POS PROS AND CONS
HMO-POS plans work best for people who want coordinated, affordable care but occasionally need out-of-network access. You get most of the cost benefits of a standard HMO with the option to see out-of-network doctors when needed, though those visits cost more. A primary care physician handles most coordination, so these plans fit best if you're comfortable with that structure and want predictable premiums.
Best New Jersey PPO Medicare Advantage Providers
New Jersey has 25 PPO plans from seven providers, averaging $29 per month, with 13 plans charging $0. MOOP limits run from $6,800 to $9,250, averaging $8,707. Plans average 3.78 stars, with nine rated 3.5 stars. All include enhanced Part D coverage and waive deductibles on select medication tiers.
- Clover Health has four $0-premium PPO plans with an $8,500 MOOP and 3.5-star CMS ratings.
- Cigna HealthCare offers one plan at $0 premium with the state's lowest MOOP at $6,800, though it carries a 3.0-star rating.
- Humana has three plans averaging $10 per month, a $7,893 MOOP and the highest CMS rating among these providers at 3.84 stars.
| Clover Health | 3.50 | $0 | $8,500 | 4 | 5 |
| Cigna HealthCare | 3.00 | $0 | $6,800 | 1 | 4.42 |
| Humana | 3.84 | $10 | $7,893 | 3 | 4.41 |
| Aetna | 4.50 | $61 | $9,250 | 8 | 3.98 |
| UnitedHealthcare | 3.50 | $39 | $8,117 | 3 | 3.95 |
| Braven Health | 4.00 | $25 | $9,188 | 3 | 3.85 |
| AmeriHealth | 2.50 | $0 | $9,250 | 3 | 3.75 |
PPO PROS AND CONS
You'll pay more with PPO Medicare Advantage plans through higher monthly premiums and out-of-pocket maximums, but you get complete provider flexibility. These plans let you visit any Medicare-approved doctor without referrals and give you access to both in-network and out-of-network care, though staying in-network saves money.
How to Find the Best New Jersey Medicare Advantage Plans
Review your health care needs and total costs to choose the right Medicare Advantage plan in New Jersey, not the monthly premium alone.
- 1Check Your Doctor and Hospital Network
Before choosing a plan, confirm your doctors, specialists and preferred hospitals are in-network. HMO plans restrict you to in-network providers except for emergencies; PPO plans allow out-of-network visits at higher costs. Learn more about health insurance network types to understand these differences.
- 2Compare Maximum Out-of-Pocket Costs
Don't focus only on monthly premiums. A plan with a $0 premium but a $7,833 MOOP could cost more annually than one with a $29 premium and a $6,750 cap if you need frequent care.
- 3Review Prescription Drug Coverage
Check that your medications appear on the plan's formulary and note their tier placement, which affects your costs. Most Medicare Advantage plans include Part D coverage, though some require separate enrollment. Higher-tier drugs carry higher out-of-pocket costs.
- 4Evaluate Additional Benefits
Many Medicare Advantage plans include dental, vision, hearing aids, fitness memberships and transportation to medical appointments. Compare which extras each plan offers against your actual needs.
- 5Consider CMS Star Ratings
Each plan's CMS star rating measures quality and performance on a scale from 1 to 5 stars. Plans rated 4 or 5 stars tend to show better customer service, care coordination and health outcomes than lower-rated options.
Average New Jersey Medicare Advantage Cost
Network design drives Medicare Advantage costs in New Jersey. Plans with narrower networks generally keep premiums and out-of-pocket expenses lower, while broader access increases costs.
HMO plans offer the state’s most affordable coverage, with $0 median premiums and $7,550 average maximum out-of-pocket (MOOP). PPO plans also have $0 median premiums but higher MOOPs at $8,708 to account for out-of-network access. HMO-POS plans average $34 per month with $7,435 MOOP, providing added point-of-service flexibility. Regional PPOs carry the highest costs, with $139 monthly premiums and $9,250 MOOP, reflecting their nationwide network coverage.
| HMO | $0 | $15 | $7,550 |
| HMO-POS | $34 | $46 | $7,435 |
| PPO | $0 | $29 | $8,708 |
| Regional PPO | $139 | $139 | $9,250 |
Best New Jersey Medicare Advantage: FAQ
Get answers about New Jersey Medicare Advantage plans:
When can I enroll in a Medicare Advantage plan in New Jersey?
In New Jersey, enrollment occurs during the Annual Enrollment Period (Oct. 15 - Dec. 7) and the Medicare Advantage Open Enrollment Period (January 1 - March 31). You may also enroll during a Special Enrollment Period if you qualify due to circumstances like relocating or losing other coverage.
Does Medicare Advantage cover prescription drugs in New Jersey?
Most Medicare Advantage plans in New Jersey include prescription drug coverage built into the plan. Before enrolling, confirm your medications appear on the plan's formulary and review their tier placement, which directly impacts your out-of-pocket costs at the pharmacy.
Do I need to change Medicare Advantage plans if I move to a different county in New Jersey?
You may need to switch plans since Medicare Advantage networks vary by county location. Contact your plan provider within 30 days of relocating to verify continued coverage availability. You can utilize a Special Enrollment Period to enroll in a different plan if necessary.
Our Methodology: How We Chose the Best New Jersey Medicare Advantage Plans
We assessed Medicare Advantage plans in New Jersey using an evaluation framework that emphasizes cost and quality. Three criteria identify the best-value plans:
- Affordability (50%): Costs make up half the total score because of their direct effect on your spending. We analyzed combined monthly premiums for Part C and Part D coverage (weighted at 30%) and in-network MOOP limits (weighted at 20%). Plans with lower premiums and MOOP thresholds score higher.
- Star Ratings (40%): CMS star ratings measure plan performance in care quality, customer service and member experience. The Overall Star Rating combines Part C and Part D scores into a single 1 to 5-star scale. Higher-rated plans score better in our evaluation.
- Availability (10%): We factor in each insurer's coverage area across the U.S. Providers serving more states score higher, as wider availability points to stronger infrastructure and better support if you relocate.
About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident insurance expert. He has analyzed the insurance market for almost a decade, first with LendingTree and now with MoneyGeek, conducting original research on hundreds of insurance companies and millions of insurance rates for insurance shoppers.
He writes about economics and insurance on MoneyGeek, breaking down complex topics so people can have confidence in their purchase. Like all MoneyGeek analysts, Mark collects and analyzes independent cost and consumer experience data on insurance companies to provide objective recommendations in our content that are independent of any of MoneyGeek's insurance company partnerships.
His insights on products ranging from car, home and renters insurance to health and life insurance have been featured in The Washington Post, The New York Times and NPR, among others.
Mark holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He started his career working in financial risk management at State Street before transitioning to the analysis of the personal insurance market. He's also a five-time Jeopardy champion!