You can join, switch or drop Medicare Advantage plans in New Jersey for 2027 during Medicare Open Enrollment, October 15 through December 7, and the new coverage starts January 1. Every New Jerseyan with Medicare had access to a $0-premium Medicare Advantage (Part C) plan in 2026, so look past the premium when you compare. What separates them is whether your doctors are in the network, how your prescriptions and New Jersey's Pharmaceutical Assistance to the Aged and Disabled (PAAD) drug help fit the plan, and how high the plan's yearly out-of-pocket limit sits.,,

In This Guide

When You Can Choose a Medicare Advantage Plan in New Jersey

Medicare Advantage plans can be joined, switched or dropped only during set enrollment periods. Four windows matter to a New Jersey shopper.

Window Dates What you can do When the change takes effect
Medicare Open Enrollment October 15 to December 7 Join, switch or drop a Medicare Advantage plan; move from Original Medicare to Medicare Advantage or back January 1
Medicare Advantage Open Enrollment Period January 1 to March 31 If already in Medicare Advantage: one change, to another Medicare Advantage plan or back to Original Medicare (and a drug plan) First day of the month after the plan gets your request
Initial Enrollment Period Usually the 7 months around your 65th birthday month Join a Medicare Advantage plan if you have Part A and Part B; change plans or return to Original Medicare within your first 3 months Varies
Special Enrollment Periods Triggered by events such as a move or a plan leaving Medicare Join, switch or drop a plan outside the yearly windows Varies by event

The table draws on Medicare's enrollment rules for each window.,, The Medicare Advantage Open Enrollment Period, January 1 to March 31, cannot be used to move from Original Medicare into a Medicare Advantage plan.

If you have reviewed your options and are happy with your current Medicare Advantage plan, you do not need to do anything during Medicare Open Enrollment: the coverage continues automatically, and any changes to its benefits or costs for the new year start January 1.

Three Special Enrollment Periods come up most for New Jersey members:

Medicare Advantage Plans in New Jersey at a Glance

A Medicare Advantage plan is a Medicare-approved plan from a private company that bundles Part A (hospital) and Part B (medical) coverage, and usually Part D drug coverage, into one plan. A Medicare Advantage plan must cover all medically necessary Part A and Part B services except hospice, which Original Medicare keeps covering even while you are in the plan.

The Centers for Medicare & Medicaid Services (CMS) reported these New Jersey figures for the 2026 plan year:

  • 85 Medicare Advantage plans were available in New Jersey in 2026, compared with 92 in 2025.
  • The average monthly Medicare Advantage plan premium in New Jersey rose from $22.50 in 2025 to $25.23 in 2026.
  • 100% of New Jerseyans with Medicare had access to a Medicare Advantage plan, and 100% had access to one with a $0 monthly premium.

The CMS figures above are for the 2026 plan year. Plans, premiums and benefits can change every year, so the 2027 options for your ZIP code are the ones to compare this fall.

Most New Jersey Medicare beneficiaries still use Original Medicare. In June 2026, CMS counted 1,842,581 people with Medicare in New Jersey: 1,079,897 in Original Medicare and 762,684 in Medicare Advantage and other Medicare health plans. Uptake differs sharply by county. In Hudson County, 49,163 of 89,187 Medicare beneficiaries were in Medicare Advantage and other health plans in June 2026; in Monmouth County, the figure was 46,245 of 148,744.

To join a Medicare Advantage plan, you must have Part A and Part B, live in the plan's service area, and be a U.S. citizen or lawfully present, and you can be in only one Medicare Advantage plan at a time. If you have job-based or union coverage, talk to that benefits administrator before you join: joining a Medicare Advantage plan can cause you, your spouse and your dependents to lose that coverage, and you may not be able to get it back.

Plan Types and Networks

Medicare Advantage plans come as HMOs, HMO Point-of-Service (HMOPOS) plans, PPOs, Private Fee-for-Service (PFFS) plans, Special Needs Plans (SNPs) and Medical Savings Account (MSA) plans, and the area where you live might have all, some or none of those types.

Any Medicare Advantage plan type may require prior authorization, meaning the plan's approval before it covers certain services or items. If a Medicare Advantage plan does not approve a prior authorization request, you may have to pay the full cost of that service, item or drug. For a fuller side-by-side, see Medicare Advantage HMO vs. PPO.

How to Compare New Jersey Medicare Advantage Plans for 2027

A Medicare Advantage plan must notify its members of plan-rule changes taking effect January 1 at least 15 days before Open Enrollment begins, that is, by September 30.

1
Step 1

Read your plan's Annual Notice of Change

The Annual Notice of Change lists the changes in coverage, costs, provider network, service area and more that take effect in January.

2
Step 2

Write down your doctors, hospitals and prescriptions

Network and prior authorization rules decide whether a plan works for you, so check each name against each plan you consider.

3
Step 3

Search Medicare Plan Finder by ZIP code

Medicare tells people to use Medicare.gov/plan-compare to compare plans side by side and find plans offering extra benefits that matter to them. The Medicare Payment Advisory Commission (MedPAC) has noted that Plan Finder carries limited detail about supplemental benefits, so confirm a dental or vision benefit with the plan itself.

4
Step 4

Compare the yearly out-of-pocket limits

Each Medicare Advantage plan has a yearly limit on what you pay for covered Part A and Part B services; PPOs set one limit for in-network care and a second, combined limit that also counts out-of-network care.

5
Step 5

Ask New Jersey's SHIP to help you weigh your options

Volunteer counselors with New Jersey's State Health Insurance Assistance Program help Medicare beneficiaries evaluate their health insurance options, including Medicare Advantage and Part D plans, free of charge; they do not sell or recommend any plan, so the choice stays yours.

6
Step 6

Enroll in the plan you choose before Medicare Open Enrollment closes

What You Pay in a Medicare Advantage Plan

In a Medicare Advantage plan you still pay the monthly Part B premium, and you may also pay the plan's own premium. The standard Medicare Part B premium is $202.90 a month in 2026. Each year the Medicare Advantage plan, not Medicare, sets what you pay for premiums, deductibles, services and drugs, and those costs can change from one year to the next.

Some Medicare Advantage plans help pay all or part of your Part B premium, a feature sometimes advertised as a "give back." Medicare calls the feature a Part B premium reduction, and it is not available in all areas. The money comes from the same plan rebate that can instead fund dental, vision or hearing benefits or lower cost sharing, so compare the whole plan rather than the size of the premium reduction.

The yearly out-of-pocket limit is the protection Original Medicare lacks. Federal rules capped Medicare Advantage plans' in-network out-of-pocket costs for Part A and Part B services at $9,250 in 2026, and many plans set a lower limit. CMS sets that federal ceiling each year. Once you reach your Medicare Advantage plan's limit, you pay nothing more for covered Part A and Part B services for the rest of the year; the limit does not count Part D drug costs, which have their own cap.

Feature Medicare Advantage plan Original Medicare
Yearly out-of-pocket limit Required in every plan for Part A and Part B services None, unless you add Medigap, Medicaid, or employer, retiree or union coverage
Prior authorization Plans may require it for certain services Generally not required; New Jersey's WISeR test adds it for a short list of services
Extra benefits Most plans offer some routine dental, vision, hearing or fitness Not covered by Original Medicare
Drug coverage Usually built in Join a separate Medicare drug plan
Medigap Cannot be used Can be added
Hospice Covered by Original Medicare, not the plan Covered

The rows above come from Medicare's descriptions of each option and CMS's WISeR model.,,,,

Prescription Drugs, PAAD and Senior Gold

Most Medicare Advantage plans include Medicare drug coverage, and every Special Needs Plan must. If you join a Medicare Advantage HMO or PPO that has no drug coverage, you cannot add a separate Medicare drug plan, and going without creditable drug coverage can mean a late enrollment penalty if you sign up later.

New Jersey's two state drug programs, PAAD (Pharmaceutical Assistance to the Aged and Disabled) and the Senior Gold Prescription Discount Program, wrap around Medicare Part D, and both are applied for through NJSave. Each treats a Medicare Advantage plan differently:

  • PAAD: a PAAD beneficiary in a Medicare Advantage plan must add a prescription benefit to that coverage, and PAAD contributes up to the regional benchmark amount toward the prescription portion of the plan's premium. In 2026, PAAD co-payments are $5 for each covered generic and $7 for each covered brand-name drug. In 2026, PAAD income must be under $54,943 for a single person or under $62,390 for a married couple.
  • Senior Gold: Senior Gold members must have Medicare Part D coverage and pay the Part D premium directly to their plan; Senior Gold does not pay it.

Check every prescription against each plan's drug list. If a PAAD member's Part D plan does not cover a drug because it is not on the plan's formulary, the member must switch to a covered drug or have the doctor ask the plan for a medical-necessity exception. The full program rules are in our guide to New Jersey PAAD and Senior Gold.

If You Have Both Medicare and New Jersey Medicaid

New Jersey's Division of Medical Assistance and Health Services tells residents with both Medicare and Medicaid that they can enroll in a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP), which coordinates Medicare and Medicaid benefits in one plan with a single ID card and a single provider network. New Jersey also has highly integrated (HIDE) SNPs, according to CMS's 2026 integration-status file. How those plans work, and how to choose one, is covered in New Jersey FIDE SNPs.

Medicare Advantage or Original Medicare and Medigap in New Jersey

Medigap works only with Original Medicare. Medigap cannot pay a Medicare Advantage plan's copayments, coinsurance, deductibles or premiums, and while you are in a Medicare Advantage plan it is illegal for anyone to sell you a Medigap policy unless you are switching back to Original Medicare. If you already have Medigap and drop it to join a Medicare Advantage plan, you may not be able to get the same policy back later.

New Jersey is one of six states in CMS's WISeR model, which tests prior authorization in Original Medicare for a select set of services, such as skin and tissue substitutes, electrical nerve stimulator implants, and knee arthroscopy for knee osteoarthritis, from January 1, 2026 through December 31, 2031. CMS states that WISeR does not change Medicare coverage and does not apply to people with Medicare Advantage. If the provider does not ask for approval, the claim goes through medical review before payment instead, and a denied claim keeps your normal Original Medicare appeal rights.

For the general trade-offs, see Original Medicare vs. Medicare Advantage.

Leaving Medicare Advantage Later

Federal law gives two trial rights that let you leave a Medicare Advantage plan in its first year and buy Medigap without medical underwriting or a pre-existing-condition waiting period:

  • You joined Medicare Advantage when you first became eligible at 65 and switch back to Original Medicare within the first year: you can buy any Medigap policy sold in New Jersey, except that Plans C and F are closed to people new to Medicare on or after January 1, 2020, who get Plan D or G instead.
  • You dropped a Medigap policy to try Medicare Advantage for the first time and have been in the plan less than a year: you can get your old policy back if the same company still sells it. If it does not, you can buy Medigap Plan A, B, C, D, F or G from a company selling in New Jersey, with the same Plan C and F limit for people new to Medicare since 2020.

Apply for the Medigap policy as early as 60 days before your Medicare Advantage coverage ends and no later than 63 days after it ends, and send your disenrollment or termination letter with the application. Without a guaranteed issue right, and outside your one-time Medigap Open Enrollment Period, there is no guarantee an insurer will sell you a Medigap policy if you do not meet its medical underwriting requirements.

New Jersey adds one protection for people under 65. A New Jerseyan who became entitled to Medicare through disability on or after January 1, 2020 can get Medigap Plan D by applying within 12 months of enrolling in Part B, at no more than the premium a 65-year-old pays: from the state's contracting carrier, currently Horizon Blue Cross Blue Shield of New Jersey, if under 50, and from any carrier selling Medigap to people 65 and older if 50 to 64. At 65, the federal 6-month Medigap Open Enrollment Period starts the first month you have Part B and are 65 or older, and it happens only once. Details are in New Jersey Medicare Supplement (Medigap) and Switching Between Medicare Advantage and Original Medicare.

Free Help Comparing Plans: New Jersey SHIP

New Jersey's SHIP is the state's State Health Insurance Assistance Program, administered by the New Jersey Department of Human Services and funded in part by a federal grant. New Jersey SHIP help is free to New Jersey Medicare beneficiaries. SHIP's volunteer counselors do not sell, recommend or endorse any insurance company or plan. New Jersey SHIP counseling sites operate in all 21 counties, appointments can be virtual, by phone or in person, and the SHIP Information Center number is 1-800-792-8820. Bring your Annual Notice of Change and your medication list. More on what counselors do is in New Jersey SHIP, and the difference from a commissioned agent is explained in SHIP Counselor vs. Medicare Broker.

Frequently Asked Questions

Can I use my New Jersey Medicare Advantage plan if I spend winters in another state?

It depends on the plan type. A Medicare Advantage HMO generally covers care only from its network, apart from emergency care, out-of-area urgent care and temporary out-of-area dialysis, so check whether the network reaches the state where you winter. A Medicare Advantage PPO generally covers out-of-network providers for covered services at a higher cost, as long as the provider agrees to treat you and has not opted out of Medicare.

Can I change my New Jersey Medicare Advantage plan after December 7?

Yes, once. From January 1 through March 31, a person already in a Medicare Advantage plan can switch to another Medicare Advantage plan or drop back to Original Medicare and join a Medicare drug plan. A New Jersey PAAD member who uses that change to return to Original Medicare should join a Medicare drug plan as part of that change, because PAAD requires Medicare-eligible members to be enrolled in a Medicare Part D plan.

Do I still pay the Part B premium with a $0-premium Medicare Advantage plan?

Yes. Medicare Advantage members still pay the monthly Medicare Part B premium, which is $202.90 in 2026., Some Medicare Advantage plans have a Part B premium reduction that pays all or part of it; the reduction lowers what you pay but does not remove the obligation to have Part B, and because plans can change what they charge each January 1, re-check it at every Open Enrollment.

Can I go back to Original Medicare and buy Medigap in New Jersey?

You can return to Original Medicare during Medicare Open Enrollment or the January-to-March Medicare Advantage Open Enrollment Period., A guaranteed right to buy Medigap applies if you are within a federal trial right, generally your first year in Medicare Advantage, inside New Jersey's 12-month under-65 window, or in your one-time Medigap Open Enrollment Period. Without a guaranteed issue right, an insurer may use medical underwriting and may deny you a policy.,

Learn More

MedicareNew Jersey Medicare Plans and CoverageNew Jersey Medicare in 2026: Original Medicare, Medicare Advantage, Part D, and Medigap, with NJ under-65 protections, 2026 costs, and free SHIP help. MedicareNew Jersey PAAD and Senior GoldNew Jersey's PAAD and Senior Gold help pay Medicare Part D drug costs for seniors. See the 2026 income limits, the copays, and how to apply through NJSave. MedicareNew Jersey FIDE SNPsA New Jersey FIDE SNP covers Medicare and NJ FamilyCare benefits, nursing-home stays included, in one plan. What it covers, what you pay, how to switch. MedicareNew Jersey Medicare Supplement (Medigap)New Jersey guarantees Medigap Plan D to under-65 Medicare beneficiaries with no age surcharge. The 2026 rules, the 12-month deadline, and how to apply. MedicareHow Medicare Advantage WorksMedicare Advantage (Part C) is a Medicare-approved private plan that gives you most of your Part A and B coverage. What you pay, networks, and when to switch. MedicareMedicare Advantage's Yearly Out-of-Pocket Cap, ExplainedEvery Medicare Advantage plan caps your yearly Part A and B costs. Original Medicare has no cap of its own unless you add other coverage. How the MOOP works.

Find personalized help comparing New Jersey Medicare Advantage plans for 2027 at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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