Medicare in New York

Victoria Burke by Victoria Burke | Licensed since 2011
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This article was updated on: 09/16/2018

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When shopping for Medicare coverage in the state of New York, it is a good idea for you to consider every available option. Because of this, Medicare.com provides a complimentary plan comparison tool so that you can review Medicare plan selections, details, and pricing in your immediate area.

About Medicare in New York

Medicare beneficiaries in New York enjoy a variety of Medicare offerings, from the federal option of Original Medicare, Part A and Part B, to plans offered by Medicare-approved insurance companies such as Medicare Advantage, Medicare Part D (prescription coverage), and Medicare Supplement insurance plans.

Not every plan offered by health insurance companies in New York will be available in each county.

Types of Medicare coverage in New York

Original Medicare, Part A and Part B, refers to federal Medicare coverage. Medicare Part A (hospital insurance) and Part B (medical insurance) are available in any state in the U.S.

Medicare Advantage, Part C, refers to plans offered by private health insurance companies with Medicare’s approval. These plans must cover at least what Original Medicare, Part A and Part B does, but can also include additional benefits, like vision, dental, and prescription drug coverage. You continue paying your monthly Medicare Part B premium when you’re enrolled in a Medicare Advantage plan along with any premium charged by the Medicare Advantage plan chosen.

Medicare Supplement insurance plans cover “gaps” left by Original Medicare, like premiums, deductibles, and copayments. Medicare Supplement, also called Medigap, features up to 10 plans, each with a letter designation (A, B, C, D, F, G, K, L, M, N). Plan benefits within each letter category do not change, no matter where the plan is purchased; for example, if you have Medigap Plan K in Georgia, it provides the same coverage as Plan K in Montana.

Medicare Part D Prescription Drug Plans are also offered by Medicare-approved insurance providers. These optional stand-alone plans provide prescription drug coverage and work alongside Medicare Part A and/or Part B insurance. Alternatively, you may enroll in a Medicare Advantage Prescription Drug plan to receive your Medicare Part A and Part B benefits, along with prescription drug coverage; these plans may also offer other benefits (such as wellness programs).

Local resources for Medicare in New York

Medicare Savings Programs in New York: Programs in New York can assist beneficiaries in paying for things like their monthly premiums. Usually in order to qualify, your income and assets must be lower than a government-set limit.

New York State Health Insurance Counseling and Assistance Program (SHIP): In New York, SHIP is called the Health Insurance Information, Counseling and Assistance Program (HIICAP). HIICAP educates New York residents about Medicare and other health insurance issues.

How to apply for Medicare in New York

To apply for Medicare in New York, you must be a United States citizen or legal permanent resident of at least five continuous years. You’re generally eligible when you are 65 or older, but you may qualify under 65 through disability or having certain conditions. You’ll be enrolled automatically as soon as you’re eligible if:

  • You or your spouse is receiving Social Security benefits or Railroad Retirement Board benefits.
  • You have Lou Gehrig’s disease (also known as ALS).

A “Welcome to Medicare” packet should be mailed out approximately three months before you turn 65. If you are under 65 and collect disability benefits from the Social Security Administration (SSA), or certain disability benefits from the Railroad Retirement Board (RRB), then you become eligible for Medicare once you enter into the 25th consecutive month of collecting those benefits. If you have ALS, your Medicare coverage starts the first month you collect SSA or RRB benefits.

If you have End-Stage Renal Disease (ESRD), you need to enroll manually; see the contact information below.

Applying for Medicare manually may be done via your local Social Security office, online, or over the phone.

  • Visit the Social Security website.
  • Call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
  • If you worked for a railroad, call the RRB at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, 9AM to 3:30PM.

If you’re in the market for Medicare insurance plan options and would like to talk over some of your options, I would be more than happy to help. There are a few ways to go about this:

  • Learn more about my background through my profile below.
  • Use the other links below to schedule a phone call or have me email you some personalized information.
  • Scroll up and click the Compare Plans button on this page.

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