Medicare Supplement Insurance Plans in New York
New York Medicare Supplement plans are offered by private insurance companies to provide Medicare beneficiaries with extra coverage that protects them from high out of pocket costs.
Copayments, coinsurance, and deductibles can quickly add up, costing beneficiaries a pretty penny.
However, with a Medigap plan, those costs will be covered.
An example of a situation you may find yourself in… lets’ say Linda was in New York City site seeing. As she was walking in the busy streets, she slipped and fell.
The ambulance came and brought her to the hospital. Her ambulance ride falls under Part B, which has a deductible is $185 in 2019.
Then the deductible for her in hospital stay is $1,364 for 2019.
So, right out the gate the out of pocket costs are just under $1,500. If Linda had a Medigap plan, most if not all of those costs would’ve been billed to the carrier.
Medicare Supplement Plans New York
A Medicare beneficiary already enrolled in Medicare Part B may enroll in a supplement plan at any time after age 65.
Normally, the best time to do so is during your six-month Medigap Open Enrollment Period (OEP).
This time period begins on the first day of the month that you are both age 65 or older and enrolled in Medicare Part B.
During this timeframe, you are eligible to enroll in any plan of your choosing, without an increase in monthly premium or exclusion of coverage.
However, New York has year round Open Enrollment. We’ll discuss this further below. Also, it’s important to sign up for Part B as soon as eligible to avoid the Part B late penalty.
Applying for 2019 Medigap Plans in New York
New York has year round Open Enrollment, meaning, the beneficiary can enroll at any time all year long with guaranteed issuance.
Seniors cannot be denied or charged any more for health status, claims experience, medical condition(s) or whether the applicant is currently undergoing healthcare treatment.
The only exception or Guaranteed Issue is a pre-existing limitation which may apply for up to six months.
NY Medicare Supplement Plans Premiums
Each individual carrier that offers a supplemental plan will determine its own monthly premium. Your location, age & sex are all determining factors. What you are quoted in Rochester, NY may very well differ compared to if you lived in Buffalo, NY.
You’ll want to compare all Medicare Supplement plans that are available to you and make a decision based on your finances and individual healthcare needs.
Comparing Medicare Supplement Plans in New York
There are many plans to choose from. All plan benefits are standardized, meaning they are the same no matter which carrier you choose to enroll with.
The reason it’s important to compare carries in your area is due to the premiums varying, not the benefits.
New York is one of the few states that prohibit doctors from charging excess charges. We’ll go into this more below.
Plan F is the most popular plan as it leaves beneficiaries with the least amount of out-of-pocket expenses. Plan G is the second most well-liked plan. The only difference is that it does NOT cover your Medicare Part B deductible like Plan F.
Plan N pays 100% of the Part B coinsurance, minus a copayment for some office visits and emergency room visits. This plan is considered one of the “cost-sharing” plans due to the above-required copays.
No Part B Excess Charges in New York
As stated above, New York is one of the few states that does not allow excess charges. For New Yorkers, you may want to go with Plan F or Plan N, rather than Plan G.
Regardless of which carrier you decide to go with, the letter plan benefits will all be the same. The only difference is the cost chosen by the carrier.
This is another example of the cost being dependent on where you live. The same letter plan in Saratoga Springs can cost more or less when compared to the same letter plan in New York City.
Medicare Advantage Plans
Medicare Advantage, sometimes called “Part C” or “MA Plans,” are offered by private insurance companies. They’ve been approved by Medicare and are usually an HMO or PPO plan. Whichever carrier you chose will then take over as your primary coverage.
You’ll be required to forfeit both Plan A and B. This means, you’ll still get your hospital and medical coverage. However, it will be in the form of your Medicare Advantage Plan.
The downside of having a Medicare Advantage plan are the limitations which include:
- Having to choose a hospital or healthcare provider within your network which can be challenging as it’s always changing.
- If you are hospitalized having a Medicare Advantage Plan, there are many out of pocket expenses during the first week(s) of hospitalization. As well as many other expenses you were unaware of, which can be difficult to afford once discharged.
- While the premiums may be lower, the out of pocket expenses will end up offsetting the original savings. In turn, it’ll end up costing you more.
Prescription Drug Plans for Medicare
Prescription drug plans, or Medicare Part D, is just that. It covers your medications. Part A and Part B does not cover any prescription costs. There’s also late enrollment penalty for going without a Part D plan.
Medicare Benefits Broken Down
Part A and Part B: Federal coverage that’s commonly known as “Original Medicare.”
Part C: Refers to plans offered by private health insurance companies approved by Medicare. These plans are required to cover the same as Part A and Part B of Original Medicare. They may also include additional benefits such as dental, vision and prescription drug coverage.
Part D: Are also Medicare-approved plans. Their sole purpose is to provide prescription drug coverage and work in conjunction with Medicare Part A and/or Part B.
Medigap Plans: Are slightly different in that they cover the remainder of what Original Medicare does not. Generally, this type of insurance helps cover premiums, deductibles, and copayments. It covers the 20% “gap” that Medicare leaves up the beneficiary to pay. It also has additional benefits such as foreign travel emergency care.
Eligibility in New York for the Disabled, Under 65
Those who get disability benefits from Social Security or certain disability benefits from the Railroad Retirement Benefits for 24 months, automatically qualify for Part A and Part B.
Many carriers, but not all, offer plans for the disabled under 65 in some states. The Federal Law in the U.S. actually does not require insurance carriers to offer this type of plan, however, some state laws do.
New York is one of those states to REQUIRE insurance providers to offer a Medigap Plan to those disabled under 65 and/or in end-stage renal disease.
If you’re on a fixed income, disabled or are a part of a low income working family, you may be eligible for financial assistance. There are a few options for those who qualify, including a Medicare Savings Program. You can find more information on this on the New York State Department of Health website.
Furthermore, every state offers Extra Help. Each state has their own individual programs. They’re provided for free and designed to help those in need of financial help.
- Where do I get information on Medicare in New York State? Contact us if you’re looking for a supplemental plan or general information on all your options.
- Does Medicare cover hospice? It does. However, you must meet the requirements, including a doctor’s certification of terminal illness.
- What does Part B cover? It covers medically necessary procedures, preventative and palliative care. This includes doctor’s visits, imaging, diagnostic testing, lab work, outpatient surgery, and procedures as well as durable medical equipment, or DME.
- How to Apply for Medicare in Syracuse, NY? If you’re trying to enroll in Original Medicare, please visit Medicare.gov. If you’re looking for information on Medigap options, please contact us at the number above!
Sign up for New York Medigap Insurance Online
New York Medicare Supplement policies can help beneficiaries pay for out-of-pocket medical expenses. All Medigap plans have a difference in costs based on where you reside and which carrier you chose.
Be smart and compare all Medicare Supplements available in your area. This will help you choose a plan to fit your individual budget and healthcare needs.
At MedicareFAQ, we would be more than happy to help guide you to find the best supplemental plan suitable for all your individual needs. Give us a call, or compare rates online here.