Jefferson Health Plans Premier (PPO)
Available to residents of Salem County, NJ for 2027. Contract H3124, plan 003, segment 0.
2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.
New for 2027. This plan has no 2026 predecessor in the CMS crosswalk.
Plan details
| Monthly premium (Part C + D) | $55.00 |
|---|---|
| — medical (Part C) part | $41.50 |
| — drug (Part D) part | $13.50 |
| In-network out-of-pocket maximum | $7,000.00 |
| Drug deductible | $0.00 |
| Drug out-of-pocket threshold | $2,400.00 |
| Plan type | PPO |
| Contract / plan | H3124-003-0 |
| Offered by | Jefferson Health Plans |
| Parent organization | Thomas Jefferson University |
| Formulary tiers | 5 |
| Member services | (833)477-4773TTY (877)454-8477 |
CMS star ratings
- Overall
- 2.5 out of 5 stars for Overall
- Health plan (Part C)
- 3 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 2.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H3124 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 · Preferred Generic | $0.00 |
| Tier 2 · Generic | $5.00 |
| Tier 3 · Preferred Brand | 25% |
| Tier 4 · Non-Preferred Drug | 29% |
| Tier 5 · Specialty Tier | 33% |
Star rating measures
| Measure | 2027 | 2026 |
|---|---|---|
| Staying Healthy: Screenings, Tests and Vaccines | ||
| Annual Flu Vaccine · C03 | 4 out of 5 stars for Annual Flu Vaccine | too new |
| Managing Chronic (Long Term) Conditions | ||
| Diabetes Care – Eye Exam · C11 | 1 out of 5 stars for Diabetes Care – Eye Exam | too new |
| Diabetes Care – Blood Sugar Controlled · C12 | 5 out of 5 stars for Diabetes Care – Blood Sugar Controlled | too new |
| Kidney Health Evaluation for Patients with Diabetes · C13 | 3 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes | too new |
| Controlling High Blood Pressure · C14 | 1 out of 5 stars for Controlling High Blood Pressure | too new |
| Transitions of Care · C19 | 2 out of 5 stars for Transitions of Care | too new |
| Member Experience with Health Plan | ||
| Getting Needed Care · C21 | 3 out of 5 stars for Getting Needed Care | too new |
| Customer Service · C23 | 1 out of 5 stars for Customer Service | too new |
| Rating of Health Care Quality · C24 | 4 out of 5 stars for Rating of Health Care Quality | too new |
| Rating of Health Plan · C25 | 3 out of 5 stars for Rating of Health Plan | too new |
| Care Coordination · C26 | 4 out of 5 stars for Care Coordination | too new |
| Member Complaints and Changes in the Health Plan's Performance | ||
| Complaints about the Health Plan · C27 | 1 out of 5 stars for Complaints about the Health Plan | too new |
| Members Choosing to Leave the Plan · C28 | 3 out of 5 stars for Members Choosing to Leave the Plan | not enough data |
| Health Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · C32 | 4 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 3 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD1: Drug Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · D01 | 4 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 4 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD2: Member Complaints and Changes in the Drug Plan’s Performance | ||
| Complaints about the Drug Plan · D02 | 1 out of 5 stars for Complaints about the Drug Plan | too new |
| Members Choosing to Leave the Plan · D03 | 3 out of 5 stars for Members Choosing to Leave the Plan | not enough data |
| DD3: Member Experience with the Drug Plan | ||
| Rating of Drug Plan · D05 | 3 out of 5 stars for Rating of Drug Plan | too new |
| DD4: Drug Safety and Accuracy of Drug Pricing | ||
| MPF Price Accuracy · D07 | 3 out of 5 stars for MPF Price Accuracy | too new |
| Medication Adherence for Diabetes Medications · D08 | 2 out of 5 stars for Medication Adherence for Diabetes Medications | too new |
| Medication Adherence for Hypertension (RAS antagonists) · D09 | 2 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) | too new |
| Medication Adherence for Cholesterol (Statins) · D10 | 2 out of 5 stars for Medication Adherence for Cholesterol (Statins) | too new |
| Statin Use in Persons with Diabetes (SUPD) · D11 | 2 out of 5 stars for Statin Use in Persons with Diabetes (SUPD) | too new |
| Concurrent Use of Opioids and Benzodiazepines (COB) · D12 | 1 out of 5 stars for Concurrent Use of Opioids and Benzodiazepines (COB) | new measure |
| Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) · D13 | 1 out of 5 stars for Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) | new measure |
Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under H3124 shares it.
Also available in 7 other NJ counties
Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.