Medicare Eligibility in New Jersey

Are you eligible for Medicare in New Jersey?

If you are a U.S. citizen or permanent legal resident who has lived in the U.S. for more than five consecutive years, you may be eligible for Medicare in New Jersey.

However, one of the following must also apply to you:

  • You are 65 or older.
  • You have received disability benefits from Social Security or the Railroad Retirement Board for two years.
  • Have end-stage renal disease, or Lou Gehrig’s disease.

If you receive Social Security or Railroad Retirement Board benefits and have worked ten qualifying years, coverage should automatically start the first day of the month you turn 65.

When Are You Eligible?

Medicare eligibility in New Jersey is based on your initial enrollment period, which consists of a seven-month window beginning three months before your 65th birthday and ending three months after your birth month. Although you can enroll later during designated open enrollment windows, you may have to pay a late penalty for Part B monthly premiums. New Jersey follows federal requirements for Medicare eligibility.

How Do I Sign Up for Medicare in New Jersey?

Here are a few ways you can sign up;

Contact the New Jersey Department of Human Services and the State Health Insurance Assistance Program for more information.

Resource Links

Plan Options for Eligible Residents

  • Medicare Part A

Part A is hospital insurance, covering inpatient hospitalization, skilled nursing facility care, hospice care, and home health care.

  • Medicare Part B

Part B is medical insurance, covering outpatient services.

(Parts A and B together are called Original Medicare. Coverage starts the month you turn 65. Part A is free to New Jersey Medicare enrollees who have worked for ten years and paid Medicare taxes. You may have to pay a premium for Part A if you do not have enough qualifying quarters. All Medicare beneficiaries pay a premium for Part B.)

  • Medicare Part C

Also known as Medicare Advantage, Part C offers an alternate way to receive Part A and Part B coverage, with additional benefits.

  • Medicare Part D

Part D is optional, providing prescription drug coverage.

(Parts C and D are elective and sold by private insurance companies.)

  • Medicare Supplement Plans (Medigap)

Supplement health plans cover out-of-pocket costs and other expenses not covered by Medicare. Each of the 10 Medigap plans offers different benefits. You can enroll in either a Medigap plan or Part C but not both.

The State of New Jersey Division of Aging Services’ health services programs help low-income seniors access healthcare, find affordable insurance plans and save on Medicare premiums and prescription drugs. Medicare Savings programs help pay Part B premiums, prescription drug costs, and other health coverage costs.

Ready to Learn More?

Choosing a plan is not an easy decision. However, educating yourself about the differences between the different types of insurance coverage, comparing different plans and policies, and talking to a licensed insurance agent will help you make the right choice.