Are you a New Yorker approaching your 65th birthday? With a milestone birthday in sight, there’s likely one thing on your mind: Medicare.
As a New York resident, you are fortunate to have a robust Medicare market with plenty of plans available.
With a bountiful array of components to choose from and piece together, it’s time to start your transition to Medicare – America’s largest health insurance program!
New York Medicare Insurance Trends
The Centers for Medicare & Medicaid Services (CMS) reported the following information on 2021 Medicare trends in New York:
- A total of 3,673,090 New York residents are currently enrolled in Medicare.
- The average Medicare Advantage monthly premium slightly decreased from $33.21 in 2020 to $32.84 in 2021.
- In 2021, there are 276 Medicare Advantage plans available.
- All New York residents with Medicare can purchase a Medicare Advantage plan, including those with $0 premiums.
- In 2021, there are 28 stand-alone Medicare Part D plans to choose from in New York.
- All New York residents with a stand-alone Part D plan can purchase a plan with a lower monthly premium than in 2020.
- There are currently 12 different Medigap plans offered in New York.
Medicare Offered in New York
Medicare is a government health care program that offers financial assistance to those 65 or older and people of any age with specific disabilities.
Original Medicare is a term used to describe the components of original Medicare direct from the federal government. Part A and Part B, respectively, provide coverage for hospital costs and general health care expenses such as doctor visits.
Medicare Advantage plans combine the benefits of Original Medicare (Part A and Part B) with supplemental coverage to provide individuals with more comprehensive healthcare coverage.
Medicare Advantage plans in New York come with additional benefits that exceed that of Original Medicare, including Part D prescription drug coverage, dental, vision or even gym memberships. For those who like the convenience of managing benefits under a single plan, this is a big plus. As of 2020, Medicare Advantage enrollment accounted for 44% of New York’s Medicare population.
In 2019, over 1.3 million New Yorkers had Part D coverage integrated with their Medicare Advantage plans.
New York Medicare Advantage options include plans from the following private insurance companies:
- Empire HealthChoice HMO
- HealthNow New York
Each insurer has its drug costs, deductibles, and forms. Before you enroll, check that your prescription is covered; prescription medication included varies from plan to plan.
Medicare Supplement Plans
Original Medicare (Part A and Part B) provides significant coverage, but it doesn’t cover everything; there is no limit on out-of-pocket costs, and prescription drug costs are not included.
To help cover a portion of the out-of-pocket costs, Medicare supplement plans (also known as Medigap plans) can be used. While Medigap plans help cover the cost of deductibles, copayments, and coinsurance, they do not provide prescription drug coverage. Instead, beneficiaries must enroll in a stand-alone Medicare Part D plan.
Medigap plan premiums are based on many factors, including age, gender, zip code, and insurer. New York has some of the most expensive Medicare supplement premiums, so comparing your options is important.
New York State law and regulation require that any insurer writing Medigap insurance must accept a Medicare enrollee’s application for coverage at any time throughout the year.
Some Medigap insurers in the state of New York include:
- AARP – UnitedHealthcare
- Empire BlueCross BlueShield
- Mutual of Omaha
- State Farm
New York Medicare Enrollment
New Yorkers are eligible for Medicare if they are a U.S. citizen and above 65 years old or are under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis. Use Medicare’s online eligibility tool if you are unsure if you qualify.
- You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
- You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
- You have ESRD or ALS.
Enrollment Period Dates
Initial Enrollment Period
This is a seven-month window that allows you to sign up for a plan
- Begins 3 months before the month you turn 65
- Ends 3 months after the month you turn 65
Medicare Open Enrollment Period
This is when you can sign up for a plan, switch a plan or leave a plan
- Begins Starts October 15th
- Ends December 7th
Special Enrollment Period
Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances.
General Enrollment Period
This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.
- Starts January 1st
- Ends March 31st
Medicare Advantage Open Enrollment Period
This is when you can switch or leave a Medicare Advantage Plan
- Starts January 1st
- Ends March 31st
New York Enrollment Tips & Advice
Looking for Medicare help in New York? These resources provide free assistance and information! New York residents can get advice, education, and more regarding their medical care coverage from these helpful sources:
- The New York State Health Insurance Information, Counseling, and Assistance Program
- The Social Security Administration
- Medicare Rights Center
How Do I Enroll in a Medicare Plan?
If you have any questions about New York Medicare and your eligibility for supplement or advantage plans, speak to one of our licensed agents today. Our agents will discuss your Medicare options and help find a plan that works for you.