What are the Medigap rules in New Jersey?

Outside your open enrollment period or a federal guaranteed issue right, a Medigap insurer can ask health questions, and it can decline you or charge more. That is the main reason the first decision at 65 matters so much.

New Jersey Medigap rules at a glance

Rule	New Jersey	Source
Medigap Open Enrollment	6 months from the month you are 65 and have Part B; no health questions	Medicare.gov
Under 50 with Medicare (disability)	A contracted carrier must issue Plan D if you apply within 12 months of Part B (eligible on or after January 1, 2020); same premium as age 65 buyers	NJ Department of Banking and Insurance
Ages 50 to 64 with Medicare (disability)	Carriers selling Medigap must issue Plan D if you apply within 12 months of Part B; rates no higher than for the same policy at 65	NJ Department of Banking and Insurance
Plans sold at 65	Standardized plans A, B, D, G, K, L, M, N and high-deductible G for anyone; Plans C, F and high-deductible F only for people eligible for Medicare before January 1, 2020	Medicare.gov Medigap guide

Source: New Jersey Department of Banking and Insurance: Medicare Supplement coverage for people under 65 (Under Age 50 Program and ages 50 to 64).

How Medigap works in New Jersey

A Medigap policy sits on top of Original Medicare and pays some or all of what Medicare leaves, such as the 20% Part B coinsurance and the Part A hospital deductible. Plans are standardized by letter, so a Plan G from one company has the same benefits as a Plan G from another; the price, the rate history and the company's service are what differ.

Medigap does not include drug coverage, so most people pair it with a stand-alone Part D plan; New Jersey has 11 of them for 2027. Plan G covers everything Original Medicare covers except the Part B deductible ($283 in 2026).

Plans C and F, which also cover the Part B deductible, are closed to anyone new to Medicare on or after January 1, 2020. If you turn 65 in 2026 or 2027, your choices are Plans A, B, D, G, K, L, M and N plus high-deductible G. Only people who were first eligible for Medicare before January 1, 2020 can still buy Plan C, Plan F or high-deductible F, and anyone who already has one can keep it (Medicare.gov, Choosing a Medigap Policy guide).

New Jersey rules if Medicare starts before 65

New Jersey law goes further than federal law for people who get Medicare early because of a disability. The Department of Banking and Insurance describes two programs. Under 50: a contracted carrier must issue Medigap Plan D to anyone under 50 who applies within 12 months of enrolling in Part B (for eligibility on or after January 1, 2020), at the same premium that carrier charges people age 65 for that plan, with no rating on health status, age or claims.

Ages 50 to 64: every carrier that sells Medigap to people 65 and older must also issue Plan D to applicants in its service area who became eligible because of a disability on or after their 50th birthday, again within 12 months of Part B, and it may not charge more than it charges for the same policy at 65. When you turn 65 you get the federal 6-month open enrollment period and can shop every plan letter (Medicare.gov).

How Medigap premiums are set, and excess charges

Each insurer decides how it prices a policy, so the same letter can cost very different amounts. The official Medicare.gov guide Choosing a Medigap Policy lists three pricing methods: community rating, where everyone pays the same regardless of age; issue-age rating, based on your age when you buy; and attained-age rating, where the premium rises as you get older. Ask which method a quote uses, because a low attained-age price at 65 can climb faster than an issue-age price.

A doctor who does not take Medicare assignment can charge up to 15% above the Medicare-approved amount, called the limiting or excess charge (Medicare.gov). Plan G pays those excess charges and Plan N does not, which is one reason Plan N usually costs less. If your doctors all accept assignment, the difference may not matter to you.

Worked example: an outpatient year without and with Plan G

Suppose Medicare approves $10,000 of outpatient care in 2026: imaging, a procedure, therapy. On Original Medicare alone you pay the $283 Part B deductible, then 20% of the remaining $9,717, or $1,943.40, for $2,226.40 in total, with no ceiling if the bills keep coming. With Plan G, your share is the $283 deductible and the policy premium.

What to do next

If you are within 6 months of starting Part B at 65, compare Medigap plans now while no health questions apply. If you are past that window, Jackie can check whether a guaranteed issue right applies before you apply anywhere, and compare Medigap with Medicare Advantage side by side at (856) 727-4221.

Related questions

Sources

1. New Jersey Department of Banking and Insurance: Medicare Supplement coverage for people under 65 (Under Age 50 Program and ages 50 to 64) New Jersey Department of Banking and Insurance
2. Medicare.gov: Ready to buy a Medigap policy? Centers for Medicare & Medicaid Services
3. 2026 Medicare Parts A & B Premiums and Deductibles Centers for Medicare & Medicaid Services
4. Medicare.gov: Choosing a Medigap Policy (official guide) Centers for Medicare & Medicaid Services
5. Medicare.gov: Medigap costs Centers for Medicare & Medicaid Services
6. Medicare.gov: Does your provider accept Medicare as full payment? Centers for Medicare & Medicaid Services

Please note: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.Garden State Medicare Solutions is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.