Humana Medicare Advantage Plans New Jersey 2025
Are you exploring your Medicare options in New Jersey for 2025? Humana Medicare Advantage plans New Jersey 2025 are tailored to meet the evolving healthcare needs of beneficiaries.
This guide offers detailed insights into the enhanced benefits, costs, and enrollment specifics for Humana Medicare Advantage plans in New Jersey for 2025, providing the essential information to make an informed decision for your health coverage.
Key Takeaways
- Humana is offering new Medicare Advantage and Prescription Drug Plans in New Jersey for 2025, including HMO, PPO, PFFS plans, and additional benefits tailored for Medicare-eligible consumers.
- These Humana Medicare Advantage Plans in New Jersey offer comprehensive coverage with an average premium of $7 per month, including benefits for Part A and B, dental, vision, hearing care, and options for lower cost preferred pharmacies.
- Enrollment in Humana Medicare Advantage Plans in New Jersey is subject to annual contract renewals and relies on eligibility criteria.
- These plans provide competitive coverage including supplementary benefits and may have plan specifics that cater to urban, rural, and suburban areas along with personalized plans for those with dual eligibility or chronic conditions.
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Understanding Humana Medicare Advantage in New Jersey
Humana, a prominent Medicare provider, offers a range of Medicare plans in New Jersey, including:
- Medicare Advantage HMO plans
- Medicare Advantage PPO plans
- Medicare Prescription Drug Plans
For 2025, Humana has announced new offerings for their Medicare Advantage and Medicare Prescription Drug Plans.
These new plans have been designed considering the needs and preferences of Medicare-eligible consumers, making them comprehensive and consumer centric.
What is a Medicare Advantage HMO?
A Medicare Advantage HMO plan offers a blend of Medicare benefits, encompassing hospital, medical coverage, and prescription drug plans. Providers are generally part of a preferred network, with a focus on coordination by a primary care physician.
A distinguishing feature of a Medicare Advantage HMO plan is that it necessitates all healthcare services be accessed within the provider network, typically offering lower monthly premiums compared to other Medicare plans.
To qualify for a Medicare Advantage HMO plan, individuals must live or work within the plan’s service area. They can also become eligible during the 7-month period when they first qualify for Medicare.
The selection of a Medicare Advantage HMO plan offers an array of comprehensive Medicare options, including the comprehensive coverage of Original Medicare along with additional perks such as vision, hearing, and dental coverage.
The Role of Medicare Contract
A Medicare contract formalizes the arrangement between the federal government and private insurers like Humana for the provision of Medicare-covered benefits.
The Centers for Medicare and Medicaid Services (CMS) is responsible for managing these contracts, supervising the delivery of benefits through Medicare Advantage plans, and ensuring compliance with government regulations.
A Medicare contract indicates Humana’s commitment to deliver Medicare Advantage Plans in New Jersey, adhering to federal regulations.
The renewal of coverage under these plans depends on contract renewal, which usually takes place automatically each year unless terminated by Medicare or Humana.
Humana, like other healthcare providers, is compelled to follow the conditions set by the federal government in their Medicare contract. These stipulations encompass specific requirements pertaining to coverage and services for beneficiaries.
Key Features of Humana Medicare Advantage Plans in NJ
Humana Medicare Advantage Plans in New Jersey offer the following benefits:
- Coverage for Medicare Parts A and B
- Supplementary benefits such as dental, vision, and hearing care
- Option to save on prescription drugs through the lower cost preferred pharmacies feature.
These plans aim to provide quality medical care to beneficiaries in New Jersey, specifically in Middlesex County.
Humana Medicare Advantage Plans in NJ provide affordable coverage with an average premium of $7 per month, along with extensive benefits. This makes it an attractive option for a longtime New Jersey resident seeking Medicare coverage.
Lower Cost Preferred Pharmacies
Humana’s preferred pharmacy network in New Jersey comprises CenterWell Pharmacy and other limited lower-cost, preferred pharmacies, offering affordable alternatives to standard pharmacies for prescription medications.
Humana’s preferred pharmacy network decreases the expenses of prescription drugs for New Jersey residents by offering lower co pays and out-of-pocket costs at preferred cost-share pharmacies.
To join Humana’s preferred pharmacy network in New Jersey, individuals can use the Pharmacy Finder tool by inputting their ZIP code or Humana member ID. The advantages of joining include:
- Reduced expenses
- Supplementary savings at participating pharmacies such as Walgreens
- The option to select from a range of pharmacies that receive financial incentives from Humana.
Dual Eligible Special Needs
Humana’s dual-eligible special needs plan in New Jersey is designed for individuals who qualify for both Medicare and Medicaid coverage.
The plan encompasses a Healthy Options Allowance for expenses such as food, pet supplies, utility bills, or rent, in addition to benefits like dental, vision, and hearing coverage.
If an individual is eligible for both Medicare and Medicaid and resides in a state where Humana provides D-SNPs, they can enroll in Humana’s dual-eligible special needs plan in New Jersey.
Enrollment can be completed once per Special Enrollment Period (SEP) or during Medicare’s Fall Open Enrollment Period.
Comprehensive Health Plan Coverage
Humana’s Medicare Advantage plans in New Jersey include coverage for:
- Medicare Parts A and B
- Dental care
- Vision care
- Hearing care
Additionally, there may be additional allowances for eligible expenses such as groceries and over-the-counter products.
The Humana Medicare Advantage plans provide coverage for long-term health conditions by potentially offering up to 100 days at a skilled nursing facility and by providing Chronic Condition Special Needs Plans (C-SNPs) tailored to specific chronic conditions such as diabetes, cardiovascular disorders, and chronic heart failure.
Humana’s Medicare Advantage plans offer a variety of preventative care services, including primary care, preventive services, and annual wellness visits.
Regional Availability: NJ, NY, OH
Humana Medicare Advantage plans are available in the states of New Jersey, New York, Ohio, and MI, MN, MO, MS.
These plans offer location-specific features, including dental, vision, and hearing coverage, and popular plan options such as Health Maintenance Organization (HMO) plans.
Pharmacies in Urban Areas
Humana guarantees access to in-network pharmacies in urban areas by meticulously choosing pharmacies based on factors like availability in specific ZIP codes or service areas, affordability, and customer feedback.
Not all medications are covered at all Humana network pharmacies in urban areas of New Jersey. Coverage varies depending on the specific Humana Medicare plan and the pharmacy network.
The urban areas in New Jersey that have a substantial presence of in-network pharmacies for Humana members are:
- Newark
- Jersey City
- Paterson
- Elizabeth
- Trenton
- Clifton
- Camden
- Passaic
- East Orange
- Bayonne
Stand Alone Prescription Drug Plans
Joining a stand-alone prescription drug plan with Humana offers:
- Basic coverage for a wide range of commonly prescribed medications
- Reasonable prescription copays and premiums
- Access to an extensive network of participating pharmacies
- Preferred mail-order cost-sharing services
The process for enrolling in a Humana stand-alone prescription drug plan in New Jersey involves the following steps:
- Visit the Humana website.
- Use the Medicare plan finder tool to select a suitable plan.
- Enroll online or contact the plan directly.
For additional assistance, contact 1-800-Medicare.
Comparing Humana Medicare Advantage Plans
Humana offers a variety of Medicare Advantage Plans, including Health Maintenance Organization (HMO) plans and PPO organization plans for 2025.
Humana’s Medicare Advantage Plans provide coverage that mirrors traditional Medicare, but also includes additional benefits and services, making them a popular choice for those seeking a Medicare supplement plan.
Enrollment and Annual Election Period
To enroll in Humana Medicare Advantage plans in New Jersey, individuals can select a plan that fits their needs, complete the enrollment process on the Humana website, and follow the instructions to finish the enrollment.
To be eligible for Humana Medicare Advantage plans, individuals must meet the eligibility criteria for Medicare, which includes being 65 years of age or older, or having a qualifying disability or end-stage renal disease if under 65. In addition, residency in a state where Humana offers these plans is required.
The annual election period for Humana Medicare Advantage plans takes place every year from October 15th to December 7th.
During this period, you have the option to transition from another Medicare plan to Humana, enabling you to select a plan that aligns more closely with your healthcare requirements.
Affordability and Alternatives
The average premium for a Humana Medicare Advantage plan in New Jersey is $7 per month. However, other costs such as copayments and out-of-pocket expenses may need to be considered.
Humana’s Medicare Advantage Plans present a cost-effective alternative, featuring an average premium of $7 per month in contrast to Original Medicare.
Individuals contemplating alternatives to Humana can find a variety of options in New Jersey, including:
- Medicare Advantage plans
- Supplemental plans
- Medicaid Managed Care Organization (MCO) plans offered by other insurers such as Aetna, Amerigroup (Wellpoint), AmeriHealth, Braven Health, Cigna, Clover Health, Health Partners Medicare, UnitedHealthcare, and Wellcare.
Rural and Suburban Coverage in ND, NE, SD, VT, and Surrounding States
Humana provides multiple Medicare Advantage plans in MN, MT, ND, such as the Humana USAA Honor (PPO), Humana Value Plus H5216-171 (PPO), and HumanaChoice H5216-088 (PPO).
Humana’s Medicare Advantage coverage in Nebraska and MT, ND, NE, SD is competitive with that in other states, as it offers plans rated 4 stars or higher, and includes dental, vision, and hearing benefits in every plan.
Humana’s Medicare Advantage plans in South Dakota typically cover:
- Medicare Parts A and B
- Additional benefits including dental, vision, and hearing care
- Some plans may also provide allowances for groceries, over-the-counter items, and even utilities and rent.
Tips for Longtime New Jersey Residents
Long-term residents of New Jersey should:
- Thoroughly compare different plans to find the most suitable option
- Explore their eligibility for NJ Save, which is designed to assist in saving on premiums and prescription costs
- Stay updated on any alterations in Medicare policies
- Seek guidance from a Medicare specialist for personalized advice.
When selecting a Medicare Advantage plan, longtime New Jersey residents should take into consideration:
- Their specific health needs
- The network coverage of the plan
- Costs involved
- Additional benefits offered
- Prescription drug coverage
- Plan ratings
- Enrollment periods
Consult the Online Pharmacy Directory at Humana.com
Individuals can visit Humana.com/finder/pharmacy to navigate the online pharmacy directory on Humana.com. The directory offers details about in-network retail pharmacies, such as their address, contact information, and operating hours.
To locate in-network pharmacies using Humana’s online directory, individuals can utilize the Pharmacy Finder by entering their ZIP code or Humana member ID.
The advantages of utilizing Humana’s online pharmacy directory include:
- Convenient access to in-network pharmacies
- Cost savings on medications
- Prescription management
- Home delivery options
Enrollment in Humana Medicare Advantage Plans: Contract Renewal and Plan Dependence
Enrollment in Humana Medicare Advantage plans is contingent upon contract renewal. The contract renewal process with Humana Medicare Advantage plans is automatic, meaning your plan will be renewed every year.
Humana guarantees the continuity of enrollment by facilitating automatic renewals of contracts.
The reliance on specific benefits or established relationships with in-network healthcare providers can significantly influence the decision to enroll in a Humana Medicare Advantage plan.
Individuals are more likely to select a plan that meets their healthcare needs and allows them to continue receiving care from preferred providers.
Summary
In summary, Humana offers a wide range of Medicare Advantage plans, each designed with unique features to meet the diverse needs of beneficiaries. From affordability to comprehensive coverage, Humana’s plans offer substantial benefits to individuals looking for the right healthcare coverage.
It’s critical to thoroughly research and compare the different plans, considering your specific health needs, budget, and the network coverage of the plan.
Frequently Asked Questions
→ What is new in Humana in 2025?
In 2025, Humana Medicare Advantage (MA) plans now offer dental, vision, and hearing benefits, providing more comprehensive coverage options for individuals.
→ What is the Humana over the counter allowance for 2025?
In 2025, Humana provides a $100 quarterly allowance for purchasing approved over-the-counter health and wellness products through their OTC Mail Order provider, with any unused amount expiring at the end of the quarter.
Transportation to plan-approved locations also includes a $0 copay for up to 36 one-way trips per year.
→ What are the disadvantages of Humana Medicare Advantage?
The disadvantages of Humana Medicare Advantage include a limited choice of doctors and medical offices, as well as potential higher overall costs, especially for complex medical needs.
→ What are the main characteristics of Humana Medicare Advantage Plans in New Jersey?
Humana Medicare Advantage Plans in New Jersey cover Medicare Parts A and B, along with supplementary benefits like dental, vision, and hearing care, offering superior quality care at a relatively low cost.
→ What is a Medicare Advantage HMO plan?
A Medicare Advantage HMO plan offers a combination of Medicare benefits, including hospital, medical coverage, and prescription drug plans.
It typically involves a network of providers and emphasizes coordination through a primary care physician.
ZRN Health & Financial Services, LLC, a Texas limited liability company
Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.