Find 2021 Medicare Plans in New York - NY Medicare Insurance Overview

Medicare Insurance in New York

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New York Medicare Insurance

New York Medical Insurance Stats

Medicare in New York

Medicare offers healthcare coverage to New York residents age 65 or older, or to those New York residents that suffer from certain medical disabilities. In 2018, 3,600,000 people are enrolled in Medicare in New York, accounting for 15% of the population in New York. In 2016 approximately $9,760 was spent per Medicare enrollee in New York, about 2.33% higher than the national average of $9,533. From 2015 to 2030 the number of seniors in New York is projected to rise by an estimated 33.07% according to calculations based off of the 2000 Census. Therefore the number of eligible Medicare beneficiaries in New York is also predicted to increase in the foreseeable future.

Local Medicare Resources

In New York Medicare beneficiaries and their caregivers can receive personal, unbiased health insurance counseling from New York’s Health Insurance Information Counseling and Assistance Program (HIICAP). HIICAP is New York’s State Health Insurance Assistance Program (SHIP). Additionally, New York’s Senior Medicare Patrol (SMP) is a program designed to help educate and empower individuals on how to identify, avoid, and report Medicare fraud, waste, and/or abuse. New York was one of the first five states to participate in SMP.

Types of Medicare Coverage

Individuals that qualify for Medicare can sign up for Medicare Part A (hospital services) and Part B (medical services) through the Federal government. Part A is generally paid for by paycheck deductions from their working years (or their spouse's) but most Medicare beneficiaries pay for Part B through monthly premiums unless they qualify for financial assistance. If you are eligible for Original Medicare (Parts A & B) or if you are already enrolled in it, you also have the option to enroll in a Medicare Advantage plan (Part C) instead of Original Medicare or add a standalone prescription drug plan (Part D) to your current Original Medicare coverage. Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. Medicare Advantage and Medicare Part D insurance plans are sold by private insurance companies that have a contract with Medicare. Many Medicare beneficiaries will elect to enroll in a Medicare Advantage plan that includes prescription drug coverage or purchase a standalone prescription drug plan to go with their Original Medicare coverage. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Additional benefits of Medicare Advantage plans such as dental, vision, or hearing coverage can help reduce out-of-pocket expenses for seniors with certain medical needs.

New York 2019 Medicare Advantage Plans at a glance

Using CMS data HealthPocket found that:

  • The average total monthly premium for a 2019 Medicare Advantage plan in New York is $42, 33.33% more than the national average of $28. 35.88% of 2019 Medicare Part C insurance plans in New York have a $0 monthly premium.
  • The maximum possible annual drug deductible in any 2019 Medicare Advantage plan with a drug component is $415, but in New York the average annual drug deductible for Medicare Part C insurance plans with drug components is $210.14. 29.79% of 2019 Medicare Part C insurance plans with a drug component in New York have a $0 annual drug deductible.
  • 48.51% of 2019 Medicare Part C insurance plans with a drug component in New York have a $0 monthly premium.
  • The average medical out-of-pocket limit for 2019 Medicare Part C insurance plans in New York is $6,381. 26.09% of 2019 Medicare Advantage plans in New York had a medical out-of-pocket limit of $3,400 or less.

To assist seniors in choosing Medicare plans, CMS assigns star ratings to Medicare Part C and Part D plans each year based on preventive care, chronic condition management, customer service, member satisfaction, and drug pricing. Ratings range from 1 star (a poor plan) to 5 stars (an excellent plan).

  • The average overall CMS star rating assigned to Medicare Part C insurance plans in New York was 3.5 stars in 2019.
  • Among New York's 2019 Medicare Advantage plans with CMS star ratings:
    • 47.83% earned a score of 4 or 4.5 stars
    • 43.48% earned a score of 3 or 3.5 stars
    • 8.70% of plans are “Not enough data available” or “Too new to be measured”.

Sources:

Data on Medicare eligibility, enrollment, and spending by state from Kaiser Family Foundation

There are 35 Medicare insurance providers that offer affordable and comprehensive Medicare insurance in New York. Of these, the companies that offer the largest variety of plans to choose from are Excellus, Universal American, and Humana. In New York,Humana has the largest selection of Medicare Advantage plans while Humana offers the most Medicare Part D plans. The following are all medicare insurance providers in New York:

CDPHP Flex (PPO)
TYPE:PPOCOST:from $0CMS Rating:
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CDPHP Vital Rx (PPO)
TYPE:PPOCOST:from $0CMS Rating:
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BlueShield Freedom Nation (PPO)
TYPE:PPOCOST:from $0CMS Rating:
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UnitedHealthcare Medicare Advantage Choice (PPO)
TYPE:PPOCOST:from $24CMS Rating:
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BlueCross BlueShield Freedom Nation (PPO)
TYPE:PPOCOST:from $25CMS Rating:
Select
CDPHP Flex Rx (PPO)
TYPE:PPOCOST:from $41CMS Rating:
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BlueCross BlueShield Forever Blue Value (PPO)
TYPE:PPOCOST:from $145CMS Rating:
Select
BlueShield Forever Blue 770 (PPO)
TYPE:PPOCOST:from $200CMS Rating:
Select
BlueCross BlueShield Forever Blue 751 (PPO)
TYPE:PPOCOST:from $204CMS Rating:
Select
Medicare BlueEssential (PPO)
TYPE:PPOCOST:from $0CMS Rating:
Select
Empire MediBlue Access (PPO)
TYPE:PPOCOST:from $90CMS Rating:Not Rated
Select
Humana Gold Plus H3533-010 (HMO)
TYPE:HMOCOST:from $36CMS Rating:
Select
Humana Gold Plus H3533-013 (HMO)
TYPE:HMOCOST:from $25CMS Rating:
Select
Humana Gold Plus H3533-032 (HMO)
TYPE:HMOCOST:from $21CMS Rating:
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Humana Gold Plus H3533-033 (HMO)
TYPE:HMOCOST:from $0CMS Rating:
Select

The following are the most popular medicare doctors in New York based on the provider utilization and payment data published by the U.S. Department of Health & Human Services.

NameSpecialtyLocation
Diagnostic RadiologyOCEANSIDE, NY
Vascular & Interventional RadiologyBROOKLYN, NY
Interventional CardiologyBROOKLYN, NY
Clinical Pathology/Laboratory MedicineNEW HYDE PARK, NY
Nuclear CardiologyNEW YORK, NY
Diagnostic RadiologyBROOKLYN, NY
Cardiovascular DiseaseBROOKLYN, NY
Internal MedicineSTATEN ISLAND, NY
Vascular & Interventional RadiologyLAKE SUCCESS, NY
OphthalmologyBROOKLYN, NY

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