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AmeriHealth 65 NJ HMO with Rx
AmeriHealth 65 NJ HMO with Rx is a Medicare Advantage plan with a Medicare contract and is offered by AmeriHealth HMO, Inc. The prescription benefits are administered by FutureScripts® Secure, a pharmacy benefit management program.
AmeriHealth 65 NJ HMO with Rx gives you all the benefits of Original Medicare plus many more. You can enroll in AmeriHealth 65 NJ HMO with Rx if you live in the service area that includes Burlington, Camden, Cumberland, Gloucester, and Salem counties in New Jersey.
AmeriHealth 65 NJ HMO with Rx provides members with:
- comprehensive medical coverage;
- Medicare Part D prescription drug coverage;
- virtually no paperwork;
- preventive care;
- extensive network with more than 3,000 primary care physicians, 50,000 specialist sites, and 100 hospitals;
- access to health resources and wellness programs;
- help managing chronic conditions, such as asthma, diabetes, and COPD.
| AmeriHealth 65 NJ HMO with Rx |  |
| Monthly premium | $191.60 |
| Yearly deductible | $1,500 |
| Primary care physician visit | $10 |
| Specialist visit | $40 |
| Emergency room | $50 Not waived if admitted |
| Ambulance | Covered in full after deductible |
| Urgent care | $10 - $40 |
| Inpatient hospital | Covered in full after deductible |
| Outpatient surgery (per date of service) | Outpatient hospital: Covered in full after $1,500 deductible Ambulatory surgical center: Covered in full, after $1,500 deductible |
| Preventive services | No copayments for outpatient lab services, routine physicals, most cancer screenings and more |
| Dental benefits | Preventive dental: $10 every 6 months; Comp dental: covered in full |
| Vision services | Medicare-covered eye exams: $40 Routine eye exams: $40 every two years Medicare-covered eyewear: One pair of eyeglasses or contacts after cataract surgery Other eyewear: $100 every 2 years ($65 frames and $35 lenses) |
| Hearing services | Medicare-covered hearing exams: $40 Routine hearing exams: $40 every 3 years Hearing aids: $500 every 3 years |
| Health/wellness education | Weight management: $200; smoking cessation: $200; Silver Sneakers basic gym membership; CPR and first aid |
| Prescription Drug Benefit | |
| Deductible (what you pay before the plan starts to pay) | $310 |
| Initial Coverage Phase (what you and the plan pay in total covered prescription drug costs up to a certain level – the Initial Coverage Limit) | After you pay your yearly deductible, you pay 25% until total yearly drug costs reach $2,830. |
| Coverage Gap (when you pay all drug costs until the catastrophic coverage begins) | You pay 100% of the cost of drugs until your true out-of-pocket (TrOOP) costs reach $4,550. |
| Catastrophic Coverage (starts after you have paid $4,550 out of pocket for covered drugs in a year) | You pay the greater of 5% coinsurance or a $2.50 copay for generic (preferred or non-preferred) drugs and a $6.30 copay for all other drugs. |
Enroll by mail
Download 
AmeriHealth 65 NJ HMO with Rx form.
Mail to:
AmeriHealth 65
Medicare Department
P O Box 7576
Philadelphia, PA 19101-8951
Summary of Benefits
The Summary of Benefits tells you about some of the plan’s features. You should refer to the Summary of Benefits for:
- applicable conditions and limitations;
- premiums;
- cost-sharing (e.g., copayments, coinsurance, and deductibles);
- any conditions associated with receipt or use of benefits.
Download the AmeriHealth 65 NJ HMO with Rx Summary of Benefits.
Evidence of Coverage
The Evidence of Coverage is our contract with you. It explains your rights, benefits, and responsibilities as a member of our plan.
Download the AmeriHealth 65 NJ HMO with Rx Evidence of Coverage.
Drug Formulary
A drug formulary is a list of generic and brand-name prescription drugs that are covered by the plan, are FDA-approved, and have been chosen for their reported medical effectiveness and value.
Download the AmeriHealth 65 NJ HMO with Rx Formulary.
Learn more
Read some of the most frequently asked questions about the AmeriHealth 65 NJ HMO with Rx.
