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a consumer's guide to New Jersey Medicare programs, Medicare Part D Prescription Drug Reimbursement and Coverage

topics: Medicare Prescription Drug Help, Medicare coverage, Medicare Advantage prescription drug programs, supplement insurance, what is Medicare? help

  Medicare New Jersey help & articles    Who Offers New Jersey Medicare Prescription Drug Plans? The Medicare Project (Home)   New Jersey MEDICAID help

New Jersey Medicare, New Jersey Medicare Prescription Drug Coverage
Medicare Help & Information, Medicare Part D In New Jersey, Medicare help

Answers and information about Medicare, prescription drug coverage and health insurance involves searching through hundreds of pages at government and private websites. To help seniors and caregivers get started in their search, our editors have compiled this digest of New Jersey Medicare help and information resources.
 

New Jersey Medicare; NJ; Medicare Part D in New Jersey

New Jersey Medicaid: Medicaid assistance and New Jersey Medicaid help Were you looking for New Jersey Medicaid instead of New Jersey Medicare? This link provides a directory of Medicare web sites, articles, publications, brochures
 
The Medicare Coverage Gap (The Doughnut Hole) A directory of web sites, articles, and publications that helps explain what and how the Prescription Drug Coverage Gap works.

New Jersey Medicare Coverage, Prescription Drug Plans
New Jersey Medicare Help Articles & Resources

Information from varied resources about Medicare in New Jersey
Important advice about how to use this data: This Web Site links you to other Web Sites on the Internet. We cannot take responsibility for information found on third party Web sites outside our control. While we attempt to provide links only to Web Sites that comply with all applicable laws and regulations and appear to have responsible information, please understand that the content on these third-party Web Sites is subject to change without notice to us. We therefore cannot be responsible for, and accept no liability for, any information or opinion contained in any third-party Web Site. Nothing on this Web Site should be construed as the giving of advice or the making of a recommendation and it should not be relied on as the basis for any decision or action. Use this web page for informational purposes only.

 
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medicaid
 
Medicare Web Page:
State Pharmaceutical Assistance Programs and Medicare Prescription Drug Coverage
source:State of New Jersey, Department of Health and Senior Services
languages: English
"New Jersey's Department of Health & Senior Services has created this Web site to help Pharmaceutical Assistance to the Aged and Disabled program (PAAD) and Senior Gold Prescription Discount program (Senior Gold) beneficiaries and caregivers..."
.
Medicare brochure or publication:
Medicare and You - 2006

source:Medicare & You 2006
file size: 104 pg.   languages: English
This handbook describes important changes in Medicare. You can find basic information about the Medicare Program as well as specific information about each type of Medicare Advantage Plan or other Medicare Health Plan and prescription drug coverage choice.
.
Medicare Web Page:
Medicare Participating Physician/Supplier Directory

source:EMPIRE MEDICARE SERVICESlanguages: English
Search by County and Specialty
.
web page: New Jersey State Health Insurance Assistance Program (SHIP)

source:New Jersey Department of Health and Senior Services
languages: English
The State Health Insurance Assistance Program (SHIP) provides free help to New Jersey Medicare beneficiaries who have problems with, or questions about their health insurance.
 
more from New Jersey Department of Health and Senior Services:
Medicare Web Page:
HOT TOPIC: New Medicare Prescription Drug Program
languages: English
"Beginning January 1, 2006, new Medicare prescription drug plans were made available to people with Medicare. Insurance companies and other private companies are working with Medicare to offer these drug plans... "

Medicare brochure or publication:
New Jersey State Strategic Plan on Aging, 2005-2008
161 pages; languages: English
"This U.S. Administration on Aging approved plan establishes priorities for meeting the needs of New Jersey's older adults... "

.
Medicare brochure or publication:
New Jersey Medicare Drug Plan Ratings

source:AARP
file size:5 pg.  languages: English
"...This AARP rating tool contains information about “stand-alone” Medicare plans in your state that cover only prescription drugs...."
 
more from AARP:
Medicare Web Page:
Medicare Prescription Drug Coverage - New Jersey: Medicare Rx Fact Sheet
languages: English
"New Jersey already runs three programs that help people with limited incomes pay for drugs and a fourth program that helps pay for other Medicare-related costs like premiums. These programs are: Medicaid, New Jersey Pharmaceutical Assistance to the Aged and Disabled (PAAD), Senior Gold, and Medicare Savings Programs..."

.
Medicare Web Page:
Indiana: Medicare Hospital Payments

source:Kaiser Family Foundation / statehealthfacts.org
languages: English
Range of Medicare Payments (Low-25th Percentile/High-75th Percentile) for Top Five Elective Inpatient Hospital Procedures, FY2005
.
Medicaid brochure or publication:
A Consumer's Guide to Getting and Keeping Health Insurance in New Jersey

source:healthinsuranceinfo.net
file size: 47pg.   languages: English
from GEORGETOWN UNIVERSITY HEALTH POLICY INSTITUTE. As a resident of New Jersey, you have rights under federal and state law that will protect you when you seek to buy, keep, or switch your health insurance, even if you have a serious health condition. This guide describes your protections as a resident of New Jersey.
.
Medicaid brochure or publication:
Your Medicare Rights and Protections

source: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
44pp   languages: English
Fairly detailed explanations and descriptions about your Medicare rights and protections.
.
Medicare brochure or publication:
Lanscape: 2007 New Jersey Stand-Alone Prescription Drug Plans

source:CENTERS FOR MEDICARE & MEDICAID SERVICES, U.S. Department of Health and Human Services
file size:3 pg.   languages: English  date:2007
New Jersey 2007 Medicare Part D Stand-Alone Prescription Drug Plans. Data as of September 12, 2006. Data as of September 12, 2006. Includes all contracts/plans regardless of 2007 approval status. Employer sponsored plans (800 series) are excluded."


Medicare brochure or publication:
Landscape: New Jersey Medicare Advantage, Cost Plans, and Demonstrations

source:CENTERS FOR MEDICARE & MEDICAID SERVICES
file size:9 pg.   languages: English
"New Jersey 2007 Medicare Advantage, Cost, and Demonstration Plans. Data as of September 12, 2006. Includes all contracts/plans regardless of 2007 approval status. Employer sponsored plans (800 series) are excluded."

How to get more information about Indiana Medicare Prescription Drug Programs

Medicare.gov has summary information about the plans offered by the companies listed in the tables below. The data sheets are called "Landscapes".
  1. The Landscape of Local Plans is a list of all plans available in your area. You can get answers to important questions for people with Medicare based on what matters to them, including:
    • Cost (premiums, deductibles and payments)
    • Coverage (important issues around what and how drugs are covered)
    • Convenience (pharmacy and mail-order options)
  2. Medicare.gov has an important help page that explains how to read and interpret the information in both Medicare Prescription Drug Plan "Landscapes. You can access the help page through this link: How to read the Medicare Prescription Drug Plans Landscape
  3. We have provided links to the landscape documents for this state in the list of publications above. 
.
.


 

Medicare prescription drug coverage plans offered in New Jersey, Medicare Advantage Plans

Important advice about how to use this data: The data for the table below came from www.medicare.gov, "The Official U.S. Government Site for People with Medicare", in December, 2006, and is subject to change at any time. To check for changes and the newest data, you should visit www.medicare.gov. Your state insurance administrator might have different data; be sure to check with them before making any decisions. Nothing on this Web Site should be construed as the giving of advice or the making of a recommendation and it should not be relied on as the basis for any decision or action.

 
44 Prescription Drug Plans in New Jersey  This list is to familiarize you with Medicare Prescription Plans available in your state, and to provide you with contact information to specific carriers. Check with the insurance provider or medicare.gov for information about coverage options, annual deductibles, approved drugs, and other limitations. Do NOT use this web page as the basis for any decision or action. (All data is subject to change. Check with medicare.gov or the insurance provider for latest data.)
Plan Name and
ID Numbers
Company
(w. link to
plan web site)
Coverage in
the Gap
About the gap
Contact Service
Phones
Humana PDP Standard S5884-062
(S5884-062)
Humana Insurance Company No gap coverage Non-Members
1-800-706-0872
TTY Users should call:
1-877-833-4486
Members
1-800-281-6918
TTY Users should call:
1-800-281-6918
Humana PDP Enhanced S5884-003
(S5884-003)
Humana Insurance Company No gap coverage Non-Members
1-800-706-0872
TTY Users should call:
1-877-833-4486
Members
1-800-281-6918
TTY Users should call:
1-800-281-6918
WellCare Signature
(S5967-038)
WellCare No gap coverage Non-Members
1-888-423-5252
Members
1-888-550-5252
TTY Users should call:
1-888-550-5252
PacifiCare Saver Plan
(S5921-288)
UnitedHealthcare No gap coverage Non-Members
1-800-943-0399
Members
1-800-797-9794
TTY Users should call:
1-714-825-3600
AdvantraRx Value
(S5674-014)
Coventry AdvantraRx No gap coverage Non-Members
1-800-882-3822
TTY Users should call:
1-800-508-9548
Members
1-866-823-5178
TTY Users should call:
1-866-823-5178
Health Net Orange
(S5678-005)
Health Net No gap coverage Non-Members
1-800-806-8811
TTY Users should call:
1-800-929-9955
Members
1-800-806-8811
TTY Users should call:
1-800-806-8811
MedicareRx Rewards
(S5960-004)
Unicare No gap coverage Non-Members
1-866-892-5335
Members
1-800-928-6201
TTY Users should call:
1-800-928-6201
AARP MedicareRx Plan
(S5820-003)
UnitedHealthcare No gap coverage Non-Members
1-888-867-5564
TTY Users should call:
1-877-730-4192
Members
1-888-867-5575
TTY Users should call:
1-888-867-5575
Health Net Orange
(S5678-011)
Health Net No gap coverage Non-Members
1-800-806-8811
TTY Users should call:
1-800-929-9955
Members
1-800-806-8811
TTY Users should call:
1-800-806-8811
First Health Premier
(S5768-007)
First Health Part D No gap coverage Non-Members
1-800-588-3322
TTY Users should call:
1-800-508-9548
Members
1-866-865-0662
TTY Users should call:
1-866-865-0662
United Medicare MedAdvance
(S5820-107)
UnitedHealthcare No gap coverage Non-Members
1-888-556-6657
TTY Users should call:
1-888-556-7065
Members
1-888-556-7047
TTY Users should call:
1-888-556-7047
Prescription Pathway Bronze Plan Reg 4
(S5597-069)
Pennsylvania Life Insurance Company No gap coverage Non-Members
1-800-765-8900
TTY Users should call:
1-866-222-3904
Members
1-800-698-8394
TTY Users should call:
1-850-432-1700
Horizon Medicare Rx Plan 1
(S5993-001)
Horizon Blue Cross Blue Shield of New Jersey, Inc. No gap coverage Non-Members
1-800-224-1234
Members
1-866-236-7376
TTY Users should call:
1-800-365-2223
Horizon Medicare Rx Plan 2
(S5993-002)
Horizon Blue Cross Blue Shield of New Jersey, Inc. No gap coverage Non-Members
1-800-224-1234
Members
1-866-236-7376
TTY Users should call:
1-800-365-2223
SilverScript
(S5601-008)
SilverScript Insurance Company No gap coverage Non-Members
1-866-552-6106
TTY Users should call:
1-866-552-6288
Members
1-866-235-5660
TTY Users should call:
1-866-235-5660
PacifiCare Select Plan
(S5921-286)
UnitedHealthcare No gap coverage Non-Members
1-800-943-0399
Members
1-800-797-9794
TTY Users should call:
1-714-825-3600
AdvantraRx Premier
(S5674-015)
Coventry AdvantraRx No gap coverage Non-Members
1-800-882-3822
TTY Users should call:
1-800-508-9548
Members
1-866-823-5178
TTY Users should call:
1-866-823-5178
MedicareRx Rewards Plus
(S5960-040)
Unicare No gap coverage Non-Members
1-866-892-5335
Members
1-800-928-6201
TTY Users should call:
1-800-928-6201
Community Care Rx BASIC
(S5803-073)
MEMBERHEALTH No gap coverage Non-Members
1-866-684-5353
TTY Users should call:
1-866-684-5351
Members
1-866-684-5353
TTY Users should call:
1-518-449-6800
YOURx PLAN
(S5660-035)
Medco YOURx PLAN No gap coverage Non-Members
1-800-758-3605
TTY Users should call:
1-800-716-3231
Members
1-800-758-4574
TTY Users should call:
1-800-758-4574
Aetna Medicare Rx Essentials
(S5810-038)
Aetna Medicare No gap coverage Non-Members
1-800-445-1796
TTY Users should call:
1-800-628-3323
Members
1-877-238-6211
TTY Users should call:
1-877-238-6211
Advantage Allegiance Plan
(S5644-005)
RxAmerica No gap coverage Non-Members
1-877-279-0370
Members
1-800-429-6686
TTY Users should call:
1-800-429-6686
UA Medicare Part D Prescription Drug Cov
(S5755-007)
United American Insurance Company No gap coverage Non-Members
1-866-524-4169
TTY Users should call:
1-866-524-4170
Members
1-866-524-4169
TTY Users should call:
1-866-524-4169
PacifiCare Comprehensive Plan
(S5921-293)
UnitedHealthcare Generic Only Non-Members
1-800-943-0399
Members
1-800-797-9794
TTY Users should call:
1-714-825-3600
Advantage Freedom Plan
(S5644-049)
RxAmerica No gap coverage Non-Members
1-877-279-0370
Members
1-800-429-6686
TTY Users should call:
1-800-429-6686
WellCare Complete
(S5967-072)
WellCare No gap coverage Non-Members
1-888-423-5252
Members
1-888-550-5252
TTY Users should call:
1-888-550-5252
CIGNATURE Rx Value Plan
(S5617-018)
CIGNA HealthCare No gap coverage Non-Members
1-800-735-1459
Members
1-800-222-6700
TTY Users should call:
1-800-222-6700
Prescription Pathway Silver Plan Reg 4
(S5825-074)
American Progressive Life & Health Ins Co of NY No gap coverage Non-Members
1-800-825-8200
TTY Users should call:
1-866-222-3904
Members
1-800-698-8396
TTY Users should call:
1-850-432-1700
Prescription Pathway Silver Plan Reg 4
(S5597-168)
Pennsylvania Life Insurance Company No gap coverage Non-Members
1-800-765-8900
TTY Users should call:
1-866-222-3904
Members
1-800-698-8394
TTY Users should call:
1-850-432-1700
WellCare Premier
(S5967-107)
WellCare No gap coverage Non-Members
1-888-423-5252
Members
1-888-550-5252
TTY Users should call:
1-888-550-5252
Community Care Rx CHOICE
(S5803-141)
MEMBERHEALTH No gap coverage Non-Members
1-866-684-5353
TTY Users should call:
1-866-684-5351
Members
1-866-684-5353
TTY Users should call:
1-518-449-6800
CIGNATURE Rx Plus Plan
(S5617-020)
CIGNA HealthCare No gap coverage Non-Members
1-800-735-1459
Members
1-800-222-6700
TTY Users should call:
1-800-222-6700
MedicareRx Rewards Premier
(S5960-074)
Unicare Generic Only Non-Members
1-866-892-5335
Members
1-800-928-6201
TTY Users should call:
1-800-928-6201
Aetna Medicare Rx Plus
(S5810-140)
Aetna Medicare Generic Only Non-Members
1-800-445-1796
TTY Users should call:
1-800-628-3323
Members
1-877-238-6211
TTY Users should call:
1-877-238-6211
AdvantraRx Premier Plus
(S5674-017)
Coventry AdvantraRx No gap coverage Non-Members
1-800-882-3822
TTY Users should call:
1-800-508-9548
Members
1-866-823-5178
TTY Users should call:
1-866-823-5178
Community Care Rx GOLD
(S5803-107)
MEMBERHEALTH No gap coverage Non-Members
1-866-684-5353
TTY Users should call:
1-866-684-5351
Members
1-866-684-5353
TTY Users should call:
1-518-449-6800
Humana PDP Complete S5884-032
(S5884-032)
Humana Insurance Company Generic and Brand Non-Members
1-800-706-0872
TTY Users should call:
1-877-833-4486
Members
1-800-281-6918
TTY Users should call:
1-800-281-6918
Prescription Pathway Gold Plan Reg 4
(S5825-018)
American Progressive Life & Health Ins Co of NY No gap coverage Non-Members
1-800-825-8200
TTY Users should call:
1-866-222-3904
Members
1-800-698-8396
TTY Users should call:
1-850-432-1700
Prescription Pathway Gold Plan Reg 4
(S5597-036)
Pennsylvania Life Insurance Company No gap coverage Non-Members
1-800-765-8900
TTY Users should call:
1-866-222-3904
Members
1-800-698-8394
TTY Users should call:
1-850-432-1700
CIGNATURE Rx Complete Plan
(S5617-174)
CIGNA HealthCare Generic Only Non-Members
1-800-735-1459
Members
1-800-222-6700
TTY Users should call:
1-800-222-6700
Sterling Prescription Drug Plan
(S4802-001)
Sterling Life Insurance Company No gap coverage Non-Members
1-888-909-1713
TTY Users should call:
1-888-858-8567
Members
1-866-865-0664
TTY Users should call:
1-866-865-0664
SilverScript Plus
(S5601-009)
SilverScript Insurance Company No gap coverage Non-Members
1-866-235-4582
TTY Users should call:
1-866-552-6288
Members
1-866-235-5660
TTY Users should call:
1-866-235-5660
Aetna Medicare Rx Premier
(S5810-174)
Aetna Medicare Generic Only Non-Members
1-800-445-1796
TTY Users should call:
1-800-628-3323
Members
1-877-238-6211
TTY Users should call:
1-877-238-6211
Prescription Pathway Platinum Plan Reg 4
(S5825-032)
American Progressive Life & Health Ins Co of NY No gap coverage Non-Members
1-800-825-8200
TTY Users should call:
1-866-222-3904
Members
1-800-698-8396
TTY Users should call:
1-850-432-1700

 
2 Medicare Special Needs Plans in New Jersey  This list is to familiarize you with Medicare Special Needs Plans available in your state, and to provide you with contact information to specific carriers. Check with the insurance provider or medicare.gov for information about coverage options, annual deductibles, approved drugs, and other limitations. Do NOT use this web page as the basis for any decision or action. (All data is subject to change. Check with medicare.gov or the insurance provider for latest data.)
Plan Name and
ID Numbers
Company
(w. link to
plan web site)
Special Rules for Enrolling Contact Service
Phones
Aetna Golden Medicare Select Plan
(H3152-067-0)
Aetna Medicare For people who are eligible for both Medicare and Medicaid. Non-Members
1-800-445-1796
TTY Users should call:
1-800-628-3323
Members
1-800-282-5366
TTY Users should call:
1-800-628-3323
AmeriChoice Personal Care Plus
(H3164-003-0)
AmeriChoice Personal Care Plus For people who are eligible for both Medicare and Medicaid. Non-Members
1-877-289-1915
TTY Users should call:
1-800-421-1220
Members
1-800-514-4911
TTY Users should call:
1-800-421-1220


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