2022 Somerset County New Jersey
Medicare Advantage Plans

There are 35 Medicare Advantage Plans available in Somerset County NJ from 8 different health insurance providers. 17 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $4500 and the highest out of pocket is $7550. Somerset County New Jersey residents can also pick from 11 Medicare Special Needs Plans. The best Medicare Advantage plan in Somerset 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
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AARP Medicare Advantage Choice (PPO)
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$0 $0 $7,550 YesEnroll
AARP Medicare Advantage Plan 1 (HMO)
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$0 $240.00 $6,900 YesEnroll
AARP Medicare Advantage Plan 3 (HMO)
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$39.00 $200.00 $6,900 YesEnroll
AARP Medicare Advantage Plan 4 (HMO)
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$81.00 $150.00 $6,900 YesEnroll
Aetna Medicare Elite 3 (HMO)
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$0 $350.00 $7,550 YesEnroll
Aetna Medicare Explorer Elite (HMO)
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$0 $300.00 $7,550 YesEnroll
Aetna Medicare Explorer Elite (PPO)
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$0 $300.00 $7,550 YesEnroll
Aetna Medicare Explorer Premier (PPO)
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$40.00 $300.00 $7,550 YesEnroll
Aetna Medicare Explorer Premier Plus (HMO-POS)
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$99.00 $195.00 $7,550 YesEnroll
Aetna Medicare Explorer Premier Plus (PPO)
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$37.00 $300.00 $7,550 YesEnroll
Aetna Medicare Premier (Regional PPO)
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$115.00 $350.00 $7,550 YesEnroll
Aetna Medicare Prime Credit (PPO)
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$0 $350.00 $7,550 YesEnroll
Aetna Medicare Prime Premier (PPO)
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$49.00 $350.00 $7,550 YesEnroll
Aetna Medicare Prime Value (HMO-POS)
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$0 $250.00 $7,550 YesEnroll
Amerivantage Balance (HMO)
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$34.40 $480.00 $7,550 YesEnroll
Amerivantage Choice (PPO)
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$0 $95.00 $7,550 YesToo NewEnroll
Amerivantage Classic (HMO)
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$0 $200.00 $6,950 YesEnroll
Clover Health Choice (PPO)
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$0 $150.00 $7,550 NoEnroll
Clover Health Choice Value (PPO)
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$37.10 $480.00 $7,550 NoEnroll
Clover Health Premier (PPO)
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$0 $200.00 $7,550 NoEnroll
Clover Health Premier Value (PPO)
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$37.10 $480.00 $7,550 NoEnroll
Horizon Medicare Blue Advantage (HMO)
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$0 $200.00 $6,700 NoEnroll
Horizon Medicare Blue Choice w/Rx (HMO)
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$78.00 $480.00 $6,700 NoEnroll
Humana Gold Plus H6622-063 (HMO)
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$0 $225.00 $6,500 NoEnroll
HumanaChoice H5216-169 (PPO)
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$0 $275.00 $7,400 NoEnroll
HumanaChoice H5216-170 (PPO)
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$33.00 $250.00 $6,500 NoEnroll
HumanaChoice H5216-172 (PPO)
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$0 $295.00 $7,550 NoEnroll
Wellcare Assist (HMO)
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$18.20 $480.00 $7,550 NoEnroll
Wellcare Giveback Open (PPO)
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$0 $300.00 $7,550 NoToo NewEnroll
Wellcare No Premium (HMO-POS)
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$0 $350.00 $7,550 NoEnroll
Wellcare No Premium Open (PPO)
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$0 $175.00 $7,550 NoToo NewEnroll


Return to 2022 Medicare Advantage Plans in New Jersey





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
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AARP Medicare Advantage Patriot (HMO)
$0 Local HMO * $6,700 Enroll
Aetna Medicare Eagle (HMO)
$0 Local HMO * $7,550 Enroll
Humana Honor (PPO)
$0 Local PPO * $4,500 Enroll
Wellcare Patriot No Premium (HMO)
$0 Local HMO * $7,550 Enroll





2022 Medicare Special Needs Plans in Somerset 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 $400.0  No Gap Coverage Dual-EligibleToo New
Amerivantage Dual Coordination (HMO D-SNP)     $37.10 $480.0  No Gap Coverage Dual-Eligible
Amerivantage Dual Secure (HMO-POS D-SNP)     $37.10 $480.0  No Gap Coverage Dual-Eligible
Amerivantage ESRD Care (HMO-POS C-SNP)     $37.10 $160.0  No Gap Coverage Chronic or Disabling Condition
Horizon NJ TotalCare (HMO D-SNP)     $29.70 $480.0  No Gap Coverage Dual-Eligible
Longevity Health Plan (PPO I-SNP)     $37.10 $480.0  No Gap Coverage InstitutionalNA
UnitedHealthcare Assisted Living Plan (PPO I-SNP)     $37.10 $200.0  No Gap Coverage Institutional
UnitedHealthcare Dual Complete ONE (HMO D-SNP)     $35.30 $480.0  No Gap Coverage Dual-Eligible
UnitedHealthcare Nursing Home Plan (HMO I-SNP)     $37.10 $480.0  No Gap Coverage Institutional
UnitedHealthcare Nursing Home Plan (PPO I-SNP)     $36.70 $480.0  No Gap Coverage Institutional
Wellcare Dual Liberty (HMO D-SNP)     $31.40 $480.0  No Gap Coverage Dual-Eligible



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
  • 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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