If you live in Edison and have Medicare, or you help a parent who does, the annual enrollment period from October 15 to December 7 is the yearly chance to review coverage and make a change. You can join, switch, or drop a Medicare Advantage or drug plan, and the plan must get the request by December 7 for coverage that starts January 1. This guide is for people in Edison, Woodbridge, Metuchen, Highland Park, Piscataway, New Brunswick, East Brunswick, South Plainfield, Perth Amboy, and Old Bridge.
This article is educational. Instant Health Help is a licensed health insurance agency, and our agent, Lobsang Rivas, is licensed in New Jersey and certified as a broker with Get Covered New Jersey. We are not Medicare, CMS, Get Covered New Jersey, the State of New Jersey, or an insurance company, and we do not quote prices or name plans here. Check official dates on Medicare.gov.
The short answer
You have three good places to start in Middlesex County, and you can use more than one:
- Medicare. Medicare.gov Plan Finder and 1-800-MEDICARE (1-800-633-4227) show the plans sold in your ZIP code.
- New Jersey SHIP, the State Health Insurance Assistance Program. The state says SHIP volunteer counselors do not sell, recommend, or endorse any plan, agent, or insurance company. Counseling sites are set up in all 21 counties, and you can reach one through your County Office on Aging or the SHIP line at 1-800-792-8820. See the New Jersey SHIP page.
- A licensed agent. An agent can compare options with you and help you enroll. Medicare.gov suggests checking the rules agents must follow.
Where do you sign up for Medicare? Medicare.gov says you sign up for Part A and Part B through Social Security, online or at a local Social Security office. Social Security is also the place to confirm that you meet Medicare’s citizenship or residency requirements.
Helping a parent with Medicare
Many families in Edison help a parent with Medicare paperwork. A few things to know first:
Who can join a plan. Medicare.gov says that to join a Medicare health or drug plan, you generally must have Part A and/or Part B, live in the plan’s service area, and be a U.S. citizen or national, a lawful permanent resident (green card holder), a Cuban-Haitian entrant, or lawfully living in the U.S. as a COFA migrant.
Your parent makes the choice. You can gather the papers and join the call, but the decision belongs to the person with Medicare.
Bring the right things. Their Medicare card, a list of every drug they take with the dose, the pharmacy they use, and their doctors’ names.
Key Medicare dates
- Annual enrollment: October 15 to December 7. Changes start January 1.
- Medicare Advantage open enrollment: January 1 to March 31, only if you are already in a Medicare Advantage plan. You can switch to another Advantage plan or go back to Original Medicare.
- Turning 65: your initial enrollment period lasts seven months, starting three months before the month you turn 65.
PAAD: New Jersey’s drug cost help
New Jersey’s Pharmaceutical Assistance to the Aged and Disabled (PAAD) program is state funded and helps eligible residents save on prescription drugs. It is for New Jersey residents age 65 or older, or age 18 to 64 and getting Social Security disability benefits, who are under the state’s income limits. The state says Medicare-eligible PAAD members must also enroll in a Medicare Part D drug plan, and you apply through the state’s NJSave online application. See the PAAD page or call the PAAD hotline at 1-800-792-9745. If income is limited, Medicare.gov also points to Extra Help, which you apply for through Social Security, and Medicare Savings Programs, which you apply for through the state.
Why the address decides the choices
Medicare.gov says you must live in a plan’s service area to join it, so choices follow the home address. Edison and Woodbridge sit just across the water from Staten Island, and a parent who lives in New York sees different plans than one who lives in New Jersey. Our agent is licensed in both states, so we can help either way.
Did a parent just move in with you? Medicare.gov says that if someone moves to a new address outside their plan’s service area, their chance to switch starts when they move and lasts for 2 full months after. If they tell the plan before the move, it can start the month before. If they moved back to the U.S. after living outside the country, they have 2 full months after the month they move back to join a plan. See Medicare’s Special Enrollment Periods page.
Turning 65 with a Get Covered New Jersey plan?
Get Covered New Jersey says that once you are eligible for Medicare, you can no longer get financial help with a Get Covered New Jersey plan. You can end that plan the month before your Medicare starts so there is no gap. See the Get Covered New Jersey FAQ.
Someone in your house under 65?
If a spouse or adult child needs their own plan, New Jersey residents apply at Get Covered New Jersey, not HealthCare.gov. Open enrollment runs November 1 to January 31, and enrolling by December 31 means coverage starts January 1. Our agent is certified as a broker with Get Covered New Jersey, so we can go through the application with you, compare plans with your doctors and prescriptions in mind, and help you enroll, at no extra cost to you for our help. We are not Get Covered New Jersey, and Get Covered New Jersey decides what you qualify for. See our New Jersey open enrollment guide for the full dates.
How we help
We help New Jersey residents with Medicare by phone and online, in English or Spanish. Learn more on our New Jersey health insurance help page. We look at the doctors, prescriptions, ZIP code, and any PAAD or retiree coverage, explain the options in plain English, and leave the decision to the person with Medicare. Adult children are welcome on the call.
Want a second set of eyes before December 7?
Have the Medicare card, the drug list, and the doctors’ names ready, and we can walk through it together.
Call (321) 315-0054 | agent@inshh.com
We do not offer every plan available in your area. Currently we represent 10 organizations which offer 489 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, is available 24 hours a day, 7 days a week, except some federal holidays. Instant Health Help is not connected with or endorsed by the U.S. government or the federal Medicare program.
Featured photo: EdisonTower by Esventy3, CC BY-SA 4.0, cropped with text added.
