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Medicare
New Jersey 2024 Plans

With more Medicare plans in more counties, Jefferson Health Plans offers a $0 premium plan and generous dental, eyewear and hearing benefits for New Jersey residents. All of our plans include comprehensive benefits for an affordable price.

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Compare Plans & Benefits

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Jefferson Health Plans offers Medicare Advantage plans with affordable premiums, no-cost or low-cost doctor’s visits, no referrals and prescription drug coverage. Review the chart below to learn more about our HMO-POS plans for New Jersey residents.

Plan Name: Silver (HMO-POS) Platinum (HMO-POS)
Monthly Premium $0 $20
Annual Medical Deductible $0 $0
PCP Visits $0 copay $0 copay
Specialist Visits $30 copay; 20% for out-of-network-providers $0 copay; 20% for out-of-network-providers
Referrals Not required Not required
Urgent Care $55 copay $55 copay
Emergency Room $100 copay (waived if admitted within 24 hours) $100 copay (waived if admitted within 24 hours)
Ambulance (Ground) $210 copay $210 copay
Inpatient Hospital $290 copay per day, days 1-5; $0 copay per day, days 6-90 $250 copay per day, days 1-5; $0 copay per day, days 6-90
Outpatient Surgery (Ambulatory Surgical Center) $200 copay $200 copay
Outpatient Surgery (Hospital Outpatient) $300 copay $300 copay
Physical/Occupational/Speech Therapy (Outpatient) $25 copay $25 copay
Lab Services $0 copay $0 copay
Radiology (X-ray) $30 copay $30 copay
Radiology (Diagnostic) $250 copay $250 copay
Diabetes (Test Strips, Monitors & Self-Monitoring Training) $0 copay $0 copay
Diabetes (Other Supplies) $0 - 20% $0 - 20%
Maximum Out-of-Pocket $5,500 $5,400
Prescription Drugs (30-day retail and mail order) Part D Deductible: $0 Preferred Generic: $0 Generic: $10 Preferred Brand: $47 Non-Preferred Brand: $100 Specialty: 33% Select Care Drugs: $0; includes gap coverage Preferred Insulin: Any insulin on formulary is $10/20; not on formulary is $35 Part D Deductible: $0 Preferred Generic: $0 Generic: $10 Preferred Brand: $47 Non-Preferred Brand: $100 Specialty: 33% Select Care Drugs: $0; includes gap coverage Preferred Insulin: Any insulin on formulary is $10/$20; not on formulary is $35
Prescription Drugs (100-day retail and mail order) Part D Deductible: $0 Preferred Generic: $0 Generic: $20 Preferred Brand: $94 Non-Preferred Brand: $200 Specialty: N/A Select Care Drugs: $0; includes gap coverage Preferred Insulin: Any insulin on formulary is $10/20; not on formulary is $35 Part D Deductible: $0 Preferred Generic: $0 Generic: $20 Preferred Brand: $94 Non-Preferred Brand: $200 Specialty: N/A Select Care Drugs: $0; includes gap coverage Preferred Insulin: Any insulin on formulary is $10/$20; not on formulary is $35
Flexcard $2,500 for additional vision, dental and hearing spending $2,500 for additional vision, dental and hearing spending
OTC Benefit $75 per quarter $75 per quarter
Dental Exams & Cleanings $0 copay; three visits per year $0 copay; three visits per year
Dental Allowance $1,000 $2,000
Annual Vision Exam $0 copay $0 copay
Vision Allowance $200 $200
Hearing Services $0 for annual hearing exam $0 for annual hearing exam
Fitness Center Membership $0 copay for SilverSneakers® membership or membership in the Salvation Army Kroc Center in Camden $0 copay for SilverSneakers® membership or membership in the Salvation Army Kroc Center in Camden
JeffConnect Included Included
Worldwide Emergency Coverage $50,000 $50,000

New Jersey 2024 Coverage Area

  • Atlantic
  • Burlington
  • Camden
  • Gloucester
  • Mercer
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This is not a full description of benefits. Copays, limits, benefits and periodicity vary by plan.

New Jersey Medicare
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Page last updated: 10/1/2024 - Y0170_MCE‐220S05‐4991_M