By Mike Miligi, Certified Medicare Insurance Planner- Michael M Insurance Services
Ocean County isn’t one town — it’s Toms River, Brick, Lakewood, Jackson, Beachwood, Berkeley Township, Manchester, Stafford, Barnegat, and a dozen more communities stretched along the Jersey Shore, each with its own mix of hospitals, doctors, and Medicare Advantage plans. For the 2027 plan year, Ocean County residents have 29 standard Medicare Advantage plans and 14 Special Needs Plans, along with 11 standalone Part D plans and 15 insurance companies offering Medicare Supplement (Medigap) policies locally. Those numbers have shifted meaningfully from last year — standard Medicare Advantage options are down, while Special Needs Plans have grown — which is exactly why the Annual Enrollment Period deserves real attention here, not a quick skim of last year’s notes.
What Is the Annual Enrollment Period?
The Medicare Annual Enrollment Period (AEP) runs every year from October 15 through December 7, with any changes taking effect January 1. During this window, you can switch Medicare Advantage plans, move between Original Medicare and Medicare Advantage, or change your Part D prescription drug plan. It’s the one guaranteed opportunity most Medicare beneficiaries get each year to make a full review of their coverage — and this year, that review matters more than usual.
A National Pullback, Showing Up Locally in Ocean County
CMS released its 2027 Medicare Advantage landscape file in late September, and it tells a clear story: major carriers are meaningfully reducing their standard Medicare Advantage offerings nationwide. UnitedHealthcare is cutting roughly 690 plans nationally and Humana roughly 2,400, even as the overall plan count stays relatively flat because Special Needs Plans continue to grow. Nearly 3 million people were already forced to find new coverage for 2026 after losing their previous plan, according to Johns Hopkins research, and early signs point to a similar scale of disruption this year.
Ocean County’s own numbers tell the same story up close: standard Medicare Advantage plans here have dropped from 36 to 29 for 2027, while Special Needs Plans grew from 11 to 14. If you’re on a standard Medicare Advantage plan today — rather than a D-SNP or C-SNP — it’s worth directly confirming your plan is still being offered for 2027 before assuming it carries over automatically.
The Two Hospital Systems Behind Most Ocean County Plans
Before comparing premiums or star ratings, it’s worth understanding the hospital landscape your plan sits on top of. Ocean County is largely split between two health systems:
- Hackensack Meridian Health — includes Ocean University Medical Center (Brick) and Southern Ocean Medical Center
- (Manahawkin) RWJBarnabas Health — includes Community Medical Center (Toms River) and Monmouth Medical Center’s Southern Campus (Lakewood)
Some Medicare Advantage plans align cleanly with one system; others include both. A plan that worked perfectly for a Brick Township resident whose specialists are all at Ocean University Medical Center could leave a Toms River resident, who sees doctors through Community Medical Center, out of network entirely — even in the same county, on paper-similar plans. With fewer standard plans on the market this year, it’s worth confirming this network alignment directly rather than assuming your plan’s structure is unchanged.
Why AEP Matters More Than a Renewal Notice Suggests
A useful local example: Braven Health — a joint venture between Horizon Blue Cross Blue Shield of NJ, Hackensack Meridian Health, and RWJBarnabas Health — has been the most-enrolled Medicare Advantage plan in Ocean County, with its Braven Medicare Choice (PPO) covering roughly 12,000 local members. Newer joint-venture plans like this one tend to see more year-to-year change in network, cost-sharing, and extra benefits than long-established carriers — which matters even more in a year when the broader market is already shifting this much. Reading the Annual Notice of Change (ANOC) each September matters more than usual this year, for any plan, not just newer ones.
New Jersey's Medigap Rules Aren't the Same as New York's
This is worth knowing if you or a neighbor has ever compared notes with someone in New York: the two states play by different rules entirely when it comes to Medicare Supplement (Medigap) plans.
New Jersey follows the federal six-month Medigap Open Enrollment window — starting the month you’re both 65 or older and enrolled in Medicare Part B. During that window, insurers must sell you any Medigap plan sold in the state, regardless of health history. Miss that window, and New Jersey insurers are generally allowed to medically underwrite your application — meaning you could be charged more, or denied altogether, based on your health.
New York, by contrast, guarantees Medigap issue year-round. That difference matters most if you’re thinking about switching from Medicare Advantage back to a Medigap plan — in New Jersey, that switch isn’t automatic the way it would be for a New York resident, unless you qualify for a specific guaranteed issue right, such as your Medicare Advantage plan being discontinued or being within your own trial right period. With 15 companies now offering Medigap locally — more options than in past years — it’s worth knowing your rights clearly before assuming the switch will go smoothly. There is pending New Jersey legislation (A2301/S2592) that would move the state toward continuous Medigap enrollment, but as of now it has not been enacted.
The Medicare Calendar at a Glance
| Window | When It Runs | What It's For |
|---|---|---|
| Initial Enrollment Period (IEP) | 7-month window around your 65th birthday | First-time Medicare enrollment |
| Annual Enrollment Period (AEP) | October 15 – December 7, every year | Full range of plan changes for anyone on Medicare |
| Medicare Advantage Open Enrollment Period (MA OEP) | January 1 – March 31, every year | One additional switch, only if you're already in a Medicare Advantage plan |
| Medigap Open Enrollment | One-time, 6-month window starting at 65 + Part B | Guaranteed-issue Medigap purchase, regardless of health |
Common AEP Pitfalls for Ocean County Residents
- Assuming your current plan is automatically still available. With standard Medicare Advantage plans down from 36 to 29 locally, confirm your plan is actually being renewed before assuming it is.
- Assuming your hospital system carries over. A plan that covered your Hackensack Meridian doctors last year isn’t guaranteed to still include them this year. Comparing plans by premium alone, without checking whether your specific specialists and medications are actually covered.
- Skipping the ANOC letter, especially on newer plans like Braven Health, where year-over-year changes tend to be more frequent than on long-established carriers.
- Assuming Medigap works the same as it does in New York. In New Jersey, timing your Medigap decision around your six-month window matters far more.
- Missing the December 7 deadline — there’s no grace period, and the narrower Medicare Advantage Open Enrollment Period that follows on January 1 isn’t a full substitute.
Your AEP Checklist for Ocean County Residents
- Read your ANOC letter the week it arrives, especially if you’re on a newer or joint-venture plan.
- Confirm your current plan is actually being offered for 2027 — with fewer standard Medicare Advantage plans available locally this year, this is worth ruling out directly.
- Identify which hospital system your doctors are actually part of — Hackensack Meridian, RWJBarnabas, or a mix of both.
- Pull your medication list and check it against your plan’s formulary, factoring in the new $700 Part D deductible and $2,400 out-of-pocket cap for 2027.
- Compare more than one plan. Between 29 standard plans and 14 Special Needs Plans, there’s still real choice locally — just a different mix than last year.
- If you’re considering Medigap, check your enrollment timing first — New Jersey’s underwriting rules outside your six-month window are far less forgiving than New York’s.
- Decide before December 7, with enough buffer to confirm your enrollment in writing
Frequently Asked Questions
How many Medicare Advantage plans are available in Ocean County for 2027?
For the 2027 plan year, Ocean County residents have 29 standard Medicare Advantage plans and 14 Special Needs Plans — down from 36 standard plans in 2026, while Special Needs Plans grew from 11. That shift reflects a national trend this year, with major carriers pulling back on standard Medicare Advantage while expanding Special Needs Plan offerings. With fewer standard options than last year, a side-by-side comparison matters more than ever.
Why are there fewer standard Medicare Advantage plans this year?
CMS’s 2027 landscape file shows major insurers nationally reducing their standard Medicare Advantage plan counts to protect margins after years of higher medical spending — UnitedHealthcare by roughly 690 plans and Humana by roughly 2,400, nationwide. Ocean County’s drop from 36 to 29 standard plans reflects that same trend locally, while the county’s Special Needs Plan count grew from 11 to 14.
Does it matter whether I use Hackensack Meridian or RWJBarnabas doctors?
Yes. Some Medicare Advantage plans are built around one system more than the other, and with fewer standard plans on the market for 2027, it’s worth confirming your specific doctors and hospital against a plan’s current-year network directly rather than assuming county-wide coverage, or that your plan from last year still exists.
Is Braven Health a good plan?
It depends on your specific doctors and needs, the same as any plan — but it’s worth knowing Braven Health is a newer joint venture between Horizon BCBSNJ, Hackensack Meridian, and RWJBarnabas, which has made it the most-enrolled plan locally. Newer plans and joint ventures can see more year-to-year changes in network and benefits than long-established carriers, so it’s worth reading the ANOC closely.
I heard Medigap works differently in New Jersey than in New York — is that true?
Yes. New York guarantees Medigap issue year-round, while New Jersey follows the federal rule of a one-time, six-month guaranteed-issue window starting when you turn 65 and enroll in Part B. Outside that window, New Jersey insurers can generally medically underwrite a Medigap application, meaning approval and pricing aren’t guaranteed. With 15 companies now offering Medigap in Ocean County, there’s real choice — but the timing rules still matter.
Can I switch from Medicare Advantage back to Medigap in New Jersey without medical underwriting?
Not automatically. Unless you qualify for a specific guaranteed issue right — such as your plan being discontinued for 2027, or you’re within your Medicare Advantage trial right period — a New Jersey insurer can ask health questions and potentially deny coverage or charge more. This is worth planning the timing carefully rather than assuming the switch will go smoothly.
What if I qualify for both Medicare and Medicaid?
United Healthcare and other carriers offer Dual Special Needs Plans (D-SNPs) in Ocean County for people who qualify for both Medicare and Medicaid. Locally, Special Needs Plan availability has grown for 2027, even as standard plan options shrank.
Are there local options for managing a chronic condition like diabetes or heart disease?
Yes. Humana Gold Plus – Diabetes and Heart is an example of a Chronic Condition Special Needs Plan (CSNP) available locally, built specifically around managing those conditions with a tailored formulary and required care coordination.
What happens if my plan isn't being renewed for 2027?
You’ll generally receive a formal non-renewal notice, and your current coverage stays active through December 31. You’ll need to choose a new Medicare Advantage plan, or return to Original Medicare, before your current coverage ends — and a plan termination can open up a guaranteed-issue right for a Medigap policy, which is especially useful to know given New Jersey’s otherwise limited guaranteed-issue window.
What happens if I miss the December 7 deadline?
If you’re already enrolled in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period (January 1 – March 31) gives you one more narrower opportunity to switch. Otherwise, you’re generally waiting for the next AEP, unless a qualifying life event — including a plan non-renewal — opens a Special Enrollment Period.
Can I keep my plan if I move to a different Ocean County township?
Usually, yes — Medicare Advantage plans are approved at the county level, so a move within Ocean County typically doesn’t affect your plan. Moving to a different county or state generally does, so it’s worth confirming your new address against your plan’s service area before any move.
Get a Comparison Built Around Your Doctors, Not Just Your ZIP Code
Between two hospital systems, a fast-growing joint-venture plan, a smaller lineup of standard Medicare Advantage plans this year, and Medigap rules that don’t work the way they do just across the state line, Ocean County’s Medicare landscape has more moving parts than most. If you want a comparison built around your actual doctors, medications, and township — not a generic “top-rated plan” list — I can put one together for you at no cost. You can see more about how I work with Ocean County residents on my Medicare Broker
Mike Miligi
Owner, Michael M Insurance Service
For over 10 years, Mike has helped seniors and other Medicare-eligible individuals understand their options, including Medicare Advantage Plans (Part C), Medicare Supplement Plans (Medigap), Prescription Drug Plans (Part D), and dental and vision programs. Mike is licensed in 12 states and certified with 15 insurance carriers. As an independent Medicare health insurance broker, he works for the client, not the insurance carriers, providing accurate, unbiased options. Mike recertifies with CMS annually and completes continuing education to stay current on industry standards.
(631) 774-3786 | mmilinsurance@gmail.com | www.mymedicaremike.com
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