Are you a New Yorker approaching your 65th birthday? With a milestone birthday in your sights, 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!
Like most things in life, it’s best to complete the process sooner than later. By delaying, you can incur surcharges. Plus, you’ve been paying into your Medicare fund your entire working life – it’s time for you to reap the rewards. Why would you want to delay?
Indeed, changing healthcare coverage can be daunting, but Medicare isn’t as complex as it might seem.
Read on as our experts explain Medicare Supplement Insurance and Medicare Advantage plans in New York.
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 do 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.
There is a six-month open enrollment period in most states where beneficiaries can enroll in a Medigap plan without answering health questions. However, New York has a unique rule that allows beneficiaries to apply for a Medigap plan without health questions all-year-round!
This is a great advantage in terms of accessibility, but because insurers cannot ask health questions, premiums are usually more expensive than other states.
New York offers all ten standardized Medigap plans:
However, Plan C and Plan F are only available to beneficiaries eligible for Medicare prior to 2020.
New York is one of the more expensive states for living, and the premiums for Medigap plans (and other Medicare coverage) often reflect that. This makes it all the more important for you to compare your options. Thankfully, there are 15 different insurers for you to compare on the market.
Start comparing Medigap plans available in your area today.
Medicare beneficiaries can either receive coverage from the federal government via Original Medicare or enroll in a private Medicare Advantage plan.
Medicare Advantage combines the benefits of Original Medicare and supplemental plans into a single plan. The plans have at least the same coverage as Original Medicare, plus Part D and other healthcare services, such as dental and vision.
In New York, beneficiaries can enroll in a Medicare Advantage plan during their initial enrollment period or the annual election period (runs annually between October 15 and December 7). During the Medicare Advantage open enrollment period (January 1 – March 31), enrollees can change or drop their coverage.
Medicare Advantage plans in New York come with additional benefits that exceed that of Original Medicare, including Part D prescription drug coverage! For those who like the convenience of managing benefits under a single plan, this is a big plus.
In 2019, over 1.3 million New Yorkers had Part D coverage integrated with their Medicare Advantage plans.
Each insurer has its own drug costs, deductibles, and forms. Before you enroll, check that your prescription is covered; prescription medication included varies from plan to plan.
Tip: Medicare Advantage holders should get prescription drug coverage through a Medicare Advantage plan instead of a stand-alone Medicare Prescription Drug Plan (Part D). If you join a Part D plan while enrolled in a Medicare Advantage plan, you’ll be disenrolled and returned to Original Medicare.
To be eligible for Medicare Advantage, you must be enrolled in Original Medicare (Part A and Part B), live in the carrier’s service area, and not have end-stage renal disease (ESRD).
Medicare Advantage plans are particularly popular in New York, with around 38% of Medicare beneficiaries enrolled in a Medicare Advantage plan, well above the national average.
New York benefits from having 13 different health insurers and 44 Medicare Advantage plans (depending on your zip code) to choose from. Costs like premiums, copayments, coinsurance, and deductibles can vary dramatically from plan to plan, so it’s important to compare every plan in your area.
Start comparing the Medicare Advantage plans in your zip code today.
During the federal Open Enrollment period, current or newly eligible Medicare beneficiaries, including people with Original Medicare, can review current health and prescription drug coverage, compare health and drug plan options available in their area, and choose coverage that best meets their needs. This is the time when Medicare eligible individuals can enroll in Medicare Advantage and Medicare Part D prescription drug plans.
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.
Medigap plan premiums are based on many factors, including age, gender, zip code, and insurer. This makes it difficult to provide an accurate estimate of the cost, but it’s worth noting that New York has some of the most expensive Medicare supplement premiums. Precisely the reason why comparing your options is so important.
To get an accurate estimate of the rates in your area, compare today.
In most other states, you only have one opportunity to apply for a Medigap plan without being declined or charged higher premiums for pre-existing health conditions; however, in New York, you can enroll at any time of the year!
If you have any questions about your New York Medicare options, speak to one of our licensed agents. Our dedicated team will help find a Medicare plan that works for you. Call us today at 1-844-236-0228.