Original Medicare provides excellent healthcare coverage and has been shown to be very effective in keeping older adults healthy and financially stable. But it does not cover everything. That means some beneficiaries find it difficult to afford certain aspects of it. Like the 20% Medicare Part B coinsurance and other out-of-pocket costs, and so they turn to New Jersey Medicare Supplement Plans for additional coverage. If you find yourself in this boat, or if you simply want to save some money on your medical expenses, you should look into one of these plans.
Medicare Supplement Plans are sold by private insurance companies to help fill the gaps in Medicare Parts A and B. These plans frequently cover your Part A deductible as well as your 20% coinsurance for Part B. But not all of them cover everything.
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The good news is that these plans require very little guesswork. They are sold by private insurance companies but are government standardized. In fact, the Centers for Medicare & Medicaid Services (CMS) regulates Medicare Supplement Plans. The CMS requires that all plans with the same letter name provide the same benefits no matter where or from whom they are purchased.
Premiums, however, differ depending on the insurance company you choose. So, it’s critical to compare different Medicare Supplement Plans as well as different insurers to find the best plan for you. EZ can assist you in comparing both. But first read our guide on how Medicare Supplement Plans work in New Jersey.
New Jersey Medicare Supplement Plans
If you need additional coverage to fill any gaps in Original Medicare, a Medicare Supplement Plan is your best option.
In New Jersey, there are ten standardized Medicare Supplement Plans. Each labeled with a letter of the alphabet: A, B, C, D, F, G, K, L, M, and N. While not every insurance company in New Jersey will offer every plan, insurance companies must offer Plan A to all customers. It’s also important to note that Plans C and F are only available to those who became Medicare-eligible prior to January 1, 2020.
To get you started, we’ve broken down all ten plans, as well as what they cover and the average premium range in New Jersey.
Plan A
Plan A, which is the only plan available from all insurers, is also the most basic. It’s basic, but it addresses one of the biggest gaps in Medicare coverage: the 20% of outpatient services you are required to pay by Medicare Part B. While all Medicare beneficiaries have access to Plan A, some states do not require insurers to offer this plan to Medicare disability beneficiaries under the age of 65.
Plan A premiums in New Jersey range from $103 to $284 per month.
Plan B
Medicare Supplement Plan B covers all the basics that Plan A does, including:
- Medicare Part A coinsurance and hospital costs – Medicare Part A only fully covers your first 60 days of inpatient hospital stays in a benefit period; after that, you are required to pay coinsurance for each day after your initial 60 days. Days 61-90 have a coinsurance of $400 a day, days 91-150 (after you use your Lifetime Reserve days) have a coinsurance of $800 a day. Plan B covers 100% of these costs.
- Medicare Part B coinsurance or copay – You’ll typically have to pay Medicare Part B coinsurance for doctor visits and other outpatient care. That means Medicare Part B pays 80% of the Medicare-approved amount for covered services, leaving you to pay the remaining 20%. Plan B covers 100% of this.
- First 3 pints of blood – Original Medicare only pays for the fourth and subsequent pints of blood if you need blood during treatment. Plan B will pay for the first three pints.
- Part A hospice care and coinsurance – Hospice care is for patients who are nearing the end of their lives. These services are covered by Medicare, but copayments are required. These copayments include $5 for each symptom and pain relief medication prescription, as well as 5% of the Medicare-approved amount for inpatient assisted living. Plan B covers all expenses related to hospice care.
Plan B is a step up from Plan A, though, because it also covers the Medicare Part A deductible, which Plan A does not. The Medicare Part A deductible in 2023 is $1,600 per benefit period; you may have to pay it more than once in a single year because it is calculated on a 60-day basis rather than on an annual basis. That means having a plan that includes this coverage could be extremely advantageous.
Plan B premiums in New Jersey will most likely range from $139 to $391 per month.
Plan C
While it is not available to all beneficiaries, Part C is one of the most comprehensive Medicare Supplement Plans available. It covers all out-of-pocket expenses, except for Medicare Part B excess charges. This means that Plan C covers the 20% coinsurance required for all outpatient services, as well as your Parts A and B deductibles.
Coverage includes the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B coinsurance and copayments
- Part B deductible
- Other Medicare-approved expenses associated with Part B coverage
Unfortunately, Plan C is no longer available to Medicare enrollees who became eligible after January 1, 2020. If you had Plan C before that date, you can keep it, and if you were eligible for Medicare before January 1, 2020 but haven’t yet signed up, you may still be able to purchase it.
Medicare Supplement Plan C premiums in New Jersey range from $163 to $515 per month.
Plan D
Plan D covers the majority of out-of-pocket expenses associated with Original Medicare including:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part B coinsurance
- First 3 pints of blood
- Skilled nursing facility (SNF) care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023. Plan D covers this coinsurance.
- Part A deductible
- 80% of foreign travel emergency costs (up to plan limits)
Medicare Supplement Plan D does not cover Medicare Part B deductibles or excess charges. If your doctor refuses to accept Medicare assignment and chooses to bill you for more than what Medicare would cover, you will be responsible for Part B excess charges. Any doctor who refuses to accept Medicare assignment can charge up to 15% more than the Medicare-approved rate for a healthcare service; the difference between what your doctor charges and the Medicare-approved amount is your excess charge, which is not covered by Plan D.
Plan D premiums in New Jersey can range from $126 to $384 per month.
Plan F
Because of its comprehensive coverage, Plan F has long been the most popular Medicare Supplement Plan on the market, but it is not available to all beneficiaries. You only have to pay your monthly Plan F premium with this plan; all other out-of-pocket expenses are covered. Plan F includes the following benefits:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B 20% coinsurance and copayments
- Medicare-approved doctor’s office fees
- Part B deductible
- Medicare Part B excess charges
- Other Medicare-approved expenses associated with Part B coverage
The only restriction is that anyone who became or becomes eligible for Medicare after 2020 will not be able to purchase Plan F. If you were eligible for Medicare before 2020, you can purchase one of these plans, or if you already have Plan F and are grandfathered in, you can keep it indefinitely.
In New Jersey, Plan F premiums typically range from $154 to $466 per month.
Plan G
If you like the sound of Plan F, but are not eligible to purchase one of these plans, look into Plan G. This plan covers almost everything that Plan F does, including:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Blood transfusion (first 3 pints)
The only thing Plan G does not cover is the Medicare Part B deductible. So, it is a very comprehensive plan – and it is also less expensive than Plan F.
Plan G premiums typically cost between $127 and $453 per month, making it more affordable than Plan F.
Plan K
Medicare Supplement Plan K reduces your out-of-pocket expenses with Original Medicare, but it does not completely fill the gaps. Plan K only covers half of the following costs:
- Medicare Part B coinsurance – Plan K covers half of these costs, so you will be responsible for 50% of your 20% Part B coinsurance. For example, if your doctor charges $100 for a service, Medicare Part B will cover $80, Plan K will cover $10, and you will pay the remaining $10.
- First 3 pints of blood
- Part A hospice care coinsurance or copayment – Plan K will pay for half of these costs.
- Skilled nursing facility care coinsurance – Plan K pays half of the coinsurance for medical care in skilled nursing care facilities.
- Medicare Part A deductible – Medicare Supplement Plan K will pay half of these deductibles, or $800. Plan K requires you to pay the Medicare Part B deductible, which is $226 in 2023.
Plan K has higher out-of-pocket costs, but it has one feature that other plans do not. An out-of-pocket maximum. That means you won’t have to pay more than $6,620 for Plan K in a single year (as of 2023). Once you’ve paid this much in out-of-pocket medical expenses, Medicare Supplement Plan K will cover the remaining approved costs for the year. Your maximum will be reset at the beginning of each calendar year.
Furthermore, while Plan K only covers half of many out-of-pocket expenses, it covers the Medicare Part A coinsurance completely. So, you won’t have to pay anything out-of-pocket if you have to stay in the hospital for more than 60 days.
Because of its higher out-of-pocket costs, Plan K premiums are lower than those of most plans. Ranging from $50 to $150 per month in New Jersey.
Plan L
Medicare Supplement Plan L covers the majority of Original Medicare expenses but not all of them. However, it covers them at a higher percentage than Plan K does. Plan L also has an out-of-pocket maximum ($3,310 in 2023). After which your insurance company will cover all of your expenses for the rest of the year. Because it covers a higher percentage of costs, and because its out-of-pocket maximum is lower than Plan K’s, Plan L can be a good deal.
Medicare Supplement Plan L pays for all Medicare Part A coinsurance and hospitalization costs. It also covers a portion of:
- Medicare Part B coinsurance – Plan L covers 75% of your Part B coinsurance.
- Blood – If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – Plan L pays 75% of the $200 per day (after the 20th day of your stay) coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – Medicare Supplement Plan L will cover 75% of your Part A deductibles for each 60-day benefit period. You must still meet your Medicare Part B deductible, which is $226 per year in 2023, if you choose Plan L.
Medicare Supplement Plan L premiums cost between $80 and $220 a month in New Jersey.
Plan M
Plan M covers the majority of your Original Medicare out-of-pocket expenses, but not all. Although it covers more than either Plans K or L do. It covers:
- Medicare Part B coinsurance – Plan M pays your Part B coinsurance and/or copayments in full.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan M will cover the first three pints of blood in full.
- Part A hospice care coinsurance or copayment – Plan M will cover all of your hospice care coinsurance and copays in full.
- Skilled nursing facility care coinsurance – Plan M covers the entire cost of Part A skilled nursing facility coinsurance.
- Part A hospital expenses and coinsurance
- Part A deductible – While Medicare Supplement Plan M covers most Part A costs, it will only cover half of your Medicare Part A deductible. If you have Plan M, you will have to pay half of the $1,600 (or $800) deductible rather than the full $1,600.
The cost of plan M premiums in New Jersey ranges from $93 to $254 per month.
Plan N
Plan N is yet another comprehensive Medicare Supplement option. It’s coverage excludes only two items: the Medicare Part B deductible ($226 in 2023) and any Medicare Part B excess charges. Which is any portion of medical bills that exceed the Medicare-approved amount. The only thing it has that most other plans do not are copayments for some Part B services.
Medicare Supplement Plan N provides nearly complete coverage for the following:
- Medicare Part B coinsurance – Plan N will cover your Part B coinsurance costs in full, with the exception of a copayment of up to $20 for some office visits. For emergency room visits that do not result in an inpatient admission, a second copayment of up to $50 may be required.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan N will cover the first three pints.
- Part A hospice care coinsurance or copayment – Plan N pays your hospice care coinsurance and copayments in full.
- Skilled nursing facility care coinsurance – Your skilled nursing facility coinsurance will be fully covered by Medicare Supplement Plan N.
- Part A deductible – Medicare Supplement Plan N pays your $1,600 deductible in full for each 60-day benefit period.
- Foreign travel emergency care – Original Medicare typically does not cover medical care received outside of the United States. If you need emergency care while traveling outside of the United States, Medicare Supplement Plan N will cover 80% of the costs of qualified emergency medical care.
The price for Plan N can range from $98 to $348 a month in New Jersey.
When to Enroll
Under federal rules, you will be given an Open Enrollment Period. Which is a six-month window that begins when you turn 65 and enroll in Medicare Part B. During the Open Enrollment Period you are given what’s called a ‘guaranteed issue’ for Medicare Supplement Plans. This means that you cannot be denied or charged more for coverage because of your health. You will only be granted this Medicare Supplement Open Enrollment Period once. So, you should take advantage of it, if at all possible.
It’s important to note that if you are under 65 and eligible for Medicare due to a disability, federal rules do not guarantee access to a Medicare Supplement Plan. Fortunately, though, New Jersey is among the majority of states that have adopted rules to ensure that enrollees under 65 have at least some access to Medicare Supplement Plans.
And, unlike many other states, New Jersey ensures that people under 65 do not pay higher premiums. In many states the premiums are still higher because insurers know that disabled enrollees are likely to incur higher costs.
Consumer protections for disabled Medicare Supplement enrollees in New Jersey include provisions for those under the age of 50. As well as those between the ages of 50 and 64. In both cases, as long as you apply for a Medicare Supplement Plan (Medicare Supplement Plan D as of 2020) within six months of enrolling in Medicare Part B, your coverage will be guaranteed-issue. Additionally, the price will not be higher than what the insurer charges enrollees who are eligible for Medicare due to their age.
How To Choose
When it comes to Medicare coverage, don’t be afraid to ask questions. Speak to an EZ agent who can explain everything to you and give you all the guidance you need. EZ can assist you in enrolling in Medicare, looking for a Medicare Supplement Plan, or simply weighing your options. Our agents work with the best insurance companies in the country. They can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs with you and help you find a plan that works for you. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.
