How to Find the Right Medigap Plans in NJ

by Kanopy Insurance

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Medigap might just be the best-kept secret for Garden State residents if you have or are thinking about getting Medicare. Teeming this Medicare Supplement Plan with Original Medicare coverage of medical expenses, prescriptions, and deductibles is often praised for helping New Jersey locals that are 65 and older make the most out of retirement.

If ever a state needed Medigap, it’s New Jersey. With 55 million Americans and over 1 million New Jersey residents using Medicare in 2015, Medigap plans become a vital aspect of enjoying retirement. Plus, state taxes for retirees are lower in New Jersey than most other states, and you can use those savings to supplement your Medicare policy.

If you’re looking to find the right Medigap plan in New Jersey, we’ve rounded up some of Medigap’s most valuable benefits and tips. From how to enroll to choosing the best plan, ahead is your guide to finding the right Medigap plan for New Jerseyans.

How Does Medigap Work in New Jersey?

While researching your options for Medigap, you will find it is also referred to as Medicare Supplement Insurance. Both alternatives refer to the same concept: a policy designed to cover some of the health care costs that Original Medicare does not. It fills in your insurance gaps.

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Insurance gaps always exist, even in a high-reward policy program like Medicare. Your premiums for Medicare Part A and Part B might be low, but you will still be responsible for additional payments such as copayments, coinsurance, and deductibles.

Supplementing your Medicare with Medigap can help you account for those payments. In New Jersey, Medigap policies are offered by private insurance companies, who seek to help you pay any medical expenses above your premiums. As a result, only existing Medicare Part A and Part B enrollees can use this policy to supplement their existing Original Medicare.

The process is simple: once you are eligible, you can enroll in one of ten supplemental plans. These plans will come with their premiums but cover many (and sometimes all) of your out-of-pocket medical expenses.

When Should I Enroll in Medigap in New Jersey?

Put simply, the best time to enroll for your Medicare supplement plan in New Jersey is during your Medigap Open Enrollment Period (OEP).

This term denotes a six-month period, which begins on the first day of the month you meet both of these criteria:

  • You are 65 years old
  • You are enrolled in Medicare Part B (If you aren't signed up for Part B by your 65th birthday month, the six month period begins once you enroll)

If you enroll within your OEP, you will not need to submit your medical background or history, which means that you don't have to worry about being denied complete coverage. In fact, you will not even need to worry about potential higher premiums as a result of your medical history.

The end of your OEP is not necessarily the end of your Medigap eligibility. As long as you are 65 years or older and remain a Medicare Part A and Part B enrollee, you are eligible for a Medigap plan. In that case, however, you may need medical underwriting, and pre-existing conditions could result in higher costs or even denial of coverage.

How to Choose a Medigap Policy in New Jersey

You can choose between one of ten standardized Medigap policy options in New Jersey. These packages vary depending on how much is covered by the supplemental insurance, and how much of your medical expenses will come out of your own pocket. Generally speaking, plans that pick up more expenses on your behalf tend to come with higher premiums in return.

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The State of New Jersey has provided a Medigap resource page with charts that outline your exact benefits, premiums, and expenses (divided by male and female options) for each of the 10 options current and aspiring retirees have in their Medicare supplemental insurance.

Here is a short overview of the state's most popular options:

Plan F: This policy is the most comprehensive and popular Medigap plan in New Jersey, with almost 200,000 enrollees as of 2014. All of your medical expenses, other than prescriptions, will be covered. Of course, because of that blanket coverage, your premiums will also be higher than they are in the below alternatives.

Plan G: The next step down from Plan F is Plan G, which covers all expenses after your Medicare Part B deductible. After paying this deductible (which is $183 in 2017), no out-of-pocket expenses will be required for the rest of the year. In exchange, your premiums tend to be between $20 and $30 lower than they are in Plan F, depending on the exact supplement insurance you choose.

Plan N: Among the ten standardized Medigap plans, Plan N is the most affordable in terms of monthly premiums. In fact, depending on your insurance provider, you can pay up to $60 less per month in premiums. In exchange, you will be responsible both for your Part B deductible, along with a $20 office visit and $50 emergency room copay. Plan N also does not cover excess charges; if you need medical service from a provider that does not accept Medicare, you might be charged up to 15 percent more than Medicare is willing to reimburse.

Finding the Best Medigap Plan For You

In short, Medigap is a perfect opportunity to make an already good health care plan even better. By adding a Medigap policy, you can make sure that you will be able to afford unexpected medical expenses.

The key to success is both understanding and making the most of your Open Enrollment Period, and the plans available to you. With that information, you can find a policy that works for your individual needs.

As you approach your OEP, start shopping around for potential Medigap plan options. Look for a plan that offers premiums affordable for your monthly budget, while still giving you a degree of security against unanticipated expenses.


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