Understanding Medicare Special Needs Plans in Somerset County, New Jersey
Somerset County, NJ offers 11 Special Needs Plans (SNPs) in 2026, including 2 with no monthly premium. Currently, about 2,297 beneficiaries are enrolled, and 36% of SNPs have a 4-star rating or higher. These plans are designed for Medicare beneficiaries who meet special eligibility criteria, such as dual coverage, qualifying chronic conditions, or residence in a long-term care facility.
You can also review all Medicare coverage options available in Somerset County, NJ.
Page last revised:
Enrollment data refreshed: September 9, 2026
* Each year CMS evaluates Medicare Advantage plans on a 5-star scale. Data sources
Dual Eligible Special Needs Plans (D-SNPs)
Dual Eligible Special Needs Plans (D-SNPs) are designed for people who qualify for both Medicare and Medicaid. These plans coordinate benefits to reduce costs and provide access to additional support services.
- Total D-SNP Plans: 6
- Average Premium: $42.08/mo
- Beneficiaries Enrolled: 2,025
- $0 Premium D-SNPs: 0
- Zero Cost D-SNP Plans: 6
- Most Popular D-SNP: UHC Dual Complete NJ-Y001 (D-SNP) with 922 enrollees
- D-SNPs Without Drug Coverage: 0
| Health Plan Name | CMS Rating* | Premium Per Mo | Network | CMS Plan ID |
|---|---|---|---|---|
| Horizon NJ TotalCare | $43 | HMO D-SNP | H8298 001 0 | |
| UHC Dual Complete NJ-Y001 | $37 | HMO D-SNP | H3113 005 0 | |
| Wellcare Fidelis Dual Align | $54 | HMO D-SNP | H0913 013 0 | |
| Aetna Medicare FIDE | $54 | HMO D-SNP | H6399 001 0 | |
| Wellpoint Full Dual Advantage | $32 | HMO D-SNP | H3240 013 0 | |
| Wellpoint Full Dual Advantage Secure | $32 | HMO-POS D-SNP | H3240 024 0 |
What D-SNP plan has the highest enrollment in Somerset County?
UHC Dual Complete NJ-Y001 (D-SNP) is the most popular D-SNP in Somerset County, with 922 enrollees.
What is the total number of D-SNP options in Somerset County?
There are 6 D-SNP plans in 2026, covering 2,025 beneficiaries.
Institutional Special Needs Plans (I-SNPs)
These plans cater to individuals residing in long-term care facilities, such as nursing homes, or those requiring extended skilled nursing facility care at home. The CMS website provides more information about I-SNPs and their coverage details.
- Total I-SNP Plans
- 3
- Average Premium
- $84.80/mo
- Beneficiaries Enrolled
- 177
- $0 Premium I-SNPs
- 0
- Average MOOP
- $15,167
- Most Popular I-SNP
- UHC Nursing Home Plan EX-F003 (I-SNP) with 131 enrollees
- I-SNPs Without Drug Coverage
- 0
| Health Plan Name | CMS Rating* | Premium Per Mo | Network | CMS Plan ID |
|---|---|---|---|---|
| UHC Nursing Home Plan EX-F003 | $42 | PPO I-SNP | H0710 026 0 | |
| Longevity Health Plan | $172 | PPO I-SNP | H9942 002 0 | |
| Longevity Health Plan | $40 | PPO I-SNP | H9942 001 0 |
What is the total number of I-SNP options in Somerset County?
Somerset County has 3 I-SNP options for 2026, serving 177 members.
How much do I-SNP plans cost on average in Somerset County?
The mean monthly I-SNP premium in Somerset County is $84.80, with 0 at no cost.
Chronic Condition Special Needs Plans (C-SNPs)
These plans are designed for individuals with severe or disabling chronic conditions. C-SNPs excel at coordinating your care among different medical specialists and often include extra benefits like prescription drug plans.
- Total C-SNP Plans 2
- Average Premium $0.00/mo
- Beneficiaries Enrolled 95
- $0 Premium C-SNPs 2
- Average MOOP $18,100
- Most Popular C-SNP Humana Gold Plus - Diabetes and Heart (C-SNP) with 81 enrollees
- C-SNPs Without Drug Coverage 0
| Health Plan Name | CMS Rating* | Premium Per Mo | Network | CMS Plan ID |
|---|---|---|---|---|
| Humana Gold Plus - Diabetes and Heart | $0 | HMO C-SNP | H6622 098 0 | |
| Wellpoint Kidney Care | $0 | HMO-POS C-SNP | H3240 017 0 |
What is the typical monthly premium for C-SNPs in Somerset County?
On average, C-SNP plans in Somerset County cost $0.00 per month.
Which C-SNP plan do most beneficiaries with chronic conditions choose in Somerset County?
The leading C-SNP in Somerset County is Humana Gold Plus - Diabetes and Heart (C-SNP), with 81 members.
How many Chronic Condition SNPs are offered in Somerset County?
In 2026, Somerset County offers 2 C-SNPs with 95 enrollees.
Medicare Special Needs Plans have with strict enrollment windows. By knowing when and how to sign up, you’ll avoid missed deadlines and keep your healthcare coverage aligned with your needs.
Understanding Enrollment Windows
- Initial Enrollment Period (IEP): Beginning three months before you turn 65 and lasting until three months after, this is the initial chance to join Medicare. You may also select a Medicare Advantage plan if it fits your needs. Learn more
- Medicare Advantage Open Enrollment Period (MA OEP): Between January 1 and March 31, people already enrolled in Medicare Advantage can make a one-time change—switch to another plan or return to Original Medicare. Learn more
- Annual Enrollment Period (AEP): From October 15 through December 7 each year, you can make changes to your Medicare coverage for the following year. Learn more
- Special Enrollment Periods (SEPs): Life events like moving to a new service area, losing other health coverage, or becoming eligible for assistance may open a Special Enrollment Period to adjust your Medicare coverage. Learn more
Ways to Enroll in Medicare Advantage Special Needs Plans
- Consult a Licensed Agent: Call a licensed insurance agent at HealthCompare 1-833-748-3201 (TTY 711), available Monday through Friday 5am–6pm and Saturday 6am–5pm PST, for help reviewing your Medicare options.
- Contact the Plan Provider Directly: Start enrollment by reaching out to the plan provider through their website or by phone with their member services team.
- Use Medicare.gov: At Medicare.gov, you can compare Medicare Advantage plans side by side and enroll securely online.
The D-SNP, C-SNP, and I-SNP plans listed on this page are available to qualifying individuals enrolled in Medicare Part A and Part B living in Warren, Watchung, Basking Ridge, Bedminster, Bernardsville, Far Hills, Gladstone, Belle Mead, Skillman, Bound Brook, Bridgewater, Franklin Park, Manville, Martinsville, Hillsborough, Neshanic Station, Raritan, Somerset, Somerville, South Bound Brook, and all other areas of Somerset County, New Jersey. For a broader statewide overview, see Medicare plan options in New Jersey.
Plans Offered for Enrollment through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, HealthSpring℠, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint
- CMS.gov, Landscape Source Files — Version: 202608
- CMS.gov, Medicare Part C & D Performance — Version: 2026
- CMS.gov, Plan Benefits Package — Version: 2026
- CMS.gov, Medicare Advantage/Part D Contract and Enrollment Data — Version: 2026-08
Some facts and percentages shown on this page (such as average premiums, distribution of plan types, and percentage of $0 premium plans) are calculated by Medicare.org using data from the CMS Plan Benefits Package (PBP) files and Part C & D Performance files. All underlying values originate from CMS, and calculations are refreshed whenever CMS issues updated data.
To explore how 2026 Medicare SNP plans available in Somerset County compare with plans offered elsewhere, you can search the Special Needs Plan directory to review options nationwide using the same authoritative data sources.
Medicare.org separates Medicare Advantage (MA/MAPD) plans and Special Needs Plans (SNPs) into different pages for clarity. As a result, plan counts, percentages, and other calculations shown here may differ from the aggregate totals published in the CMS Landscape files. All plan availability and benefit details originate from CMS.
Learn more about how we use CMS data.
- CMS.gov, "Medicare Advantage Plan Fact Sheet" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — Last accessed 23 May, 2025
- Medicare.gov, "Joining a plan" — Last accessed 21 May, 2025
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment 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 Medicare coverage interpretation and resolution.