Medicare Supplement Plans in New York
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 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 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.
New York 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 Medigap 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 Part B deductible like Plan F.
However, all first-dollar coverage plans are going away in 2020, including Plan F, high-deductible Plan F, and Plan C. Good news is, there’s a new high-deductible Plan G being introduced in 2020 to replace HDF.
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.
Bluecross Blueshield NY
A popular carrier in New York is Empire Blue Cross Blue Shield. This company is a subsidiary of WellPoint. They’re unique due to them owning their network locally and are able to customize their healthcare plans.
No Part B Excess Charges in New York
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 in New York
Medicare Advantage 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.
Part D in New York
Prescription drug plans, or Part D, is just that. It covers your medications. Part A and Part B do not cover any prescription costs. There’s also late enrollment penalty for going without a Part D plan.
New York Medicare Parts A, B, C & D
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.
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 to 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.
New York State FAQs:
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.
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. Call us at the number above or fill out an online rate form today!