New Jersey Medicare

Differences in Gap Coverage in New Jersey

Medicare covers a good portion of your medical expenses. However, with every part of Medicare there are cost-sharing amounts that each beneficiary must pay. A few examples of cost-sharing are deductibles, copayments, and coinsurance.

Without the right gap coverage, these cost-sharing amounts can add up to thousands of dollars by the end of the year in New Jersey. Gap coverage plans are plans that provide help to the beneficiary when it comes to paying for the additional expenses that Medicare does not pay in full.

Plan Types for Gap Coverage: Medigap Plans

There are two different plan types for gap coverage, Medigap and Advantage. Depending on what type of patient you are and how much you’d like to spend on gap coverage, determines which type of plan might be best for you.

Medigap plans, also known as Medicare Supplement plans, offer full or partial coverage for the cost-sharing amounts. Monthly premiums prices for Medigap plans are decided depending on the beneficiary’s location, age, gender, and tobacco use. Typically, Medigap plans have higher monthly premiums than Medicare Advantage plans.

New Jersey Medicare gives you a chance to enroll in a Medigap plan without having to answer multiple health questions. Once you miss that chance, you will be required to answer those questions and depending on your answers, you may be unable to enroll.

One thing that beneficiaries love about Medigap plans is that they don’t have networks. This means you are able to use your Medigap plan anywhere throughout the United States.

Because Medigap plans don’t have networks, you won’t have to worry about checking to see if your doctors accept those plans. If the doctor accepts Medicare, they will accept your Medigap plan.

Plan Types for Gap Coverage: Medicare Advantage Plans

Medicare Advantage plans are quite different from Medigap plans. For instance, advantage plans have monthly premiums as low as $0, while Medigap plans can be much more.

Unlike Medigap plans, advantage plans do not have a certain period where you get a pass for their health questions. However, advantage plans only have one health question you must answer, instead of multiple.

Advantage plans in New Jersey do have networks. Each program within Medicare Advantage plans have certain rules for their networks that they set. For instance, HMO networks are much more restrictive than PPO networks.

When having an advantage plan, you should look out for changes within your plan. Medigap plans stay the same usually from year to year. However, Medicare Advantage plans change annually.

Another thing to consider when choosing your plan type, is if you want a drug plan or not. Medigap plans do not include drug coverage. Therefore, if you want drug coverage, you will have to enroll in a separate plan. Medicare Advantage plans on the other hand, usually do include drug coverage.

Deciding Your Plan Type

If you are considering enrolling in gap coverage, the best thing to do is to look at all your options. Options in pricing, coverage, and even average annual rate changes. Our team here at Boomer Benefits specializes in checking all of the above. We are able to layout all of your possible choices from multiple insurance carries, rather than just one company.

To get a free quote today, contact us at our website or give us a call at 1-855-732-9055.