NEW JERSEY MEDICARE ADVANTAGE PLANS FOR 2015 Data as of October 10, 2014 Plan Name (Plan ID #) Plan Type Full Premium Premium with PAAD or Medicaid Drug Coverage Performance Rating* AARP Medicare Complete Essential (008) HMO $0 Does Not Work with PAAD or Medicaid No (1) 3 stars HMO $0 $0 Yes 3 stars Bergen, Essex, Hudson, Mercer, Middlesex, Monmouth, Ocean, Passaic, Union AARP Medicare Complete Plan 2 (012) HMO $0 $0 Yes 3 stars Essex and Ocean AARP Medicare Complete Plan 3 (014) HMO $39 $1.40 Yes 3 stars Bergen, Mercer, Middlesex, Passaic, Union UnitedHealthcare MedicareComplete FOCUS (013) HMO $0 $0 Yes 3 stars Essex, Hudson, Monmouth, Ocean HMO $0 Does Not Work with PAAD or Medicaid No (1) 4 stars HMO $0 $0 Yes 4 stars HMO $151 $116.00 Yes 4 stars HMO $49 $25.20 Yes 4 stars Ocean HMO $38 $16.90 Yes 4 stars Camden. Gloucester, Mercer HMO $65 $38.10 Yes 4 stars Atlantic, Burlington, Camden, Cumberland, Gloucester, Salem Company AARP Medicare Complete Plan 1 SecureHorizons by United Healthcare (004) H3107 1-800-547-5514 aarpmedicareplans.com Aetna Medicare Basic HMO H3152-045 Aetna Medicare NNJ Prime Plan HMO H3152 (080) Aetna Medicare Premier HMO H3152 (048) Aetna Medicare Value HMO Aetna Medicare 1-800-832-2640 aetnamedicare.com H3152 (046) Aetna Medicare Value HMO H3152 (077) Aetna Medicare Standard HMO H3152 (022) Counties Where Available Bergen, Essex, Hudson, Middlesex, Monmouth, Morris, Ocean, Passaic, Sussex, Union Bergen, Essex, Hudson, Hunterdon, Morris, Passaic, Somerset, Sussex, Union, Warren Bergen, Essex, Hudson, Middlesex Monmouth, Morris, Ocean, Passaic, Sussex, Union 4 stars Aetna Medicare Standard PPO (H5512-037) Aetna Medicare Select Plus PPO (H5512-052) (1) HMO No Drug Benefit: Cannot combine with Stand-Alone Medicare Part D Drug Plan. *Plan's Rating provided by Medicare and based on 1 to 5 stars, with 5 highest rating. New Jersey Department of Human Services State Health Insurance Assistance Program PPO $69 $33.30 Yes 4 stars Essex, Hudson, Middlesex Morris, Ocean, Passaic PPO $139 $126.20 Yes 4 stars Plan Types: HMO- Health Maintenance Organization restricted to using network providers PPO- Preferred Provider Organization, in-network and out-of-network coverage MSA - Medical Savings Account, high deductible plan Note: This chart does not include PACE Plans . See Page 4 for Special Needs Plans (SNPs) Page 1 of 4 NEW JERSEY MEDICARE ADVANTAGE PLANS FOR 2015 Company AmeriHealth 65 H3156 1-800-898-3492 AmeriHealth65.com Plan Name (Plan ID #) Plan Type Full Premium Premium with PAAD or Medicaid Drug Coverage Performance Rating* Counties Where Available No (1) 3.5 stars Burlington, Camden, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Ocean, Salem, Somerset, Union AmeriHealth 65 Preferred Medical Only (029) HMO $40.00 Does Not Work with PAAD or Medicaid AmeriHealth 65 Preferred Medical Only (033) HMO $55.00 Does Not Work with PAAD or Medicaid No (1) 3.5 stars Bergen, Cape May, Monmouth, Morris, Passaic, Sussex, Warren AmeriHealth 65 Preferred Medical Only (035) HMO $120.00 Does Not Work with PAAD or Medicaid No (1) 3.5 stars Atlantic AmeriHealth 65 Preferred Rx (036) HMO $147 $109.40 Yes 3.5 stars Atlantic AmeriHealth 65 Preferred Rx (030) HMO $62 $24.40 Yes 3.5 stars Burlington, Camden, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Ocean, Salem, Somerset, Union AmeriHealth 65 Preferred Rx (034) HMO $87 $49.40 Yes 3.5 stars Bergen, Cape May, Monmouth, Morris, Passaic, Sussex, Warren CarePoint Health Plans CarePoint Advantage PPO $0 $0 Yes not enough data for rating Hudson 888-657-1207 carepoint.org CarePoint Advantage NJ PPO $0 $0 Yes not enough data for rating Bergen, Essex, Passaic, Somerset, Union HMO $0 $0 Yes 4.5 stars PPO $109 $71.40 Yes not enough data for rating $0 No But can Enroll in Part D Plan not enough data for rating (H5141-001) (H5141-004) Geisinger Gold Classic Rx (H3594-146) Geisinger Gold 800-426-9313 Geisinger Gold Preferred Rx (H9412-003) meridianGeisingergold.com Geisinger Gold Reserve 100 (MSA) (H2792-001) New Jersey Department of Human Services State Health Insurance Assistance Program Medical Savings Account $0 with High Deductible Page 2 of 4 Monmouth and Ocean NEW JERSEY MEDICARE ADVANTAGE PLANS FOR 2015 Plan Name (Plan ID #) Plan Type Full Premium Premium with PAAD or Medicaid Drug Coverage Performance Rating* Counties Where Available Horizon Medicare Blue Patient-Centered w Rx (024) HMO $0 $0 Yes 3 stars Essex, Hudson, Ocean, Salem, Warren Horizon Medicare Blue Patient-Centered w Rx (026) HMO $57.20 $19.60 Yes 3 stars Middlesex, Morris, Sussex, Union Horizon Medicare Blue Patient-Centered w Rx (027) HMO $68.90 $31.30 Yes 3 stars Bergen, Cape May, Mercer, Monmouth, Passaic, Somerset Horizon Medicare Blue Patient-Centered w Rx (028) HMO $109.10 $71.50 Yes 3 stars Atlantic, Camden, Cumberland, Gloucester, Hunterdon Horizon Medicare Blue Value (013) HMO $20 Does Not Work with PAAD or Medicaid No (1) 3 stars Cape May, Essex, Hudson, Ocean, Salem, Union, Warren Horizon Medicare Blue Value w/Rx (004) HMO $79.00 $41.40 Yes 3 stars Cape May, Essex, Hudson, Ocean, Salem, Union, Warren Company Horizon Blue Cross Blue Shield of NJ H3154 1-800-224-1234 medicare.horizonblue.com Horizon Medicare Blue Choice with Rx (22) HMO $178.00 $140.40 Yes 3 stars Atlantic, Bergen, Burlington, Camden, Cumberland, Gloucester, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Passaic, Somerset, Sussex Horizon Medicare Blue PPO (H7971-001) PPO $228.50 $190.90 Yes not enough data for rating Sussex County Humana Choice PPO $295.00 $270.80 Yes 4 stars Bergen, Burlington,Gloucester, Morris, Somerset, Warren WellCare Value (002) HMO $0 $0 Yes 2.5 stars Essex, Hudson WellCare Value (012) HMO $0 $0 Yes 2.5 stars Middlesex, Passaic Humana Benefit Plan of Illinois 1-800-833-2364 H5525-018 humana.com WellCare H0913 1-866-360-8137 wellcare.com (1) HMO No Drug Benefit: Cannot combine with Stand-Alone Medicare Part D Drug Plan. * Plan's Rating provided by Medicare and based on 1 to 5 stars, with 5 highest rating. New Jersey Department of Human Services State Health Insurance Assistance Program Plan Types: HMO- Health Maintenance Organization restricted to using network providers PPO- Preferred Provider Organization, in-network and out-of-network coverage Note: This chart does not include PACE plans. See Page 4 for Special Needs Plans (SNPs) Page 3 of 4 NEW JERSEY MEDICARE ADVANTAGE PLANS FOR 2015 Company Plan Name (Plan ID #) Plan Type Full Premium Premium with PAAD or Medicaid Drug Coverage Performance Rating* Counties Where Available Amerigroup New Jersey 877-470-4131 Amerivantage Speciality + Rx DSNP HMO/ DSNP $0 $0 YES 3 stars Bergen, Burlington, Essex, Hudson, Middlesex, Monmouth, Ocean, Passaic, Somerset, Union HMO/ DSNP $0 $0 YES not enough data for rating Essex, Monmouth, Ocean, Union H3240-013 myamerigroup.com United Healthcare 888-834-3721 United Healthcare Dual Complete One uhccommunityplan.com H3113-005 DSNP- Special Needs Plan for Dual Eligibles. This Medicare/Medicaid HMO only enrolls members with both Medicare and full Medicaid benefits. New Jersey Department of Human Services State Health Insurance Assistance Program Page 4 of 4
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