Medicare Plan Options in New York

Medicare supplement plans in New York were designed to pay for the things that Medicare doesn’t, such as your deductibles and coinsurance. Most major insurance companies offer supplement plans and the plans are standardized which makes it easy to compare them.

When Medicare was created in the 1960’s, it was designed to provide basic coverage for people aged 65 and older. It was not designed to be free or to cover 100% of all your medical expenses. Instead, Medicare covers roughly 80% of your healthcare services. Just like other insurance you’ve had in the past, though, there will be some cost-sharing out of your own pocket to cover the rest. This is where a New York Medigap plan could come in handy.

New York Medicare 101

Traditional Medicare is made up of Part A hospital benefits and Part B outpatient benefits. Part A will cover inpatient hospital stay as well as skilled nursing and hospice care.  Part B will cover your outpatient services like doctor visits, lab testing, medical supplies and equipment and even diagnostic imaging.

With these plans you have access to Medicare par providers across the nation with no referrals needed.

Medicare Part B will also pay for drugs delivered to you in a clinical setting. However, it will not cover retail outpatient drugs. Instead, you can buy a Part D drug plan which functions as a pharmacy card. When you present your card of the pharmacist, he will bill your plan for the medication and you will pay just a copay.

Medicare Plan Options in New York State

Of all the Medicare Supplement plan options in New York, there are a few which are best sellers. Medigap Plan F pays for all of the gaps in your Medicare coverage, leaving you with virtually nothing to pay at the hospital or at the doctor’s office. Medigap Plan G offers almost as much coverage, but you must pay for your own Medicare Part B deductible, which is $185 in 2019. Fortunately, Medigap Plan G usually offers lower monthly premiums than Medigap Plan F in most areas, so it could be a better value for some people.

Plan N was created in 2010, making it the newest plan option on the market. On Plan N, you will have to pay the Part B deductible and copays of up to $20 at the doctor’s office. You will also pay copays for ER visits and if your doctor doesn’t accept Medicare assignment rates, you will pay for your own Medicare Part B excess charges as well.  

While Medicare supplement plans in New York offer the most comprehensive coverage, about one-third of current Medicare recipients decide to enroll instead in a Part C Medicare Advantage plan. These newer plans are private Medicare policies offered by private insurance company. When you enroll in a New York Medicare Advantage plan, you are opting to get your Medicare Part A and B benefits delivered to you through the plan’s network instead of through Traditional Medicare.

Medicare Advantage plans in New York could have either an HMO or PPO network. 

With HMO plans, you must treat only with doctors in the network except in cases of emergency. These plans will often require you to choose a primary care doctor whom you would see first to get a referral slip before you can consult a specialist. If that feels too restrictive, you could consider a Medicare Advantage PPO plan where you can visit providers outside the network at a higher cost.

Most Medicare Advantage policies also have Medicare Part D built into the plan. This means you’ll use the same ID card at the doctor and the pharmacy and you pay nothing extra for Part D.  Before you enroll in a Medicare Advantage plan in New York, you will want to consult the plan’s online directory of providers to make sure that your favorite doctors and hospitals are in the network.  

When deciding which cover is best for you, think about what will provide you the most peace of mind. If you are uncertain, visit a licensed insurance agent for guidance.