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Medicare Advantage Plans in New Jersey That Best Fits Your Needs

This year, shopping for a Medicare Advantage (Part C) plan will be critical. With potential benefit changes, it’s important to ensure you are on the plan that best fits your needs in 2025.

By Clover Health

If you're looking for a Medicare Advantage plan like those offered by Clover Health in New Jersey, we’re here to help you. 

Are you new to Medicare and looking for the best plan for you? Did you have a Medicare Advantage plan in the past that lacked the necessary coverage? Has your insurance company’s plan changed, and are you looking for what is available in your area? 

The good news is that you’ve come to the right place. We will walk you through how to find the best Medicare Advantage plan for you.
 

What to look for in Medicare Advantage Plans in New Jersey

Everyone’s healthcare needs are different. Finding the best Medicare option means finding the best option for you. To do that, you must understand your needs and know what to look for in a Medicare Advantage plan. 

 

Here are the factors to consider when comparing Medicare Advantage Plans like those offered by Clover Health

 

Monthly plan premiums - Monthly plan premiums affect how much you pay every month regardless of healthcare needs. In addition to Medicare Part B premiums, you may also have to pay a monthly premium for your Medicare Advantage plan and Medicare Part D, if not included. Fortunately, there are many $0 monthly premium plans in New Jersey.
The plan’s provider network - Most Medicare Advantage plans, like those offered by Clover Health, have a network of hospitals, doctors, and pharmacies that they are contracted with. This allows plan members to get affordable healthcare. If your providers are not listed in the plan’s provider network, it could mean higher healthcare costs.
Out-of-pocket maximums - Original Medicare does not have an out-of-pocket maximum, which means there is no limit to how high your healthcare expenses can get in a given year. Medicare Advantage Plans, however, do offer out-of-pocket maximums. Each plan is different, so you should compare plans. Consider how much you are willing to potentially pay out of pocket in the coming year. 
Deductibles, coinsurance, and copays - Every Medicare plan will have its own “cost-sharing” expenses that take the form of deductibles, coinsurance, and copays. These expenses can vary drastically from plan to plan and affect how much you pay for each doctor visit and other healthcare services.
Prescription Drug coverage - Most Medicare Advantage Plans include prescription drug coverage, but not all do. Each plan has a formulary that determines what drugs are available for coverage and what you will pay for a 30-, 60-, and 90-day supply.
Additional benefits and reward programs - Some Medicare Advantage plans offer unique benefits and reward programs. For example, some offer additional allowances for dental care, eyewear, and over-the-counter items. Some also offer a reward program that rewards plan members for making healthy living decisions. 

As you decide what is best for you, you should ask yourself these questions: What are your needs? Are you healthy but want to be covered in case something major happens? Do you see a specialist for any medical conditions? Will you have any major surgeries coming up next year? How much can you afford to pay out of pocket for healthcare costs throughout the year? All of these things will determine your needs. 

The Medicare Advantage plan that is right for you will provide coverage in these specific areas. 

 

Compare Medicare Advantage Plans in New Jersey

Medicare Advantage plans, like those offered by Clover Health, provide the same coverage as Original Medicare (Medicare Part A and B), plus additional benefits. It could be a good plan to consider when deciding the best healthcare coverage for you.

Medicare Advantage plans are different across the U.S., so when it comes time to compare plans, you should only consider comparing plans offered in your county. Plans offered in Atlantic County might not be available in Essex County or even its neighbors in Cap May. To find a plan, you will need to take the time to explore the plans available in your county. You can go to medicare.gov to compare all the plans available in your county.

 

New Jersey Medicare Advantage Plan Enrollment

You must meet the eligibility requirements before signing up for a Medicare Advantage (Part C) plan. To be eligible, you must be turning 65, be 65 or older, or have a qualifying disability. You must also be enrolled in both Medicare Part A and B. Lastly, you cannot be enrolled in a Medigap policy. 


If you are interested in a Medicare Advantage Plan, you can enroll in a plan during one of the enrollment periods. 
 

  • Initial Coverage Election - This period starts three months before your 65th birthday, your birthday month, and lasts three months after your 65th birthday. 
  • Annual Election Period (AEP) - Every year, the AEP takes place from October 15th to December 7th. During this time, anyone eligible can switch from Original Medicare to a Medicare Advantage Plan, change Medicare Advantage plans or alter prescription drug coverage. 
  • Open Enrollment Period - Between January 1st through March 31st, you can make changes to your plan if you find it is not suitable for your needs. If you’ve already signed up for a Medicare Advantage plan, you can switch to a different plan or go back to Original Medicare and sign up for a separate prescription drug plan (Part D). Any changes you make during this time will start on the first day of the next month.
  • Other Special Enrollment Periods - Throughout the year, special circumstances may qualify as a special enrollment period, allowing a plan holder to change Medicare Advantage plans or switch back to Original Medicare. These can include life changes such as moving to a new area, losing current health coverage, Medicare changing its contract with the insurance carrier,  or other special circumstances that would change your coverage needs. Click on our Special Enrollment Period blog to learn more.

 

If you are eligible for a Medicare Advantage plan and are in a qualifying enrollment period, then you are able to enroll in a Medicare Advantage plan. 


You can find an insurance company that offers plans in your area. To enroll in a plan, you can apply online or contact the company directly. 

 

Additional Medicare Resources 

Understanding Medicare and its various parts and plans can be difficult. To help you find the best plans, we have listed several resources below.

 

  • New Jersey Division of Aging Services - Provides information to make it easier for older adults to live in the community as long as possible with independence, dignity, and choice. This includes helpful Medicare information and resources.
  • The Clover Living Blog - Offers Medicare information and provides additional healthy living tips for seniors. 
  • Medicare.gov - Offers Medicare information and resources to help seniors get the most out of their Medicare plans and benefits. 
  • Shop Clover Health Medicare Advantage Plans in New Jersey - Find zero and low monthly plan premium Medicare Advantage plans online and explore additional benefits offered through our various plans.