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The 2023 Medicare Advantage Plans in Mercer County NJ.



2022 Mercer County New Jersey
Medicare Advantage Plans

There are 38 Medicare Advantage Plans available in Mercer County NJ from 9 different health insurance providers. 20 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3900 and the highest out of pocket is $7550. Mercer County New Jersey residents can also pick from 10 Medicare Special Needs Plans. The best Medicare Advantage plan in Mercer County New Jersey received a 4.5 overall star rating from CMS and the lowest rated plan is 3.5 stars.



(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)

Name ⇅ Premium Deductible MOOP Gap Plan
Rating
Click
for
Formulary
AARP Medicare Advantage Choice (PPO)
(H8768-022)

$0$0$7,550YesBrowse
Formulary
AARP Medicare Advantage Plan 1 (HMO)
(H0755-043)

$0$240.00$6,900YesBrowse
Formulary
AARP Medicare Advantage Plan 3 (HMO)
(H0755-044)

$39.00$200.00$6,900YesBrowse
Formulary
AARP Medicare Advantage Plan 4 (HMO)
(H0755-045)

$81.00$150.00$6,900YesBrowse
Formulary
Aetna Medicare Elite 3 (HMO)
(H3152-088)

$0$350.00$7,550YesBrowse
Formulary
Aetna Medicare Explorer Elite (HMO)
(H3152-084)

$0$300.00$7,550YesBrowse
Formulary
Aetna Medicare Explorer Elite 2 (HMO)
(H3152-092)

$0$350.00$7,550YesBrowse
Formulary
Aetna Medicare Explorer Premier (PPO)
(H5521-037)

$105.00$250.00$7,550YesBrowse
Formulary
Aetna Medicare Explorer Premier Plus (HMO-POS)
(H3152-048)

$99.00$195.00$7,550YesBrowse
Formulary
Aetna Medicare Explorer Premier Plus (PPO)
(H5521-278)

$37.00$300.00$7,550YesBrowse
Formulary
Aetna Medicare Premier (Regional PPO)
(R6694-006)

$115.00$350.00$7,550YesBrowse
Formulary
Aetna Medicare Prime Credit (PPO)
(H5521-277)

$0$350.00$7,550YesBrowse
Formulary
Aetna Medicare Prime Premier (PPO)
(H5521-275)

$49.00$350.00$7,550YesBrowse
Formulary
Aetna Medicare Prime Value (HMO-POS)
(H3152-080)

$0$250.00$7,550YesBrowse
Formulary
Amerivantage Balance (HMO)
(H3240-021)

$34.40$480.00$7,550YesBrowse
Formulary
Amerivantage Choice (PPO)
(H8343-007)

$0$95.00$7,550YesToo NewBrowse
Formulary
Amerivantage Classic (HMO)
(H3240-022)

$0$200.00$6,950YesBrowse
Formulary
Cigna Preferred Medicare (HMO)
(H3949-032)

$0$0$7,200YesBrowse
Formulary
Cigna Preferred Plus Medicare (HMO)
(H3949-033)

$60.00$0$6,200YesBrowse
Formulary
Cigna True Choice Plus Medicare (PPO)
(H7849-033)

$30.00$0$7,300YesBrowse
Formulary
Clover Health Choice (PPO)
(H5141-004)

$0$150.00$7,550NoBrowse
Formulary
Clover Health Choice Value (PPO)
(H5141-007)

$37.10$480.00$7,550NoBrowse
Formulary
Clover Health Premier (PPO)
(H5141-054)

$0$200.00$7,550NoBrowse
Formulary
Clover Health Premier Value (PPO)
(H5141-055)

$37.10$480.00$7,550NoBrowse
Formulary
Horizon Medicare Blue Access (PPO)
(H7971-003)

$36.00$250.00$6,700NoNABrowse
Formulary
Horizon Medicare Blue Advantage (HMO)
(H3154-030)

$31.00$250.00$6,700NoBrowse
Formulary
Horizon Medicare Blue Choice w-Rx (HMO)
(H3154-022)

$78.00$480.00$6,700NoBrowse
Formulary
HumanaChoice H5216-185 (PPO)
(H5216-185)

$0$0$6,700NoBrowse
Formulary
HumanaChoice H5216-186 (PPO)
(H5216-186)

$30.00$250.00$6,700NoBrowse
Formulary
Wellcare Assist (HMO)
(H0913-015)

$18.20$480.00$7,550NoBrowse
Formulary
Wellcare Giveback Open (PPO)
(H8711-002)

$0$300.00$7,550NoToo NewBrowse
Formulary
Wellcare No Premium (HMO-POS)
(H0913-002)

$0$350.00$7,550NoBrowse
Formulary
Wellcare No Premium Open (PPO)
(H8711-001)

$0$175.00$7,550NoToo NewBrowse
Formulary


Return to 2022 Medicare Advantage Plans in New Jersey

Middlesex County Medicare Advantage





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
AARP Medicare Advantage Patriot (HMO)
(H0755-037)

$0Local HMO *$6,700
Aetna Medicare Eagle (HMO)
(H3152-045)

$0Local HMO *$7,550
Humana Honor (PPO)
(H5216-221)

$0Local PPO *$6,700
HumanaChoice H5216-116 (PPO)
(H5216-116)

$0Local PPO *$3,900
Wellcare Patriot No Premium (HMO)
(H0913-020)

$0Local HMO *$7,550





2022 Medicare Special Needs Plans in Mercer county New Jersey

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Aetna Assure Premier Plus (HMO D-SNP) $27.30$400.0No Gap CoverageDual-EligibleToo New
Amerivantage Dual Coordination (HMO D-SNP) $37.10$480.0No Gap CoverageDual-Eligible
Amerivantage Dual Secure (HMO-POS D-SNP) $37.10$480.0No Gap CoverageDual-Eligible
Horizon NJ TotalCare (HMO D-SNP) $29.70$480.0No Gap CoverageDual-Eligible
Longevity Health Plan (PPO I-SNP) $37.10$480.0No Gap CoverageInstitutionalNA
UnitedHealthcare Assisted Living Plan (PPO I-SNP) $37.10$200.0No Gap CoverageInstitutional
UnitedHealthcare Dual Complete ONE (HMO D-SNP) $35.30$480.0No Gap CoverageDual-Eligible
UnitedHealthcare Nursing Home Plan (HMO I-SNP) $37.10$480.0No Gap CoverageInstitutional
UnitedHealthcare Nursing Home Plan (PPO I-SNP) $36.70$480.0No Gap CoverageInstitutional
Wellcare Dual Liberty (HMO D-SNP) $31.40$480.0No Gap CoverageDual-Eligible



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

  • 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
  • Many - Many Generics and Some Brands
  • Some - Some Generics and Few Brands

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 1, 2021.
Plans are subject to change as contracts are finalized.
Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2022, 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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Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.