Key Takeaways:
- New York offers a range of Medicare plans, including Original Medicare, Medicare Advantage, Part D, and Medigap, each with varying costs and benefits.
- Medicare costs in New York depend on the plan type, coverage choices, and provider network. Comparing plans will help you find the most cost-effective option.
- To choose the best Medicare plan for you, carefully consider your health needs, budget, and preferred doctors and hospitals. State and local resources can help you make informed decisions.
Navigating Medicare plans can be challenging, especially in a state like New York. With multiple plan types available and numerous insurance providers offering coverage, it’s crucial to compare your options carefully to find the right fit for your healthcare needs and budget.
In this guide, we’ll break down the different types of Medicare plans in New York, explore their costs and benefits, and provide you with the resources you need to make an informed decision about your healthcare coverage.
Types of Medicare Plans Available in New York
Medicare plans in New York offer different benefits, costs, and provider networks, so it’s important to understand the nuances of each type.
Original Medicare (Part A and Part B)
Original Medicare provides foundational coverage for eligible New York residents through two main components. Here’s what you need to know about coverage and costs:
Medicare Part A (Hospital Insurance) Coverage and Costs:
- Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home healthcare.
- If you paid Medicare taxes while working (generally at least 10 years), you qualify for premium-free Part A, paying $0. If you haven’t qualified for premium-free coverage, it may cost $285 or $518 per month in 2025, depending on your work history.
- $1,676 in 2025 deductible per benefit period, with no limit to the number of benefit periods.
- Copayments vary based on the length of inpatient stay.
Medicare Part B (Medical Insurance) Coverage and Costs:
- Covers outpatient care, doctor’s visits, preventive care services, and medical equipment.
- $185 monthly premium in 2025 (or higher, depending on your income).
- $257 (in 2025) deductible once each year.
- Usually, you’ll pay 20% of the cost for each Medicare-covered service or item (post-deductible).
Data sourced from Medicare Basics
Medicare Advantage (Part C)
Medicare Advantage plans, also known as Part C, are popular in New York. They offer residents all the benefits of Original Medicare (Part A and Part B) and additional coverage.
Private insurance companies approved by Medicare offer Part C plans, and the additional benefits often include dental, vision, hearing, and prescription drug coverage.
In New York, in 2025:
- In 2025, 280 Medicare Advantage plans are available, compared to 241 plans in 2024.
- The average monthly Medicare Advantage plan premium changed from $30.35 in 2024 to $42.90 in 2025.
- $0 is the lowest monthly premium for a Medicare Advantage plan.
- 100% of people with Medicare will have access to a Medicare Advantage plan with a $0 monthly premium.
Top Medicare Advantage Plans in New York:
Insurance Carrier | CMS Star Rating | Network Availability | Monthly Premium | Deductible | In-Network Out-of-pocket Max |
---|---|---|---|---|---|
United Healthcare (AARP Medicare Advantage Plan) | 3.82★ | 49 states and DC | $0 | $0 | $8,900 |
Humana (HumanaChoice Plan) | 3.63★ | 48 states, DC, and PR | $0 | $270 | $9,350 |
Aetna (Medicare Premier Plan) | 4.27★ | 44 states and DC | $81 | $0 | $6,750 |
Cigna (True Choice Courage Medicare) | 3.93★ | 29 states and DC | $0 | $500 | $6,800 |
Data gathered via CMS.gov and direct provider plans. Comparison of plans from New York Zip Code 10016. Star ratings and plan information reflect publicly available data as of 2025.
Private insurers offering Medicare Advantage plans in New York include:
- Aetna
- Cigna
- Highmark
- Excellus BlueCross BlueShield
- Humana
- UnitedHealthcare
Get personalized Medicare guidance in New York.
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Medicare Prescription Drug Plans (Part D)
If you have Original Medicare, you can add prescription drug coverage by enrolling in a stand-alone Medicare Part D plan. A Medicare Advantage plan could also include this.
When choosing a Medicare Part D plan in New York, it’s important to consider its formulary and the list of medications it covers. Consider the medication cost in each formulary’s tiers and compare it to the plan’s monthly premium, deductibles, and copayments to find a reasonable balance.
In 2025, New York residents can choose from 12 stand-alone Medicare prescription drug plans (PDPs). Anyone enrolled in Medicare will have access to at least one plan.
- Approximately 61% of people with a stand-alone Medicare prescription drug plan will have the chance to switch to a plan with a lower monthly premium than their 2024 costs.
- The lowest monthly premium for a stand-alone Medicare prescription drug plan is $38.70.
- Almost 38% (37.92%) of those with a stand-alone Medicare prescription drug plan avail Extra Help, a program offering additional financial support.
Plan Name | Monthly Premium | Deductible | CMS Star Rating |
---|---|---|---|
WellCare Value Script | $38.70 | $590 | 3★ |
Cigna Healthcare Assurance Rx | $48.90 | $590 | 2★ |
AARP MedicareRxPreferred from UHC | $113.70 | $0 | 2★ |
Note: Data from MedicareWire
Medigap (Medicare Supplement) Plans
Medigap plans, also known as Medicare Supplement Insurance, help pay for some of the out-of-pocket costs that Original Medicare doesn’t cover, such as copayments, coinsurance, and deductibles.
Plan G and Plan N are popular Medigap plans in New York. While Plan G covers most out-of-pocket costs except for Medicare Part B deductibles, Plan N is more affordable but excludes Medicare Part B excess charges and smaller copayments.
In New York, typical premiums for Medicare Plan G are $150-200 per month, and for Plan N are $120 – $170 per month. However, these vary depending on age, gender, location, tobacco usage, etc.
Top Medigap providers in New York, for both Plan G and Plan N, include:
- AARP
- Globe Life
- Humana
- Bankers Life and Casualty Company
Average Costs of Medicare Plans in New York
Understanding the various costs associated with Medicare plans in New York helps you budget effectively for your healthcare needs.
Here’s a comprehensive summary of each plan type in New York:
Plan Type | Average Monthly Premium | Average Deductible | Coverage Details |
---|---|---|---|
Original Medicare Part A | $0 (if you do not qualify: $285 or $518) | $1,676 | Inpatient care, such as hospital stays, skilled nursing facility care, and hospice care |
Original Medicare Part B | $185 | $257 | Outpatient care, preventive services, and medical equipment |
Medicare Advantage | $42.90 | Varies per plan ($0 – $590) | All Original Medicare + extra benefits like vision, hearing, and dental care |
Part D | $97.13 | $456 | Prescription drugs |
Medigap Plan G and N | $120 – $200 | N/A | Fills gaps in Original Medicare out-of-pocket costs |
Note: All data reflect 2025 averages sourced from Medicare.gov, CMS.gov, and MedicareWire and may vary by provider.
Top Medicare Advantage and Medigap Providers in New York
New York residents can access numerous high-quality Medicare Advantage and Medigap insurance providers. Let’s take a deeper look at the top providers in each category.
Best Medicare Advantage Providers
Medicare Advantage plans in New York combine Original Medicare benefits with additional coverage options, making them an attractive choice for many beneficiaries. When choosing a plan, it’s essential to consider the insurance provider’s coverage and reputation to get the best benefits for your budget.
Carrier | Highest Rating | Lowest Rating | Median Rating | Total Number of MA Contracts |
---|---|---|---|---|
Aetna | 4.5 | 2.5 | 4.0 | 45 |
Centene | 4.0 | 2.0 | 3.0 | 106 |
Cigna | 4.5 | 3.0 | 3.5 | 17 |
Elevance (Anthem BCBS) | 5.0 | 2.5 | 3.5 | 46 |
Humana | 5.0 | 3.0 | 4.0 | 48 |
United Healthcare | 5.0 | 3.0 | 4.0 | 75 |
Note: Medicare Advantage CMS Star Ratings: 6 Major Carriers (Updated 11/15/24).
Best Medigap Providers
New York residents have access to several highly rated Medigap insurance providers. To find the best option for your needs, evaluate each provider based on its network, customer satisfaction, and affordability.
Here’s how the top providers compare for both Plan G and Plan N coverage:
Plan G Providers
Carrier | Average Monthly Premium | Fee | A.M. Best Rating |
---|---|---|---|
AARP | $210.75 | None | A |
Globe Life | $271.00 | None | A+ |
Humana | $244.86 | None | A- |
Mutual of Omaha | $337.93 | None | A+ |
Bankers Life and Casualty Company | $432.41 | None | B |
Plan N Providers
Carrier | Average Monthly Premium | Fee | A.M. Best Rating |
---|---|---|---|
AARP | $148.50 | None | A |
Globe Life | $202.00 | None | A+ |
Humana | $173.35 | None | A- |
Bankers Life and Casualty Company | $245.03 | None | B |
CDPHP | $185.94 | $25.00 | N/A |
Note: Plan G and Plan N data from MedicareWire
How to Choose the Right Medicare Plan in New York
Selecting the appropriate Medicare coverage requires careful consideration of several factors. You should evaluate your current and future healthcare needs and match them with available Medicare plans and your budget.
Here are some practical steps to help you evaluate and compare different Medicare plans in New York:
1. Assess your healthcare needs.
- Consider your current health status and any chronic conditions.
- Estimate your anticipated healthcare needs for the coming year, including doctor’s visits, hospitalizations, and prescription medications.
2. Evaluate what prescription drugs you need.
- Make a list of all the prescription drugs you currently take.
- Use the Medicare Plan Finder tool to compare Part D plans and see which ones cover your medications at the lowest cost.
3. Compare costs.
- Pay close attention to monthly premiums, deductibles, copayments, and coinsurance for each plan.
- Consider your budget and how much you can afford to spend on healthcare each month.
4. Review provider networks.
- Ensure your preferred doctors and hospitals are included in the plan’s network.
- If you travel frequently, check if the plan offers coverage outside New York.
5. Consider additional benefits.
- Some Medicare Advantage plans offer extra benefits like dental, vision, and hearing coverage.
- Decide how important these benefits are for you and factor them into your decision.
How to Enroll in a Medicare Plan in New York
Knowing the Medicare enrollment process in advance helps secure your desired plan with minimum worry. Here are the key enrollment processes, periods, and deadlines for getting your Medicare coverage.
1. Initial Enrollment Period (IEP)
This is your first chance to enroll in Medicare Parts A and B. It’s a 7-month window: 3 months before your 65th birthday, birth month, and 3 months after. This IEP applies to all Medicare plans, barring Medigap, starting when you’re 65 and enrolled in Part B.
2. Annual Open Enrollment Period
This runs from October 15th to December 7th each year. During this period, you can make changes to all your Medicare plans:
- Switch between Original Medicare and Medicare Advantage.
- Change from one Medicare Advantage plan to another.
- Enroll in, switch, or drop a Part D plan.
An additional period, known as the Medicare Advantage Open Enrollment Period, runs from January 1 to March 31 each year. During this, those enrolled in Medicare Advantage can switch between plans or revert to Original Medicare.
3. Special Enrollment Periods (SEPs):
Certain life events, such as moving or losing employer coverage, can activate these periods. During these, you can make changes to your Medicare coverage despite not being in the standard enrollment periods.
Steps to Enroll:
- Review and Compare Plans: Starting October 1st, 2024, you can begin comparing plans on Medicare.gov using the Medicare Plan Finder tool. Pay attention to costs, coverage, and provider networks.
- Enroll Online or by Phone: You can enroll in a Medicare plan online through the Medicare.gov website. Alternatively, Call 1-800-MEDICARE (1-800-633-4227) to enroll by phone. Help is available 24 hours a day, seven days a week, in English, Spanish, and over 200 languages.
- Enroll with an Insurance Agent: You can also enroll in a Medicare plan through a licensed insurance agent, such as CoverRight.
Medicare Resources for New York Residents
Navigating Medicare plans in New York can be complex, but resources are available to help you understand your options and make informed decisions.
- New York State Office for the Aging: This office provides advocacy, community programs, and resources for older adults in New York. It provides information on various topics related to aging, including healthcare and long-term care.
- New York State’s HIICAP (Health Insurance Information, Counseling, and Assistance Program): HIICAP offers free, unbiased counseling and assistance with Medicare and other health insurance options. Their trained counselors can help you understand your coverage, compare plans, and resolve problems.
- New York State Department of Health: The Department of Health provides information on various health-related topics, including Medicare and Medicaid.
- Medicare Rights Center: This is a national nonprofit organization based in New York City that works to ensure access to affordable health care for older adults and people with disabilities. You can call their national helpline number, Monday through Friday, at 800-333-4114.
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Sources
- Centers for Medicare & Medicaid Services (CMS)
- Medicare Open Enrollment Partner Resources. Published 2024. Available at: cms.gov. Last Accessed November 13, 2024.
- Centers for Medicare & Medicaid Services (CMS)
- 2024 Medicare Advantage and Part D Ratings Fact Sheet. Published October 13, 2023. Available at: cms.gov. Last Accessed November 13, 2024.
- Medicare.gov
- Medigap Coverage Information: When to Buy. Available at: medicare.gov. Last Accessed November 13, 2024.
- Medicare.gov
- Medigap Overview. Available at: medicare.gov. Last Accessed November 13, 2024