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The 2019 Medicare Advantage Plans in Ocean County NJ.



2017 Medicare Advantage Plans in Ocean County New Jersey

There are 13 Medicare Advantage Plans available in Ocean County NJ from 3 health insurance providers and 4 Special Needs Plans available. 3 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3400 and the highest out of pocket is $6700. The highest rated plan available in Ocean County received a 4.5 overall star rating from CMS and the lowest rated plan is 3 stars.

(Click the Plan Name for More Details)

Name Monthly
Premium
C+D
Part D
Deductible
Type  Gap  Max Out
of
Pocket
Overall Rating Formulary
AARP MedicareComplete Essential (HMO)
(H0755-037)
$0.00 Local HMO * $6,700
AARP MedicareComplete Plan 1 (HMO)
(H0755-034)
$0.00 $290.00 Local HMO No $6,700 Browse
Formulary
AARP MedicareComplete Plan 2 (HMO)
(H0755-038)
$0.00 $250.00 Local HMO No $6,700 Browse
Formulary
AARP MedicareComplete Plan 3 (HMO)
(H0755-035)
$36.00 $225.00 Local HMO No $5,900 Browse
Formulary
AARP MedicareComplete Plan 4 (HMO)
(H0755-036)
$76.00 $0.00 Local HMO No $3,400 Browse
Formulary
Aetna Medicare Basic Plan (HMO)
(H3152-045)
$0.00 Local HMO * $6,700
Aetna Medicare Elite Plan (HMO)
(H3152-082)
$0.00 $0.00 Local HMO Yes $6,700 Browse
Formulary
Aetna Medicare NJ Connect Gold (Regional PPO)
(R6694-001)
$151.00 $280.00 Regional PPO No $5,400 Too NewBrowse
Formulary
Aetna Medicare Premier Plan (HMO)
(H3152-048)
$164.00 $200.00 Local HMO Yes $6,700 Browse
Formulary
Aetna Medicare Standard Plan (PPO)
(H5521-037)
$79.00 $0.00 Local PPO Yes $6,700 Browse
Formulary
Horizon Medicare Blue Patient-Centered w/Rx (HMO)
(H3154-024)
$15.60 $400.00 Local HMO No $6,700 Browse
Formulary
Horizon Medicare Blue Value (HMO)
(H3154-013)
$49.00 Local HMO * $6,700
Horizon Medicare Blue Value w/ Rx (HMO)
(H3154-004)
$96.10 $400.00 Local HMO No $6,700 Browse
Formulary
Return to 2017 Medicare Advantage Plans in New Jersey

* Plan Type does not offer Medicare Part D drug coverage.



Medicare Special Needs Plans in Ocean county New Jersey

Plan Name Monthly
Consolidated
Premium C+D
Part D
Deductible
 Gap  Special Needs
Type
Overall Rating
Amerivantage Dual Coordination (HMO SNP)
(H3240- 013)
   $40.80 $400.00  No Dual-EligibleBrowse
Formulary
Amerivantage ESRD (HMO-POS SNP)
(H3240- 017)
   $40.80 $300.00  No Chronic or Disabling ConditionBrowse
Formulary
UnitedHealthcare Dual Complete ONE (HMO SNP)
(H3113- 005)
   $38.70 $400.00  No Dual-EligibleBrowse
Formulary
UnitedHealthcare Nursing Home Plan (HMO SNP)
(H5322- 003)
   $24.10 $400.00  No InstitutionalBrowse
Formulary


Plan Type Is the type of organization offering the Medicare Plans.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescription Drug Plan
  • SNP - Special Needs Plan
  • POS - Point of Service
  • PFFS - Private Fee For Service

Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your provider for details.

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

Benefit Type
  • (EA) Enhanced Alternative may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above standard "generic" coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs.

  • (DS) Defined Standard Benefit
  • (BA) Basic Alternative
  • (AE) Actuarially Equivalent Standard

  • GAP

    In 2017 once you and your plan provider have spent $3700 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") Once you reach the coverage gap you will pay 40% of the plans cost for covered brand-name prescription drugs and 51% on generic drugs unless your plan offers additional coverage.

    Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable



    Source: CMS.

    Data as of September 6, 2016.

    Plans are subject to change as contracts are finalized.

    Includes 2017 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2017, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.

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