- Entity
- county:new-jersey-sussex-34037
- Digest
- 2027-county-ma-aggregate
- Population Scope
- Standard Medicare Advantage plans only; Special Needs Plans (SNPs) excluded
- Source URL
- https://www.medicareplans.com/medicare-advantage/new-jersey/sussex/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-county-plan-index
- Total Standard Medicare Advantage Plans
- 27
- PPO Plans
- 16
- HMO Plans
- 3
- HMO-POS Plans
- 8
- PFFS Plans
- 0
- Average Monthly Premium
- 31.32
- Average MOOP
- 8894.44
- Average Part D Deductible
- 645
- $0 Premium Plans
- 15
- Plans Without Part D Coverage
- 6
- Average CMS Star Rating
- 4
- $0 Premium Plan Share
- 55.56
- 5-Star Plan Share
- 15
- 4+ Star Plan Share
- 74
- 3-Star Plan Share
- 26
- Below 3-Star Plan Share
- 0
- Not-Rated Plan Share
- 0
- PPO Average Monthly Premium
- 30.16
- PPO Average MOOP
- 9171.88
- PPO Enrollment
- 3710
- PPO $0 Premium Plans
- 9
- PPO Plans Without Part D Coverage
- 4
- HMO Average Monthly Premium
- 44.67
- HMO Average MOOP
- 9850
- HMO Enrollment
- 122
- HMO $0 Premium Plans
- 1
- HMO Plans Without Part D Coverage
- 1
- HMO-POS Average Monthly Premium
- 28.63
- HMO-POS Average MOOP
- 7981.25
- HMO-POS Enrollment
- 1996
- HMO-POS $0 Premium Plans
- 5
- HMO-POS Plans Without Part D Coverage
- 1
- Entity
- county:new-jersey-sussex-34037
- Digest
- 2027-county-ma-aggregate
- Population Scope
- Standard Medicare Advantage plans only; Special Needs Plans (SNPs) excluded
- Source URL
- https://www.medicareplans.com/medicare-advantage/new-jersey/sussex/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-new-jersey-sussex-34037-landscape-stats
- Plans Indexed
- 27
- Standard Medicare Advantage Plans
-
-
Clover Health Choice
H5141-004-0 -
Clover Health Choice Giveback
H5141-054-0 -
Clover Health Choice Value
H5141-007-0 -
Clover Health Valor
H5141-061-0 -
HumanaChoice Giveback H7617-127
H7617-127-0 -
AARP Medicare Advantage from UHC NJ-0004
H8768-022-0 -
AARP Medicare Advantage from UHC NJ-0005
H8768-035-0 -
AARP Medicare Advantage from UHC NJ-6
H8768-058-0 -
AARP Medicare Advantage Patriot No Rx NJ-MA2
H8768-059-0 -
Aetna Medicare Eagle Giveback
H5521-504-0 -
Aetna Medicare Eagle Giveback
H3152-045-0 -
Aetna Medicare Elite
H3152-098-0 -
Aetna Medicare Enhanced
R6694-006-0 -
Aetna Medicare Prime
H5521-392-0 -
Aetna Medicare Prime
H3152-080-0 -
Aetna Medicare Prime Extra
H5521-275-0 -
Aetna Medicare Prime Giveback
H5521-277-0 -
Aetna Medicare Signature
H3152-048-0 -
Humana USAA Honor Giveback
H5216-174-0 -
HumanaChoice H5216-461
H5216-461-0 -
AARP Medicare Advantage Essentials from UHC NJ-1
H0755-038-0 -
AARP Medicare Advantage Extras from UHC NJ-7
H0755-046-0 -
AARP Medicare Advantage from UHC NJ-0002
H0755-044-0 -
AARP Medicare Advantage from UHC NJ-0003
H0755-045-0 -
AARP Medicare Advantage Patriot No Rx NJ-MA01
H0755-037-0 -
Wellcare Assist
H0913-015-0 -
Wellcare Low Premium
H0913-002-0
-
Clover Health Choice
- Total Standard Medicare Advantage Enrollment
- 5828
2027 Medicare Advantage Plans in Sussex County, NJ
Last update: .
For 2027, Sussex County, NJ includes 30 Medicare Advantage plans. Enrollment across these plans totals approximately 5,828, with 15 $0 premium options and 74% rated 4 stars or higher.
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow members to choose care from both in-network and out-of-network providers. Out-of-network care usually costs more, but PPOs offer greater flexibility in how members access care.
- Total PPO Plans
- 16
- Average Monthly Premium
- $30.16/mo
- Total PPO Enrollment
- 3,710
- $0 Premium PPO Plans
- 9
- Average MOOP
- $9,172
- Top PPO by Enrollment
- AARP Medicare Advantage from UHC NJ-0004 (PPO) — 755 enrollees
- PPO Plans Without Drug Coverage
- 4
What is the typical premium for PPO plans available in Sussex?
PPO plans in Sussex cost $30.16 per month on average.
Which PPO plan do most beneficiaries choose in Sussex?
The most popular PPO plan in Sussex is AARP Medicare Advantage from UHC NJ-0004 (PPO), with 755 enrollees.
How many PPO options are offered without drug coverage in Sussex?
4 PPO plans in Sussex do not include prescription drug coverage.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans generally require members to use in-network doctors, hospitals, and other providers, except in emergencies. Because of this structure, HMOs often have lower premiums and out-of-pocket costs than other plan types.
- Total HMO Plans 3
- Average Monthly Premium $44.67/mo
- Total HMO Enrollment 122
- $0 Premium HMO Plans 1
- Average MOOP $9,850
- Top HMO by Enrollment Aetna Medicare Elite (HMO) — 59 enrollees
- HMO Plans Without Drug Coverage 1
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Aetna Medicare Eagle Giveback | $0 | $9,850 | N/A | H3152-045-0 | |
| Aetna Medicare Elite | $25 | $9,850 | $700 | H3152-098-0 | |
| Aetna Medicare Signature | $109 | $9,850 | $700 | H3152-048-0 |
What is the total number of HMO plans offered in Sussex?
In 2027, Sussex County has 3 HMO plans with 122 enrollees.
How much do HMO plans cost in Sussex?
The typical HMO premium in Sussex is $44.67, and 1 plans have no monthly premium.
Medicare Advantage HMO-POS Plans
HMO-POS plans are structured like HMOs, requiring in-network care for the lowest costs, while allowing limited out-of-network access at higher cost. This provides added flexibility compared with standard HMO plans.
- Total HMO-POS Plans
- 8
- Average Monthly Premium
- $28.63/mo
- Total HMO-POS Enrollment
- 1,996
- $0 Premium HMO-POS Plans
- 5
- Average MOOP
- $7,981
- Top HMO-POS by Enrollment
- Aetna Medicare Prime (HMO-POS) — 892 enrollees
- HMO-POS Plans Without Drug Coverage
- 1
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Aetna Medicare Prime | $0 | $9,850 | $700 | H3152-080-0 | |
| AARP Medicare Advantage Essentials from UHC NJ-1 | $0 | $7,150 | $685 | H0755-038-0 | |
| AARP Medicare Advantage Extras from UHC NJ-7 | $0 | $7,150 | $685 | H0755-046-0 | |
| AARP Medicare Advantage from UHC NJ-0002 | $79 | $7,150 | $595 | H0755-044-0 | |
| AARP Medicare Advantage from UHC NJ-0003 | $115 | $6,900 | $595 | H0755-045-0 | |
| AARP Medicare Advantage Patriot No Rx NJ-MA01 | $0 | $7,150 | N/A | H0755-037-0 | |
| Wellcare Assist | $0 | $9,250 | $700 | H0913-015-0 | |
| Wellcare Low Premium | $35 | $9,250 | $700 | H0913-002-0 |
- What is the average monthly premium for HMO-POS plans?
- HMO-POS plans in Sussex cost $28.63 per month on average.
- Which HMO-POS plan is most popular in Sussex?
- The most popular HMO-POS plan in Sussex is Aetna Medicare Prime (HMO-POS), with 892 enrollees.
- How many HMO-POS plans in Sussex do not include drug coverage?
- There are 1 HMO-POS plans in Sussex without prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Sussex County, NJ (2027) are summarized below.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | 4 | 15% |
| 4 Stars (includes 5 Stars) | 20 | 74% |
| 3 Stars | 7 | 26% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 4 | |
* Star ratings are based on CMS quality measures and reflect plan performance for the 2027 rating period.
Medicare Advantage plans listed on this page are available to eligible beneficiaries residing in Sussex County, New Jersey, including communities such as Franklin, Glenwood, Hamburg, Highland Lakes, Ogdensburg, Stockholm, Sussex, Vernon, Andover, Branchville, Montague, Hopatcong, Lafayette, Newton, Sparta, Stanhope, and other areas throughout the county. Plan availability is determined by county of residence, not by city.
- CMS.gov, Medicare Advantage & Special Needs Plan Landscape Source Files — Version: 202609
- CMS.gov, Medicare Part C & D Performance Data — Version: 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Version: 2026-09
All plan counts, enrollment totals, averages, and percentage distributions are calculated at the county level using CMS data and include standard Medicare Advantage (MA/MAPD) plans only, based on a consistent aggregation methodology.
Data sources and methodology documentation .
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Explore your Medicare coverage options" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
MedicarePlans.com is an independent, non-government informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard .
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.