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Medicare plans in Sussex County, NJ — 2026
What agents look up before working a county: plan count, carriers, $0-premium share, star distribution, MOOP range, the 65+ and 60–64 population, and what changed since last year.
In 2026, Sussex County, New Jersey has 48 Medicare plans (24 Medicare Advantage with drug coverage, 6 without, 12 standalone Part D, 6 Special Needs) from 9 carriers. 11 Medicare Advantage plans have a $0 premium. The lowest in-network out-of-pocket maximum is $6,500.
Market snapshot
- Residents 65 and older
- 27,656
- Residents 60–64, aging in over the next five years
- 11,159
- Medicare eligibles
- 35,257
- Medicare Advantage penetration
- 34.2%
- Plans per 1,000 residents 65+
- 1.7
Carriers by number of plans
- Aetna Medicare — 12 plans
- UnitedHealthcare — 12 plans
- Wellcare — 8 plans
- Clover Health — 4 plans
- HealthSpring — 3 plans
- Horizon Blue Cross Blue Shield of New Jersey — 3 plans
- Humana — 3 plans
- Wellpoint — 2 plans
Plans sorted by CMS star rating, then premium
| Plan | Carrier | Category | Plan type | Monthly premium | Drug deductible | Out-of-pocket maximum | Star rating |
|---|
| Aetna Medicare Prime (PPO) (H5521-392-0) | Aetna Medicare | MA-PD | PPO | $0 | $615 | $9,250 | 4.5 |
|---|
| Aetna Medicare Prime Giveback (PPO) (H5521-277-0) | Aetna Medicare | MA-PD | PPO | $0 | $615 | $9,250 | 4.5 |
|---|
| Clover Health Choice (PPO) (H5141-004-0) | Clover Health | MA-PD | PPO | $0 | $150 | $9,250 | 4.5 |
|---|
| Clover Health Choice Giveback (PPO) (H5141-054-0) | Clover Health | MA-PD | PPO | $0 | $200 | $8,499 | 4.5 |
|---|
| Clover Health Choice Value (PPO) (H5141-007-0) | Clover Health | MA-PD | PPO | $31 | $220 | $9,250 | 4.5 |
|---|
| Aetna Medicare Prime Extra (PPO) (H5521-275-0) | Aetna Medicare | MA-PD | PPO | $74 | $615 | $9,250 | 4.5 |
|---|
| Aetna Medicare Enhanced Extra (PPO) (H5521-513-0) | Aetna Medicare | MA-PD | PPO | $91 | $615 | $9,250 | 4.5 |
|---|
| Aetna Medicare Eagle Giveback (PPO) (H5521-504-0) | Aetna Medicare | MA | PPO | | | $9,250 | 4.5 |
|---|
| Clover Health Valor (PPO) (H5141-061-0) | Clover Health | MA | PPO | | | $9,250 | 4.5 |
|---|
| Aetna Medicare Prime (HMO-POS) (H3152-080-0) | Aetna Medicare | MA-PD | HMO-POS | $0 | $615 | $9,250 | 4.0 |
|---|
Showing 10 of 48 plans.
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About this data
Source: CMS Medicare Advantage/Part D Landscape files, plan year 2026; population: U.S. Census Bureau ACS 5-year 2024; MA penetration: CMS September 2026.
This page summarizes publicly available CMS data. It is not a plan finder and does not recommend plans. To compare and enroll in plans, use Medicare.gov or talk to a licensed agent. Medicare.gov plan finder.