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Medicare

Medicare Advantage Plans in New Jersey

Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare offered by private insurance companies approved by Medicare. These are usually network plans such as HMOs and PPOs, with copayments and coinsurance throughout the plan. If you have one, it becomes your primary coverage, but you still keep paying your Part B premium. Plans that look alike in an advert can behave very differently when you need care, so Jackie starts with your doctors and your prescriptions, not the brochure.

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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.

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What to know before you choose

There is a lot to choose from. For 2027, the CMS Landscape file lists 41 Medicare Advantage plans in Camden County from 10 insurance organizations, not counting Special Needs Plans. 34 of them include Part D drug coverage, 33 have a $0 Part C premium, and in-network out-of-pocket limits run from $4,150 to $9,850 a year (CMS CY2027 Landscape). Each New Jersey county has its own list, so the comparison starts with your ZIP code. A spread that wide is why a TV advert is a poor way to choose.

The upside: one plan for most of your care, everything Original Medicare covers plus emergency and urgent care, usually drug coverage, often dental, vision or hearing extras, and you cannot be turned down for your health. The downside: you are restricted to the plan network except in an emergency, premiums and benefits can change every year, and moving to a Medigap plan later can be difficult.

A $0 premium plan still has costs. You keep paying your Part B premium to Medicare, $202.90 a month in 2026 for most people, and you pay copays and coinsurance as you use care, up to the plan's maximum out-of-pocket. What really decides your cost for the year is whether your doctors are in the network and how your prescriptions are priced on the plan's drug list.

Plan types matter more than most people expect. In Camden County for 2027 there are 26 PPO plans, 8 HMO plans with a point of service option and 7 HMO plans (CMS CY2027 Landscape). An HMO usually keeps you inside its network except for emergencies and urgent care and may ask for referrals. A PPO lets you go out of network at a higher cost, which suits people who travel or see doctors across the river in Philadelphia. An HMO with a point of service option sits in between.

Special Needs Plans are a separate group: 13 in Camden County for 2027 (5 for people with both Medicare and NJ FamilyCare, 5 for certain chronic conditions and 3 for people who live in a facility). If you qualify for one, it is worth a look; if you do not, it should not be counted as a choice you have.

Here is what a hard year can look like, as an illustration and not a quote. Say you are on a $0 premium plan and a hospital stay plus follow up care pushes you to the plan's in-network out-of-pocket maximum. In Camden County the 2027 maximums run from $4,150 to $9,850. Add twelve months of the 2026 Part B premium, $202.90 times 12, which is $2,434.80. On a plan with the lowest maximum, your Part B premiums plus covered in-network medical costs come to about $6,584.80 for that year; on a plan with the highest, about $12,284.80. Drug costs are counted separately: on a plan with drug coverage, what you pay for covered drugs stops at $2,400 in 2027 (CMS CY2027 Rate Announcement). Read the maximums as the most a bad year can cost, not a prediction of your bill.

Star ratings help, with care. CMS publishes each plan's 2027 Star Rating on Medicare Plan Finder for this enrollment period. A rating says how a plan performed, not whether your doctor is in it, so check both.

We pride ourselves in being the expert from start to finish. Consultations are by phone, Zoom, or in person, at no cost to you: call or text Jackie at (856) 727-4221.

New Jersey rules to know

If your income and savings are limited, New Jersey's Medicare Savings Programs can pay your Part B premium. In 2026 the QMB program covers single people with yearly income up to $15,960 and SLMB and QI go higher, up to $21,546 for QI (NJ Department of Human Services). You apply through the NJSave application.

If you have both Medicare and NJ FamilyCare, the state Medicaid program, a Dual Special Needs Plan may fit. You can apply for NJ FamilyCare online, by mail, or with help from your County Social Services Agency (NJ Division of Medical Assistance and Health Services).

For a no-cost, no-obligation review, call or text Jackie at (856) 727-4221. Medicare.gov and 1-800-MEDICARE list every plan in your area if you want to check a comparison against the full list, and your county Office on Aging can point you to local programs.

How and when to enroll

  1. When you first get Medicare: your Initial Enrollment Period is seven months, the three months before your 65th birthday month, that month, and the three after. You need Part A and Part B, and you must live in the plan's service area.
  2. Annual Enrollment: October 15 to December 7, 2026 for coverage starting January 1, 2027. This is when you can join, switch or drop a plan.
  3. Medicare Advantage Open Enrollment: January 1 to March 31, 2027, one change if you are already in a Medicare Advantage plan, including a move back to Original Medicare.
  4. Special Enrollment Periods open after events such as a move out of the service area, losing employer coverage, or qualifying for NJ FamilyCare.
  5. Bring your Medicare card, a list of every doctor and hospital you use, and every prescription with its dose. Jackie does the comparison with you, you decide, and she helps with the application.

Common mistakes to avoid

  • Choosing on the premium alone. A $0 premium plan with your doctor out of network can cost far more than a plan with a small premium.
  • Not checking the hospital. Your primary doctor may be in network while the hospital you would use is not.
  • Letting a plan roll over every year. Networks, drug lists and copays change each January; the Annual Notice of Change arrives in late September.
  • Assuming you can always switch to a Medigap plan later. Outside your Medigap window or a federal protection, a Medigap company can ask health questions and decline you.

What Jackie checks for you

  1. Your ZIP code and county first, because each New Jersey county has its own plan list.
  2. Every prescription with its dose and your pharmacy, priced on each plan that covers your area.
  3. Your doctors and the hospital you would use, checked against each plan network for 2027, at the office you actually visit.
  4. The 2027 Summary of Benefits for the costs people forget: the daily hospital copay, skilled nursing copays, specialist copays, outpatient surgery, imaging and prior authorization rules.
  5. The total, side by side: premium, likely copays, drug costs and the worst case maximum. Then you decide.

Questions to ask Jackie

  • Is every one of my doctors in this exact plan for 2027, at the office I use?
  • What do I pay for a hospital stay, day by day, and for a stay in skilled nursing afterwards?
  • Are my drugs on the formulary, on which tier, and with any prior authorization or step therapy?
  • What is the in-network maximum, and is there a separate one out of network?

How Jackie helps

  • Doctor by doctor network check for 2027, including specialists and the hospital you would use
  • Prescription by prescription drug list check: tier, pharmacy price, prior authorization and quantity limits
  • The maximum out-of-pocket explained in plain English, so you know what a bad year could cost
  • Extras compared honestly: dental, vision, hearing and fitness benefits
  • HMO, PPO and Special Needs Plan trade-offs explained before you choose
  • A review every Annual Enrollment Period, and one New Jersey phone number the rest of the year

Who it fits

You are turning 65, new to Medicare, or already on a plan that changed for 2027. You want one plan that handles most of your care, and you want someone to confirm your own doctors and prescriptions before you sign anything.

Does a $0 premium Medicare Advantage plan cost nothing?

No. "$0" describes the plan premium only. You still pay your Part B premium ($202.90 a month in 2026 for most people) plus copays and coinsurance when you use care, up to the plan's yearly out-of-pocket limit. Your real cost depends on whether your doctors are in network and how your drugs are priced, which is what Jackie checks first.

Next steps

Sources: CY2027 Medicare Advantage and Part D Landscape (Centers for Medicare & Medicaid Services, 2027) ; 2026 Medicare Parts A and B Premiums and Deductibles (Centers for Medicare & Medicaid Services, 2026) ; CY2027 Medicare Advantage and Part D Rate Announcement (Centers for Medicare & Medicaid Services, 2026/2027) ; NJ Medicare Savings Programs (QMB, SLMB, QI), 2026 limits (New Jersey Department of Human Services, 2026) ; NJ FamilyCare: Aged, Blind, Disabled programs (New Jersey Division of Medical Assistance and Health Services, 2026) . Reviewed 2026-10-20.

Tools

Run the numbers first

Calculators for this coverage. Results are estimates, not quotes.

Medicare enrollment dates

See your seven-month Initial Enrollment Period, your earliest coverage date and your Medigap open enrollment window.

Part B penalty calculator

See how much a late start on Part B adds to your premium, every month, for as long as you have Part B.

Part D penalty calculator

See what going without drug coverage adds to your Part D premium, for as long as you keep Part D.

Part D drug cost calculator

Estimate what your prescriptions cost you in a year on the 2027 Part D standard benefit (the $2,400 cap) or the 2026 benefit.

IRMAA calculator

See whether your income adds a surcharge to your Part B and Part D premiums, and how much.

Medigap vs Advantage costs

Compare what each path could cost you in a typical year and in a heavy-use year, with medical and drug costs counted separately.

Guides

Related guides

How to Check Your Doctors and Drugs Before Choosing a Plan

A step-by-step way to confirm your doctors are in network and your prescriptions are covered before you choose a 2027 Medicare plan: a Medicare Plan Finder walkthrough, drug tiers, prior authorization and the questions to ask the office and the pharmacy.

Your Annual Medicare Review Checklist for 2027

What to check every fall before your Medicare plan renews: the Annual Notice of Change, your drugs and pharmacy, your doctors, a worked total yearly cost comparison, and the questions to ask before December 7, 2026.

Medicare Enrollment Periods and Deadlines Explained

Every Medicare enrollment window in one place: the Initial Enrollment Period, Annual Enrollment October 15 to December 7, Medicare Advantage Open Enrollment, Special Enrollment Periods, the Medigap window and New Jersey's rules for people under 65.

FAQ

Medicare Advantage: common questions

When can I join or switch Medicare Advantage plans for 2027?

Annual Enrollment runs October 15 to December 7, 2026, and changes take effect January 1, 2027. If you are new to Medicare, your Initial Enrollment Period is the seven months around your 65th birthday month.

If you are already in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period, January 1 to March 31, allows one change. A move, loss of other coverage and some other events open a Special Enrollment Period.

How many Medicare Advantage plans are there in Camden County for 2027?

The CMS CY2027 Landscape lists 41 Medicare Advantage plans in Camden County from 10 insurance organizations, not counting Special Needs Plans. 33 have a $0 Part C premium, and in-network out-of-pocket limits run from $4,150 to $9,850. Other New Jersey counties have their own lists, so the comparison starts with your ZIP code.

What happens if my doctor leaves my Medicare Advantage network?

A doctor leaving mid-year does not by itself let you change plans. You would usually move to another in-network doctor, or pay out-of-network costs, which on many HMOs means paying the full bill.

That is why Jackie checks every provider before you enroll and again every fall.

Can I switch from Medicare Advantage back to Original Medicare and a Medigap plan?

You can return to Original Medicare during Annual Enrollment or the January to March Medicare Advantage Open Enrollment Period. Getting a Medigap plan afterwards is the harder part: outside your first six months on Part B or a federal protection, a company can ask health questions and decline you.

If you joined Medicare Advantage when you first got Medicare and leave within the first year, a federal trial right lets you buy Medigap without health questions.

We speak insurance, so you don't have to.

Medicare Advantage for South Jersey and all of New Jersey: no pressure, plain answers, and a review every year.

Book a no-cost consultation with Jackie Call (856) 727-4221

Serving South Jersey and all of New Jersey · (856) 727-4221

Content reviewed by Jackie Layser, Licensed Medicare Insurance Agent at Garden State Medicare Solutions, New Jersey, helping Medicare clients since 2008. How we source and review our content. Last updated .