NJ Medicare AEP Guide 2026

New Jersey Medicare enrollees are receiving notices about significant premium increases and plan changes for 2026. The Medicare annual enrollment period (October 15 - December 7) brings major adjustments that will impact thousands of beneficiaries across the state.

We here at NJ Life and Health have received dozens of calls from concerned enrollees in recent weeks as people receive their Part D increase notices and Advantage plan termination letters.

We've created this free guide to help you navigate what you can do during Medicare AEP in NJ! If you;d like to work with us, visit www.njlifeandhealth.com or call 848-226-6897.

Medicare Annual Enrollment Period Overview

The Medicare annual enrollment period runs from October 15th through December 7th each year. It is the Super Bowl of the Medicare world, and a large percentage of all Medicare enrollments happen during this time.

What You Can Change During Annual Enrollment:

• Switch between Medicare Advantage plans

• Change Medicare Part D prescription drug plans

• Move from Medicare Advantage to Original Medicare

• Move from Original Medicare to Medicare Advantage

  
  

Important Note: All changes take effect January 1st, 2026.

Part D Premium Increases

New Jersey's Part D landscape is consolidating from 14 available standalone plans to just 12 in 2026. More significantly, premiums are increasing substantially across the board.

Premium Changes:

• 2025 Average: $61 per month

• 2026 Average: $78 per month

  
  

According to my colleague licensed broker John O'Hara, this represents the biggest headline for 2026 Medicare changes. Plans that previously cost under $10 or $20 monthly are experiencing dramatic increases or disappearing entirely.

Why Part D Premiums Are Increasing

The Inflation Reduction Act established a $2,000 annual out-of-pocket maximum for Part D plans starting in 2025. While this benefits enrollees with expensive medications, insurance companies are offsetting these costs by raising premiums across the board.

Medicare Advantage Plan Terminations

Some of the Affected Counties:

• Bergen

• Passaic

• Camden

• Hunterdon

• Middlesex

• Morris

• Somerset

• Sussex

• Warren

  
  

Some popular Medicare Advantage plans are terminating coverage in these counties for 2026. We heaviliy emphasize the critical importance of reviewing all Medicare mail during this period to ensure you're not losing your current plan.

What Happens When Plans Terminate:

• Coverage continues through December 31st, 2025

• You most likely have Original Medicare only starting January 1st, 2026

• We recommend selecting a new plan during Annual Enrollment to protect yourself

  
  

Medicare Supplement Premium Increases

Medicare supplements are experiencing significant rate increases across New Jersey. My colleague Jo Gallo reports that 15%, 20%, or even 25% premium increases over the past year are common among their supplement clients.

It may be time to shop around if your premiums are getting too high. The good news is you can apply for a new Medicare Supplement in NJ all year, not just during Medicare Annual Enrollment!

Medicare Supplement Shopping Strategy

Medicare supplements are federally standardized products, which means identical plans offer the same coverage regardless of the insurance carrier. As Gallo notes, it's a major misconception that there's any difference between Plan G offerings from different companies beyond pricing. You will get identical service when you switch.

Potential Savings: $50-100 monthly by switching carriers for identical coverage.

In order to switch Medicare Supplements, you have to go through Medical Underwriting. This means the company you're applying for has the right to ask you questions about your health and look through your medical records.

Underwriting Requirements

Common Reasons for Denial:

• Scheduled surgeries (including routine procedures)

• Active physical therapy

• Cancer diagnosis within 2 years

• Heart attack within 2 years

• Severe chronic condition like Alzheimer's or Aids/HIV.

  
  

Future Application Strategy: Even if you can't qualify immediately, the NJ Life and Health team often schedules future application dates when clients will meet health requirements. You may only have to wait 3-6 months.

Alternative Coverage Strategy

Some enrollees are facing $60-80 in combined monthly Medicare cost increases, making traditional supplement coverage financially challenging. NJ Life and Health has been recommending a new MA+ approach for enrollees who feel they can no longer afford the monthly costs of their Medicare Supplement and Part D plan.

Medicare Advantage Plus Approach:

Coverage Components:

1. Low-premium Medicare Advantage plan ($0-30 monthly)

2. Hospital indemnity insurance ($10-30 monthly)

3. Critical illness coverage ($20-50 monthly)

Hopsital Indemenity Example: Hospital Indemnity policies provide lump-sum payments for major diagnoses. An example would be paying $25 monthly and receiving a $1000 check upon hospital admission, and $250 a day for the first 5 days you're admitted.

Critical Illness Benefit Example: Critical illness policies provide lump-sum payments for major diagnoses. An example would be paying $25 monthly and receiving a $10,000 check upon cancer diagnosis.

Professional Help Limitations

Finding professional assistance with Part D plan selection has become more challenging. Most Medicare Part D plans in NJ no longer offer broker commissions, which makes it difficult for brokers to provide this service since they're not compensated for the work.

This is particularly challenging since Part D is often considered the most complex aspect of Medicare planning. NJ Life and Health will still help you if you need it a second look at your options.

Action Items Before December 7th

Required Steps:

1. Review all Medicare mail - don't discard as junk mail

2. Verify plan continuation - confirm your plans aren't terminating

3. Calculate total 2026 costs - Part B + supplements/Advantage + Part D

4. Research alternatives - if current costs are unmanageable

5. Seek professional guidance - contact a licensed broker if needed. We recommend the team here at NJ Life and Health!

Author Bio

Ken Connolly is a licensed life and health insurance broker in NJ and several other states.

To work with NJ Life and Health, call 848-226-6897 or visit www.njlifeandhealth.com

Disclaimer: We do not offer every plan available in your area.  We represent a number of MA organizations, which offer products in your area.  Any information we provide is limited to those plans we do offer in your area.  Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.