Medicare Special Needs Plans in New Jersey
Every Special Needs Plan in New Jersey for 2027, from the CMS plan landscape file. You can join one only if you fit its group: Medicare and Medicaid (D-SNP), a qualifying chronic condition (C-SNP) or nursing-home-level care (I-SNP). Pick your county to see the plans sold there.
Showing all 15 plans.
D-SNPs: Medicare and Medicaid
Sorted by CMS star rating, then by how closely the plan is integrated with New Jersey Medicaid, then by worst-case year. If Medicaid or the QMB program pays your Medicare cost sharing, the out-of-pocket maximum matters less than the network and how well the plan works with Medicaid.
| # | Plan | Premium / month | In-network max out-of-pocket | Worst-case year | Stars |
|---|---|---|---|---|---|
| 1 | Horizon NJ TotalCare (HMO D-SNP)Horizon Blue Cross Blue Shield of New Jersey · HMO D-SNPFully integrated (FIDE) · $0 Medicare cost sharingAll 21 counties | $36.30 | $9,850 | $10,286 | 4★ |
| 2 | Aetna Medicare FIDE (HMO D-SNP)Aetna Medicare · HMO D-SNPFully integrated (FIDE) · $0 Medicare cost sharingAll 21 counties | $0 | $9,850 | $9,850 | 3★ |
| 3 | Wellcare Fidelis Dual Align (HMO D-SNP)Wellcare · HMO D-SNPFully integrated (FIDE) · $0 Medicare cost sharing20 of 21 counties | $28.40 | $9,850 | $10,191 | 3★ |
| 4 | Wellpoint Full Dual Advantage (HMO D-SNP)Wellpoint · HMO D-SNPFully integrated (FIDE) · $0 Medicare cost sharingAll 21 counties | $30.70 | $9,850 | $10,218 | 3★ |
| 5 | UHC Dual Complete NJ-Y001 (HMO D-SNP)UnitedHealthcare · HMO D-SNPHighly integrated (HIDE) · $0 Medicare cost sharing20 of 21 counties | $4.10 | $9,850 | $9,899 | 3★ |
C-SNPs: chronic conditions
Sorted by worst-case year: 12 months of premiums plus the in-network out-of-pocket maximum. Each plan lists the conditions it serves; you need one of them, confirmed by your doctor or another clinician, to join.
| # | Plan | Premium / month | In-network max out-of-pocket | Worst-case year | Stars |
|---|---|---|---|---|---|
| 1 | UHC Complete Care NJ-8 (HMO-POS C-SNP)UnitedHealthcare · HMO-POS C-SNPCardiovascular disorders, Chronic heart failure, DiabetesAll 21 counties | $0 | $7,150 | $7,150 | 3.5★ |
| 2 | Humana Gold Plus - Diabetes and Heart (HMO C-SNP)Humana · HMO C-SNPCardiovascular disorders, Chronic heart failure, Diabetes11 of 21 counties | $0 | $9,350 | $9,350 | 4★ |
| 3 | DEVOTED C-SNP CHOICE GIVEBACK EXTRAS 005 NJ (PPO C-SNP)Devoted Health · PPO C-SNPCardiovascular disorders, Chronic heart failure, Diabetes14 of 21 counties | $0 | $9,650 | $9,650 | Too new to rate |
| 4 | DEVOTED C-SNP CHOICE ENHANCED 004 NJ (PPO C-SNP)Devoted Health · PPO C-SNPCardiovascular disorders, Chronic heart failure, Diabetes14 of 21 counties | $0 | $9,850 | $9,850 | Too new to rate |
| 5 | DEVOTED C-SNP CHOICE PLUS 003 NJ (PPO C-SNP)Devoted Health · PPO C-SNPCardiovascular disorders, Chronic heart failure, Diabetes14 of 21 counties | $0 | $9,850 | $9,850 | Too new to rate |
| 6 | Horizon Specialty Care (HMO C-SNP)Horizon Blue Cross Blue Shield of New Jersey · HMO C-SNPCardiovascular disorders, Chronic heart failure, Diabetes7 of 21 counties | $0 | $9,850 | $9,850 | 4★ |
| 7 | Wellpoint Kidney Care (HMO-POS C-SNP)Wellpoint · HMO-POS C-SNPChronic kidney disease15 of 21 counties | $0 | $9,850 | $9,850 | 3★ |
I-SNPs: institutional care
For people who live, or are expected to live, at least 90 days in a nursing home or similar facility, or who need that level of care at home. Sorted by worst-case year.
| # | Plan | Premium / month | In-network max out-of-pocket | Worst-case year | Stars |
|---|---|---|---|---|---|
| 1 | Longevity Health Plan (PPO I-SNP)Longevity Health Plan · PPO I-SNPFacility-based18 of 21 counties | $172 | $4,500 | $6,564 | 5★ |
| 2 | UHC Nursing Home Plan EX-F003 (PPO I-SNP)UnitedHealthcare · PPO I-SNPFacility-based16 of 21 counties | $18.10 | $9,850 | $10,067 | 5★ |
| 3 | Longevity Health Plan (PPO I-SNP)Longevity Health Plan · PPO I-SNPFacility-based18 of 21 counties | $18.80 | $9,850 | $10,076 | 5★ |
Worst-case year = 12 × monthly plan premium + in-network maximum out-of-pocket, for covered Part A and B services. Many D-SNP members pay $0 in premiums with Extra Help. Star ratings are CMS’s 2027 overall ratings for the contract behind each plan. Plans under CMS sanction aren’t listed. How we sort
Before you enroll: check the plan’s network and drug list in the official Medicare Plan Finder, and ask the plan whether you qualify. Free one-on-one help: your State Health Insurance Assistance Program.
Questions
How many Special Needs Plans are in New Jersey for 2027?
CMS lists 15: 5 D-SNPs (Medicare and Medicaid), 7 C-SNPs (chronic conditions) and 3 I-SNPs (institutional), from 8 parent companies. Not every plan is sold in every county; use the county filter.
Which D-SNPs in New Jersey are integrated with Medicaid?
5 of the 5 D-SNPs are fully integrated, highly integrated or applicable integrated plans, which cover or coordinate Medicaid benefits more closely. The rest are coordination-only plans. Integrated plans are listed first among plans with the same star rating.
Do Special Needs Plans include drug coverage?
Yes. Every Special Needs Plan must include Part D drug coverage.
Can I stay in a Special Needs Plan if I no longer qualify?
Only while you still meet the plan's rules. If you lose eligibility, you may get a Special Enrollment Period to join another plan.
Sources
- CMS, CY 2027 Medicare Advantage and Prescription Drug Plan Landscape (CY2027_Landscape_202609.csv), Special Needs Plan rows — cms.gov; star ratings from the CMS 2027 Star Ratings Data Tables — cms.gov.
- Medicare.gov, “Special Needs Plans” — medicare.gov.
Educational information, not a recommendation to join any plan. We are not an insurance agent or broker, and we are not connected with or endorsed by the U.S. government or the federal Medicare program. Plan details can change; confirm with the plan or Medicare.gov. · Advertiser disclosure
Keep going
- How Special Needs Plans work →
- General Medicare Advantage plans in New Jersey →
- Medicare Savings Programs →
- Extra Help with drug costs →
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