New Jersey Medigap Under 65 Rules (2026)

New Jersey guarantees a Medigap policy to residents who reach Medicare under 65 through disability and apply within 12 months of Part B enrollment, at no more than the premium a 65-year-old pays.1 The federal Medigap Open Enrollment Period does not open until you are both 65 and enrolled in Part B.2 New Jersey does not make you wait for that birthday: state law runs two guaranteed-issue tracks, one for people under age 50 and one for ages 50 through 64, both landing on Medicare Supplement Plan D and both governed by that 12-month application deadline.1

In This Guide

• Key Takeaways
• How Medigap Works in New Jersey
• The New Jersey Under-65 Medigap Rule
• How to Use the New Jersey Under-65 Medigap Right
• Plan G vs Plan N: The Choice at 65
• Why Plan D, and Why Plans C and F Are Closed
• When You Can Buy or Switch
• What It Costs and How Insurers Price It
• Who Regulates Medigap in New Jersey and How to Complain
• Frequently Asked Questions

How Medigap Works in New Jersey

Medigap is private insurance that pays the deductibles and coinsurance Original Medicare leaves to you. A Medigap policy pairs with Original Medicare rather than with a Medicare Advantage plan, and each Medigap policy covers one person, so a New Jersey couple needs two policies. New Jersey uses the federal standardized framework: policies are sold as lettered plans A-D, F, G, and K-N (Plans E, H, I, and J are no longer sold, though someone who already holds one can generally keep it), and the benefits inside a letter are fixed by federal rule, so a Plan G from one New Jersey insurer covers what a Plan G from another covers.4 Insurers compete on price and service, so the letter is your first decision and the company your second.

The exposure Medigap closes is real money. In 2026 the annual Part B deductible is $283, after which Original Medicare pays 80% of the approved amount for most outpatient care and leaves you the remaining 20% with no annual cap, and the Part A inpatient hospital deductible is $1,736 per benefit period, which can apply more than once in a year.5,6

What New Jersey adds sits at the other end of the age range.

The New Jersey Under-65 Medigap Rule

The federal open-enrollment window is written around a 65th birthday, which leaves people who reach Medicare earlier, through disability, outside it. New Jersey addressed that in 1995 with a law requiring that Medicare Supplement coverage be available to residents who become entitled to Medicare before 65 because of disability, administered by DOBI. Medicare's official Medigap guide lists New Jersey among the states requiring insurers to offer at least one kind of policy to people with Medicare under 65.1

The law splits into two tracks with different sellers, the same plan letter, and the same deadline.

If you are under age 50

N.J.S.A. 17B:26A-14 through 17 directs DOBI to run a program assuring that people under 50 who become entitled to Medicare due to disability can get Medicare Supplement coverage. At least one New Jersey carrier, designated the Contracting Carrier, must issue coverage to any applicant under 50 who applies within 12 months of enrolling in Medicare Part B, for people who became Medicare-eligible on or after January 1, 2020, and it offers Plan D to that group. The Contracting Carrier must charge an under-50 buyer the same premium it charges a 65-year-old buying that plan, and may not rate on health status, age, or claims. The losses it absorbs are spread by assessment across all carriers writing health benefits plans in New Jersey. DOBI names Horizon Blue Cross Blue Shield of New Jersey as the current Contracting Carrier, and the rules sit at N.J.A.C. 11:4-23A.1

Because the Contracting Carrier is a contract award rather than a permanent designation, confirm the current one on DOBI's Medicare Supplement Under 50 page before you apply.

If you become eligible between 50 and 64

This track has no single designated seller. Under N.J.S.A. 17B:26A-13, every carrier that offers Medigap to people 65 and older in New Jersey must also issue Plan D to any applicant in its service area who becomes Medicare-eligible due to disability on or after January 1, 2020, provided they apply within 12 months of enrolling in Part B. New Jersey carriers must rate those under-65 Plan D policies on the same basis as all other Medicare Supplement plans, and may not charge more than the carrier charges a 65-year-old for the same policy. The rules sit at N.J.A.C. 11:4-23B.1

The practical difference is choice: under 50 you take what the Contracting Carrier offers; from 50 to 64 you can shop the whole New Jersey market for the same Plan D.

One date governs both New Jersey tracks: Plan D applies to New Jersey applicants who became Medicare-eligible on or after January 1, 2020, while anyone eligible before then was covered under Plan C, with a six-month application window on the 50-to-64 track.1

How to Use the New Jersey Under-65 Medigap Right

New Jersey's 12-month under-65 Medigap guarantee runs on a clock, and that clock starts at your Medicare Part B enrollment date.1

If 12 months have passed since your Part B enrollment, New Jersey's under-65 Plan D guarantee no longer applies to you. Your federal six-month Medigap Open Enrollment Period still arrives when you turn 65 and are enrolled in Part B, and during it an insurer cannot refuse to sell you any Medigap policy it offers, cannot medically underwrite your application, and cannot charge you more because you have health problems. One limit applies even then: the insurer may refuse to cover your out-of-pocket costs for a pre-existing condition for up to six months, unless you had at least six months of continuous prior creditable coverage.2

Plan G vs Plan N: The Choice at 65

New Jersey's under-65 buyers get Plan D.1 At 65 the choice widens to the full lettered menu, and most people compare two of them. Medigap Plan G is available to people newly eligible for Medicare on or after January 1, 2020, and gives the same benefits as Plan F except that Plan G does not cover the annual Part B deductible; Plan G does cover Part B excess charges.4

Plan G pays these gaps Original Medicare leaves you:2

• the Part A hospital deductible
• the Part A coinsurance, plus hospital costs for up to an additional 365 days
• the Part B coinsurance
• the blood benefit for the first three pints
• the Part A hospice care coinsurance
• skilled nursing facility care coinsurance
• foreign travel emergency care, at 80% up to plan limits rather than in full2

Medigap Plan N pays 100% of the Part B coinsurance except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that do not lead to an inpatient admission, and Plan N does not cover Part B excess charges. In exchange, Plan N usually carries a lower premium than Plan G.4

There is a third version of the same letter. High-deductible Plan G pays those identical benefits, but only after you have paid Medicare-covered costs up to a separate deductible of $2,950 in 2026.4

Both letters are federally standardized, so every insurer's Plan G is identical to every other Plan G and every Plan N to every other Plan N; the two differ on cost sharing.4

Why Plan D, and Why Plans C and F Are Closed

Plans C and F once covered the annual Part B deductible. Under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), any Medigap plan that pays the annual Part B deductible is closed to people who first became eligible for Medicare on or after January 1, 2020; people eligible before then may still buy or keep Medigap Plan C or Plan F.1

New Jersey's under-65 program moves on that same January 1, 2020 line: Plan C for people eligible before it, Plan D for people eligible on or after it.1 One naming trap: Plan D is a Medigap letter, not Medicare Part D drug coverage. Drug costs are handled below.

When You Can Buy or Switch

New Jersey gives you three protected paths.

• The under-65 disability window. New Jersey gives you 12 months from Medicare Part B enrollment, on either the under-50 or the 50-through-64 track, to buy Plan D.1
• The federal Medigap Open Enrollment Period. A one-time six months beginning the first month you are both 65 or older and enrolled in Part B, carrying the no-refusal, no-underwriting, no-health-pricing guarantee described above.2
• Federal guaranteed-issue rights. Federal law also defines situations, mostly outside the Medigap Open Enrollment Period, in which an insurer must sell you a Medigap policy and cannot charge you more or impose a pre-existing-condition waiting period. Those rights are federal minimums, and some states grant broader Medigap rights. The qualifying situations, and the federal deadline that applies to them:
  • Medicare Advantage plan loss: your plan leaves Medicare, stops serving your area, or you move out of its service area.
  • Loss of group coverage: you lose employer or union group health coverage that pays after Medicare.
  • Insurer failure: your Medigap insurer goes bankrupt or ends your coverage through no fault of your own.
  • Misrepresentation: the company misled you or broke the rules.
  • The 12-month trial right: you dropped a Medigap policy to join a Medicare Advantage plan for the first time, and you switch back within those 12 months.
  • Deadline to apply: no later than 63 days after your prior coverage ends, in most of those federal guaranteed-issue situations.8

Some states add a yearly birthday-rule window on top of the federal rights, letting a policyholder switch plans each year without medical underwriting; California, Illinois, Maryland, and Virginia are four of them. New Jersey does not appear on the published lists of those states, and the lists themselves say plainly that they are not exhaustive.3 So plan around the three windows above, and ask DOBI or a New Jersey SHIP counselor whether any further right applies before you assume none does.7

What It Costs and How Insurers Price It

Benefits inside a plan letter are identical across companies, so premium is what separates two quotes for the same letter.4 What New Jersey adds is a ceiling on the under-65 premium, set separately on each track above, and a floor on what carriers have to pay back out. New Jersey Medicare Supplement carriers must meet a 65% loss ratio on individual policies or a 75% loss ratio on group policies each calendar year.1 A loss ratio is the share of premium that has to leave the company again as claims.

Drug costs sit outside all of this, and New Jersey runs two state-funded programs that wrap around Medicare Part D, both applied for through NJSave, the state's single application for them (hotline 1-800-792-9745). PAAD (Pharmaceutical Assistance to the Aged and Disabled) is the lower tier, open in 2026 to New Jersey residents 65 or older, or aged 18 to 64 and receiving Social Security Title II Disability benefits. The Senior Gold Prescription Discount Program is the higher tier, with its own 2026 income band and its own co-payment structure.9

PAAD's disability route reaches the same people the under-65 Medigap rule does.

Who Regulates Medigap in New Jersey and How to Complain

DOBI regulates Medicare Supplement insurance in New Jersey and runs the under-65 programs. If a carrier refuses to issue Plan D inside your window, quotes an age-loaded premium, or mishandles a claim, the complaint goes to DOBI's Consumer Inquiry and Response Center (CIRC). You can reach the CIRC at 1-800-446-7467 or 609-292-7272, open a formal complaint through the online form on that page, or write to NJDOBI, PO Box 471, Trenton, NJ 08625-0471.1 Get the refusal in writing first, and name the statute for your track.

Before it gets that far, New Jersey's SHIP, administered by the New Jersey Department of Human Services, gives free Medicare counseling through trained volunteers in all 21 counties. Counselors handle plan comparisons, enrollment, and screening for the programs that help pay Medicare costs. New Jersey's SHIP statewide counseling line is 1-800-792-8820.7

Learn More

Find personalized help comparing New Jersey Medigap options, including the under-65 Plan D tracks, 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.