Your Guide to the Best New Jersey Medigap Plans

One of the biggest questions people have when considering their Medicare options is, “Can I keep my doctors?” With a Medigap plan, the answer is a resounding yes. Because these plans supplement your Original Medicare, you have the freedom to see any doctor or visit any hospital in the U.S. that accepts Medicare. There are no restrictive networks to worry about. This flexibility is a primary reason why so many people choose this path. It allows you to maintain relationships with the healthcare providers you trust. Ahead, we’ll walk through how New Jersey Medigap plans work to preserve that freedom of choice while also protecting you from unpredictable medical costs.

Key Takeaways

Choose any doctor who accepts Medicare: Medigap plans work with your Original Medicare to cover out-of-pocket costs, giving you the freedom to see your preferred providers without network restrictions. Just remember to get a separate Part D plan for your prescriptions.
Enroll on time to guarantee your coverage: Your six-month Medigap Open Enrollment Period is the most important time to sign up. During this window, which starts when you’re 65 and have Part B, insurance companies cannot deny you a policy or charge more for pre-existing conditions.
Shop for price, not just plan benefits: Because Medigap plans are standardized, a Plan G from one company offers the same medical coverage as a Plan G from another. This allows you to focus your comparison on the monthly premium and the insurance company’s reputation.

What Are Medigap Plans in New Jersey?

If you’re enrolled in Original Medicare (Part A and Part B), you know it doesn’t cover everything. Those out-of-pocket costs, like deductibles and coinsurance, can add up quickly. That’s where Medicare Supplement Insurance, also known as Medigap, comes in. These plans are sold by private insurance companies and are designed to help fill the “gaps” in your Original Medicare coverage.

While private companies offer the plans, the plans themselves are standardized by the government. This means that a Plan G in New Jersey has the same basic benefits, no matter which insurance company you buy it from. This makes it much easier to compare plans based on price and the company’s reputation.

What Medicare Supplement Plans Cover

Medigap plans are built to handle many of the costs that Original Medicare leaves for you to pay. All standardized Medigap plans in New Jersey provide core benefits that help pay for things like your Part A hospital coinsurance, hospice care coinsurance, and your Part B copayments. They also cover the first three pints of blood if you need a transfusion.

It’s just as important to know what Medigap doesn’t cover. These plans are not designed to pay for services like routine dental or vision exams, hearing aids, or long-term care in a nursing home. For those services, you would need separate, standalone insurance policies. Medigap also doesn’t include prescription drug coverage, so you’ll need a separate Medicare Part D plan for your medications.

How Medigap Works with Original Medicare

Think of a Medigap plan as a partner to your Original Medicare. You don’t give up your red, white, and blue Medicare card. Instead, you use both. When you visit a doctor or hospital, you’ll show both your Medicare card and your Medigap card. Medicare pays its share of the approved amount first, and then your Medigap policy pays its share. You continue to pay your monthly Part B premium directly to Medicare.

Worried about choosing the wrong plan? If you decide to try a Medicare Advantage plan for the first time and find it’s not for you, Medicare gives you a special 12-month trial right period. This allows you to switch back to your original Medigap policy if you make the change within a year.

Medigap vs. Medicare Advantage: What’s the Difference?

This is one of the most common points of confusion, so let’s clear it up. A Medigap plan works with your Original Medicare. A Medicare Advantage plan (also called Part C) is an alternative to Original Medicare. When you join a Medicare Advantage plan, a private insurance company takes over and provides your Part A and Part B benefits. These plans often have different network rules, like HMOs or PPOs, and may include extra benefits like dental or vision.

Here’s the most important rule: you cannot have both a Medigap policy and a Medicare Advantage plan at the same time. If you have a Medigap plan and enroll in a Medicare Advantage plan, you’ll have to drop your Medigap policy. They serve two different purposes in your healthcare coverage.

An Overview of Plans F, G, and N

You’ll hear a lot about different “letter plans,” but three tend to dominate the conversation: F, G, and N. Plan F was once the most popular because it covered everything, leaving you with virtually no out-of-pocket costs. However, Plan F is only available to people who were eligible for Medicare before January 1, 2020.

For anyone new to Medicare, Plan G is now the most comprehensive option. It covers almost everything Plan F did. The only difference is that you must first pay the annual Part B deductible yourself. After that, Plan G picks up 100% of the covered costs. Plan N is another excellent choice, often with lower monthly premiums. In exchange, you’ll have small copays for some doctor visits and emergency room trips.

Compare Medigap Plan Coverage and Benefits

When you start looking at Medigap plans, you’ll notice a lot of letters—Plan A, B, C, and so on. While there are several options, most people find that their best choice is Plan G, Plan N, or, for those who qualify, Plan F. These three plans offer the most comprehensive coverage and peace of mind. Let’s walk through what each one offers so you can see how they stack up.

What Does Plan G Cover?

Plan G is the most popular choice for people new to Medicare, and for good reason. It offers fantastic coverage that picks up most of the costs that Original Medicare doesn’t pay. Think of it as your all-around financial protection. The main thing to know is that Plan G covers most costs after you meet your yearly Part B deductible. Once you’ve paid that amount out-of-pocket for doctor visits or other outpatient services, Plan G steps in to cover your remaining Medicare-approved costs for the rest of the year. This includes your Part A hospital deductible, coinsurance for hospital and skilled nursing facility stays, and foreign travel emergencies. It provides robust, predictable coverage that simplifies your healthcare budget.

Understanding Plan N’s Cost-Sharing

If you’re looking for a plan with a lower monthly premium than Plan G, Plan N is an excellent alternative. It provides strong coverage but asks you to share a small portion of the costs. In exchange for that lower premium, you might pay up to $20 for some office visits and up to $50 for emergency room visits if you aren’t admitted to the hospital. Like Plan G, you’ll still need to pay the annual Part B deductible. The other key difference is that Plan N is similar to Plan G but doesn’t cover Part B excess charges. An excess charge is a small, extra amount (up to 15%) that some doctors can charge above the Medicare-approved amount. While these charges are rare, it’s something to be aware of when choosing your plan.

Why People Still Talk About Plan F

You’ve probably heard friends or family members mention Plan F. For years, it was considered the top-tier plan because it offered the most coverage available. However, a federal law changed who can purchase it. Plan F… is not available to people who became eligible for Medicare on or after January 1, 2020. If you were eligible for Medicare before that date, you might still be able to buy a Plan F. It’s known for its “first-dollar” coverage, meaning it pays for everything Original Medicare doesn’t, including the annual Part B deductible. While it provides the highest level of coverage, it also comes with the highest premium. For anyone new to Medicare, Plan G now offers the most comprehensive benefits you can buy.

See How Plans F, G, and N Compare

Comparing Medigap plans can feel complicated, but there’s one rule that makes it much simpler: standardization. This means that all plans of the same letter… offer the exact same benefits, no matter which insurance company sells them. A Plan G from one company has the same medical coverage as a Plan G from another. This allows you to focus on comparing prices and the company’s reputation instead of getting lost in benefit details.

Here’s the quick takeaway:

Plan G is the go-to for new enrollees, covering nearly everything except the Part B deductible.
Plan N offers lower premiums in exchange for small copays and no coverage for excess charges.
Plan F has the most coverage but is only available if you were eligible for Medicare before 2020.

You can see a full comparison of Medigap benefits on the official Medicare website.

How Much Do Medigap Plans Cost in New Jersey?

Figuring out the cost of a Medigap plan is a top priority for most people, and for good reason. You want to know what to budget for and ensure you’re getting a fair price. While Medigap plans are standardized by the government—meaning a Plan G from one company has the same basic benefits as a Plan G from another—the prices can vary quite a bit. The final monthly premium you pay will depend on the specific plan you choose, the insurance company you go with, and a few personal details. Let’s break down what you can expect to pay and what goes into that final number.

What to Expect for Monthly Premiums

In New Jersey, the monthly premiums for Medigap plans can have a wide range. For standard plans like Plan G or Plan N, you can generally expect to see prices somewhere between $50 and $871 per month. If you’re considering a high-deductible plan, which requires you to pay more out-of-pocket before the plan starts covering costs, the premiums are lower, typically falling between $46 and $217 per month. This is just a ballpark to give you an idea. Your actual quote will be more specific once you get into the details of your application and the plan you select.

What Influences Your Premium Price?

So, why the big range in prices? Several key things affect your monthly premium. The most obvious one is the plan type you select. A plan with more comprehensive coverage, like Plan G, will usually cost more than a plan that involves some cost-sharing, like Plan N. The insurance company itself is another major factor, as each one sets its own rates. Finally, your personal details play a role. Insurance companies will look at your age, gender, location within New Jersey, and whether or not you use tobacco when calculating your premium.

How Insurance Companies Set Your Rates

It’s helpful to understand how insurance companies arrive at their prices. They generally use one of three methods to set your Medigap premiums:

Community-rated: Everyone who has the same policy pays the same monthly premium, regardless of their age.
Issue-age-rated: Your premium is based on your age when you first buy the policy. It won’t go up just because you get older, but it can increase for other reasons, like inflation.
Attained-age-rated: Your premium is based on your current age, so it will increase as you get older. These plans often start with lower premiums but can become more expensive over time.

Knowing which rating method a company uses is key to predicting your future costs.

Ways to Save on Your Medigap Plan

Even though premiums are set by the company, there are sometimes opportunities to save a little money. Don’t hesitate to ask an insurance company about any available discounts. Some common ones include a household discount if your spouse is also enrolling in a plan with the same company. You might also find discounts for being a non-smoker, setting up automatic payments from your bank account, or choosing to pay your premium annually instead of monthly. Every little bit helps, so it’s always worth asking what options are available to you.

Why Your Rates Might Go Up Over Time

It’s a common concern: will my premium stay the same year after year? The short answer is probably not. Even if you have an issue-age-rated plan where your premium isn’t supposed to increase based on your age, rates can still go up due to inflation and other economic factors. For attained-age-rated plans, you can expect your premium to increase as you get older. When you’re comparing plans, it’s a smart move to ask the insurance company about their rate increase history and whether you should expect your premium to change over time.

When and How to Enroll in a Medigap Plan

Timing is everything when it comes to enrolling in a Medigap plan. While it might seem like just another date to remember, choosing the right time to apply can make a significant difference in your coverage options and costs. Certain enrollment periods protect you, ensuring you can get a policy without an insurance company looking into your health history. Understanding these windows is the key to getting the best plan for your needs without any hassle. Let’s walk through the most important periods and rules so you feel confident about when and how to sign up.

Your Medigap Open Enrollment Period

The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This is a six-month window that starts on the first day of the month you are both 65 or older and enrolled in Medicare Part B. During this time, you have a golden ticket: insurance companies cannot use your health history to make decisions. This means they can’t refuse to sell you any policy they offer, charge you more because of pre-existing conditions, or make you wait for coverage to start. Think of it as your one-time, guaranteed pass to get the plan you want.

What Are Guaranteed Issue Rights?

If you miss your Open Enrollment Period, don’t worry—you might get another chance. Certain situations give you guaranteed issue rights, also called “Medigap protections.” These are special circumstances where insurance companies are required to offer you a Medigap policy. For example, you might have a guaranteed issue right if you’re moving out of your Medicare Advantage Plan’s service area or if your current Medigap insurance company goes out of business. These rights act as a safety net, giving you another opportunity to get coverage without answering health questions.

How Pre-existing Conditions Affect Your Application

Applying for a Medigap plan outside of your Open Enrollment Period or without a guaranteed issue right changes the game. At this point, insurance companies can generally use medical underwriting. This means they will ask you a series of health questions and review your medical history to decide whether to accept your application and how much to charge you. If you have pre-existing health conditions, an insurer could legally deny you coverage or charge you a higher premium. This is why taking advantage of your initial six-month open enrollment window is so important for your long-term peace of mind.

Special Enrollment Rules in New Jersey

New Jersey offers some helpful flexibility if you decide to try a Medicare Advantage Plan. If you drop your Medigap policy to join a Medicare Advantage Plan for the very first time, you have what’s called a “trial right.” This gives you up to 12 months to try out the new plan. If you decide it’s not for you and want to switch back to Original Medicare, you can get your old Medigap policy back if the same company still sells it. This rule allows you to test the waters with a different type of plan without losing your Medigap safety net.

Can You Change Your Medigap Plan?

Yes, you can apply to change your Medigap plan at any time of the year. However, unless you have a guaranteed issue right, you will likely have to go through medical underwriting. This means the new insurance company can review your health history and may deny your application based on pre-existing conditions. One exception is if you joined a Medicare Advantage Plan when you first became eligible for Medicare at 65. If you decide to switch to Original Medicare within your first year, you have a special right to buy a Medigap policy from any insurer in your state.

How to Choose the Right Medigap Plan for You

Picking the right Medigap plan feels like a huge decision, but you can break it down into simple, manageable steps. It’s all about finding the balance between the coverage you need and a premium that fits your budget. By thinking through your personal situation and comparing your options carefully, you can find a plan that gives you peace of mind.

Assess Your Personal Health Needs

The best Medigap plan for your neighbor might not be the best one for you. Start by taking a look at your own health and lifestyle. Think about how often you visit the doctor or specialists. Do you have any chronic conditions that require regular care? Also, consider your financial situation. How much can you comfortably afford for a monthly premium versus paying for co-pays and deductibles out-of-pocket? Your personal health, budget, and even your travel plans are all important pieces of the puzzle when choosing a plan. A little self-reflection now will help you select a plan that truly works for you long-term.

Compare Insurance Companies, Not Just Plans

Here’s a key piece of information: Medigap plans are standardized. That means a Plan G from one company offers the exact same basic benefits as a Plan G from another. So, while the coverage is identical, the price can be very different. This is why it’s so important to compare how much different companies charge for the same lettered plan. You should also look into the company’s reputation for customer service and rate stability. You’re not just buying a plan; you’re choosing a company to partner with for your healthcare needs. Don’t be afraid to shop around to find the best value.

How to Use the Medicare Plan Finder Tool

A great place to start your research is with Medicare’s official online tool. The Medicare Plan Finder lets you see which Medigap policies are available in your specific zip code. You can enter your information to compare the plans side-by-side. It’s a helpful resource for getting a general idea of what’s out there. However, the sheer number of options can sometimes feel overwhelming. Use it as a starting point to gather information, and don’t worry if you have questions. The tool is a resource, not a final decision-maker.

The Role of an Independent Insurance Agent

If you’re feeling stuck after looking at the Plan Finder, that’s completely normal. This is where talking to an independent insurance agent can make a world of difference. Unlike an agent who works for a single company, an independent agent represents multiple carriers. Their job is to help you find the right fit for your needs, not to push one specific product. They can offer personalized advice, answer your specific questions, and help you understand the fine print. This guidance can simplify the process and give you confidence in your final choice.

Tips for Comparing Plan Premiums

When you start getting quotes, you’ll notice that premiums can vary quite a bit. Costs vary based on the insurance company, the plan you choose, and several personal factors. Your age, gender, zip code, and whether you use tobacco can all influence your monthly premium. Some companies may also offer household discounts if more than one person in your home enrolls. As you compare prices, make sure you’re providing the same information to each company to get an accurate, apples-to-apples comparison. This will help you see which company offers the most competitive rate for your situation.

Key Questions to Ask Before You Enroll

Choosing a Medigap plan is a big decision, and it’s completely normal to have questions as you get ready to enroll. Before you finalize your choice, it helps to think through a few key areas to ensure the plan you pick fits your life perfectly. Considering your doctors, medications, budget, and future health needs will give you confidence in your decision. Let’s walk through these final important questions to make sure you feel secure and prepared for the road ahead.

Can I Keep My Doctors?

This is one of the most important questions for many people, and with Medigap, the answer is refreshingly simple. A Medigap plan allows you to see any doctor, specialist, or hospital in the country as long as they accept Medicare. There are no restrictive networks to worry about, giving you the freedom to choose your healthcare providers. This is a significant advantage over Medicare Advantage plans, which usually have a defined network of local providers. If maintaining your relationships with your current doctors is a priority for you, a Medigap plan provides that stability and peace of mind.

What About Prescription Drugs?

It’s crucial to understand that Medigap plans sold today do not include prescription drug coverage. If you need your medications covered, you will have to enroll in a separate Medicare Part D plan. This is a standalone policy that comes with its own monthly premium. When you are planning your healthcare budget, remember to account for both your Medigap premium and your Part D premium. Factoring in both costs will give you a clear and accurate picture of your total monthly healthcare expenses, so there are no surprises down the line.

How Much Financial Protection Do You Need?

Take a moment to think about your comfort level with potential medical costs. If you expect to have more healthcare needs or simply want to avoid large, unexpected bills, a Medigap plan can be a smart financial choice. Although you pay a monthly premium, the plan covers many of the out-of-pocket costs that Original Medicare leaves behind, which can lead to significant savings over time. It’s a trade-off: you can pay a predictable monthly premium for comprehensive coverage or risk higher, less predictable costs when you need medical care. Thinking about your personal healthcare needs will help you decide which path feels right for your financial situation.

Plan for Your Future Health Needs

Timing is everything when it comes to enrolling in a Medigap plan. The best time to sign up is during your six-month Medigap Open Enrollment Period, which begins on the first day of the month you are 65 or older and enrolled in Medicare Part B. During this protected window, insurance companies cannot deny you coverage or charge you more based on your health history. If you miss this period and decide to apply later, you may have to answer medical questions, and insurers could potentially deny your application or charge you a higher premium. Planning ahead and enrolling during this critical time ensures you can get the plan you want without any issues.

Frequently Asked Questions

If all Plan G policies are the same, why do the prices differ so much? This is an excellent question and a common point of confusion. While the government standardizes the benefits of each lettered plan, the private insurance companies that sell them set their own prices. Each company calculates its premiums based on its own business costs, the rating method it uses (like issue-age or attained-age), and the demographics of its customers in your area. This is why it’s so important to compare quotes from several different companies for the exact same plan.

Can I still get a Medigap plan if I missed my initial enrollment window? Yes, you can apply for a Medigap plan at any time, but the process is different outside of your one-time Open Enrollment Period. If you apply later, insurance companies can generally use medical underwriting. This means they can ask you questions about your health history and, based on your answers, they could charge you a higher premium or even deny your application. This is why taking advantage of your initial six-month window is so valuable—it guarantees your acceptance.

Do I have to worry about finding doctors ‘in-network’ with a Medigap plan? No, and this is one of the biggest benefits of choosing a Medigap plan. These plans don’t have provider networks. As long as your doctor or hospital accepts Original Medicare—which the vast majority do—they will accept your Medigap plan, regardless of which insurance company you bought it from. This gives you the freedom to see any Medicare-accepting specialist in the country without needing a referral.

I keep hearing about Plan F, G, and N. How do I know which one is right for me? Choosing between these popular plans comes down to your eligibility and how you prefer to handle costs. If you were eligible for Medicare before 2020, you might still be able to buy Plan F, which covers everything. For everyone else, Plan G is the most comprehensive option available; you just pay the annual Part B deductible, and the plan covers the rest. If you’d prefer a lower monthly premium and are comfortable with small copays for some doctor visits, Plan N is a fantastic alternative.

Does my Medigap plan cover my prescriptions or dental visits? Medigap plans are designed specifically to cover the gaps in your hospital (Part A) and medical (Part B) insurance. They do not include coverage for prescription drugs, routine dental exams, vision care, or hearing aids. To get help with your medication costs, you will need to enroll in a separate Medicare Part D prescription drug plan. For services like dental or vision, you would need to purchase other standalone insurance policies.