Medicare in New Jersey: 2026 Plans, Costs, and Enrollment Guide
- 83 Medicare Advantage plans from 13 carriers across 21 of 22 counties (CMS CY2026 Landscape)
- Avg MA premium: $36.27/month — median $31; above national average
- 29 Medigap carriers offering Plan G statewide (TPP rate DB, CY2026)
- PAAD + Senior Gold state pharmaceutical assistance programs supplement Part D
- 12 standalone Part D plans from 6 carriers; avg premium $73.10/month
- LIS benchmark: $54.17/mo (PDP Region 4: NJ — CMS CY2026 Regional Rates)
New Jersey Medicare Snapshot
New Jersey has a dense, well-developed Medicare market — 83 MA plans from 13 carriers covering 21 of 22 counties for 2026 (CMS CY2026 Landscape). New Jersey's plan mix leans PPO and reflects the state's position in the NYC–Philadelphia metro corridor: 42 PPO, 16 HMO-POS, 11 HMO, 5 HMO D-SNP, and 3 PPO I-SNP plans. The state also has its own MA carrier, Braven Health — a Horizon BCBSNJ / Hackensack Meridian Health joint venture.
The average consolidated MA premium is $36.27/month (median $31.00) — well above national averages, reflecting denser metro networks and richer plan designs. The standard Medicare Part B premium is $202.90/month in 2026. On the supplement side, New Jersey has 29 carriers offering Plan G under attained-age rating, plus two state-run drug assistance programs (PAAD and Senior Gold) that supplement Part D.
| Metric | New Jersey 2026 | Source |
|---|---|---|
| MA plans available | 83 (13 carriers, 21 of 22 counties) | CMS CY2026 Landscape |
| Avg consolidated MA premium | $36.27/mo (median $31.00) | CMS CY2026 Landscape |
| Avg MA star rating | 3.82 / 5.0 | CMS CY2026 Landscape |
| Medigap carriers (Plan G) | 29 (attained-age rating) | TPP internal data, CY2026 |
| Standalone Part D plans | 12 (6 carriers) | CMS CY2026 Landscape |
| Avg Part D premium | $73.10/mo | CMS CY2026 Landscape |
| Part D LIS benchmark (Region 4) | $54.17/mo | CMS CY2026 Regional Rates & Benchmarks |
| County range (MA plans) | Atlantic (57) → Sussex (36) | CMS CY2026 Landscape |
Plan Types Available in New Jersey
Medicare Advantage (Part C)
In New Jersey, 83 MA plans are available for 2026 from 13 carriers (CMS CY2026 Landscape). Plan type mix: 42 PPO, 16 HMO-POS, 11 HMO, 5 HMO D-SNP (dual-eligible special needs), and 3 PPO I-SNP (institutional special needs). PPOs dominate, reflecting the cross-border nature of NJ healthcare — many beneficiaries use providers in NY or PA.
County availability ranges from 57 MA plans in Atlantic County (south) to 36 plans in Sussex County (northwest) — one of the most uniformly distributed MA markets nationally. Top carriers: Aetna Medicare and UnitedHealthcare (17 plans each), Braven Health (10 plans, NJ-exclusive). Average star rating is 3.82.
Medigap (Medicare Supplement)
New Jersey has 29 carriers offering Plan G in the TPP rate database (TPP rate DB, CY2026). The full set of 12 federally standardized plan letters (A through N, plus high-deductible variants HDG and HDF) is available statewide under standard federal rules. New Jersey uses attained-age rating — premiums increase as you age.
Plan F is closed to new enrollees as of January 1, 2020 under MACRA / the 21st Century Cures Act; the same closure applies to High-Deductible Plan F (HDF) — only beneficiaries who became Medicare-eligible before January 1, 2020 may still purchase Plan F or HDF. High-Deductible Plan G (HDG) is the post-2020 high-deductible Medigap option and is offered in New Jersey by 21 carriers. See our MA vs Medigap comparison →
Standalone Part D (Prescription Drug Plans)
New Jersey is CMS PDP Region 4 — New Jersey alone. For 2026, there are 12 standalone PDP plans from 6 carriers. Average total premium is $73.10/month (CMS CY2026 Landscape) — one of the higher averages in the country.
Costs in New Jersey
Medicare Advantage Premiums
The average consolidated MA premium in New Jersey is $36.27/month (median $31.00) (CMS CY2026 Landscape) — above the national average. The standard Medicare Part B premium is $202.90/month in 2026.
The top three carriers by plan count are Aetna Medicare and UnitedHealthcare (17 plans each), followed by Braven Health (10 plans) (CMS CY2026 Landscape). Average star rating is 3.82.
Medigap Premiums — Plan G and HDG
Medigap premiums in New Jersey vary by carrier, age, gender, tobacco use, and rating method (attained-age in NJ, so rates rise with age). Across the 29 carriers offering Plan G in New Jersey (non-tobacco rates, ages 65–85), monthly premiums range from approximately $148 to $608/month (TPP rate database, CY2026).
High-Deductible Plan G (HDG) is offered by 21 New Jersey carriers; premiums range from approximately $140 to $565/month across ages 65–85, non-tobacco rates (TPP rate database, CY2026). HDG works well for beneficiaries who want catastrophic protection at a lower monthly cost and can absorb the $2,950 deductible (2026).
Part D Costs and the LIS Benchmark
For 2026, New Jersey Part D premiums average $73.10/month across 12 standalone PDP plans. The CMS Low Income Subsidy (LIS / Extra Help) benchmark premium for PDP Region 4 (New Jersey) is $54.17/month (CMS CY2026 Regional Rates and Benchmarks).
New Jersey-Specific Medicare Rules
New Jersey Medigap Protections
New Jersey follows standard federal Medigap rules. You have a 6-month Medigap Open Enrollment Period that starts the month you are both 65 or older and enrolled in Medicare Part B. During this guaranteed-issue window, insurers cannot deny you coverage or charge higher premiums based on your health history.
After this window closes, medical underwriting applies and coverage is not guaranteed. New Jersey does not have a Birthday Rule or other annual switch right. Enrolling in Medigap during the initial Open Enrollment Period is especially important. NJ uses attained-age rating, so when comparing carriers, ask for both current premium and a projection over 5–10 years.
PAAD and Senior Gold — State Pharmaceutical Assistance
New Jersey operates two state-run pharmaceutical assistance programs that supplement Medicare Part D for eligible residents:
- PAAD (Pharmaceutical Assistance to the Aged & Disabled): For NJ residents 65+ or 18+ on Social Security Disability, with income up to approximately $54,000 (single) / $61,000 (married). Provides drug coverage with $5 generic / $7 brand co-pays after Medicare Part D pays its share.
- Senior Gold Prescription Discount Program: Higher income thresholds (approximately $64,000 single / $71,000 married). Provides co-pay assistance with a slightly different cost structure than PAAD.
Both programs work alongside Medicare Part D and can substantially reduce out-of-pocket drug costs. Apply through the NJ Department of Human Services Division of Aging Services. More information at https://www.nj.gov/humanservices/doas/services/paad. Income thresholds are updated periodically — verify current limits before applying.
Medicare Savings Programs (MSPs)
New Jersey offers Medicare Savings Programs (MSPs) administered by the NJ Department of Human Services Division of Medical Assistance and Health Services:
- QMB (Qualified Medicare Beneficiary): Covers Part A and Part B premiums, deductibles, and cost-sharing.
- SLMB (Specified Low-Income Medicare Beneficiary): Covers Part B premiums only.
- QI (Qualifying Individual): Also covers Part B premiums; subject to annual appropriations.
Apply through your local County Welfare Agency or contact New Jersey SHIP (1-800-792-8820) for free enrollment assistance. MSP enrollment also automatically qualifies you for Extra Help / LIS on Part D. Learn more about MSPs →
New Jersey SHIP
New Jersey SHIP (State Health Insurance Assistance Program) provides free, unbiased counseling on all Medicare options statewide. Administered by the New Jersey Department of Human Services Division of Aging Services.
Phone: 1-800-792-8820
Website: https://www.nj.gov/humanservices/doas/services/ship
Enrolling in Medicare in New Jersey
Standard Enrollment Periods
- Initial Enrollment Period (IEP): 7-month window centered on your 65th birthday month. Enroll at ssa.gov or call 1-800-772-1213.
- Annual Election Period (AEP): October 15 – December 7 each year.
- Medicare Advantage Open Enrollment Period (OEP): January 1 – March 31.
- Medigap Open Enrollment Period: 6-month guaranteed-issue window starting when you are 65+ and enrolled in Part B. After this window, medical underwriting applies (NJ has no Birthday Rule).
- Special Enrollment Periods (SEPs): Learn more →
New Jersey SHIP Counseling
Contact NJ SHIP at 1-800-792-8820 for free one-on-one Medicare guidance statewide.