Find 2018 Medicare Plans in New York - NY Medicare Insurance Overview

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New York Medicare Insurance

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 2017, 3,343,349 people are enrolled in Medicare in New York, accounting for 15% of the population in New York. In 2009 approximately $11,604 was spent per Medicare enrollee in New York, about 11.95% higher than the national average of $10,365. 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 2017 Medicare Advantage Plans at a glance

Using CMS data HealthPocket found that:

  • The average total monthly premium for a 2017 Medicare Advantage plan in New York is $52.55, 15.89% less than the national average of $62.48. 34.34% of 2017 Medicare Part C insurance plans in New York have a $0 monthly premium.
  • The maximum possible annual drug deductible in any 2017 Medicare Advantage plan with a drug component is $400, but in New York the average annual drug deductible for Medicare Part C insurance plans with drug components is $123.89. 55.95% of 2017 Medicare Part C insurance plans with a drug component in New York have a $0 annual drug deductible.
  • The average total monthly premium for a 2017 Medicare Advantage plan without a drug component in New York is $25.91. 62.33% of 2017 Medicare Part C insurance plans without a drug component in New York have a $0 monthly premium.
  • The average medical out-of-pocket limit for 2017 Medicare Part C insurance plans in New York is $6148.93. 3.65% of 2017 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 3.9 stars in 2017.
  • Among New York's 2017 Medicare Advantage plans with CMS star ratings:
    • 57.06% earned a score of 4 or 4.5 stars
    • 34.9% earned a score of 3 or 3.5 stars
    • 3.35% earned a score of 2 or 2.5 stars
    • 4.69% 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

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New York Medicare Insurance Companies

There are 40 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 Universal American, Humana, and Excellus. In New York,. The following are all medicare insurance providers in New York:

Humana

18 Plans

Excellus

17 Plans

MVP

8 Plans

Aetna

8 Plans

BlueCross BlueShield of WNY and BlueShield of NEN

7 Plans

Empire

5 Plans

CDPHP

5 Plans

BlueCross BlueShield of WNY and BlueShield of NEN

5 Plans

Quality Health Plans

3 Plans

WellCare

2 Plans

MetroPlus

2 Plans

HORIZON INSURANCE COMPANY

2 Plans

HM HEALTH INSURANCE COMPANY

2 Plans

Elderplan

2 Plans

Cigna

2 Plans

MERIT HEALTH INSURANCE COMPANY

1 Plans

GuildNet

1 Plans

2018 Best Medicare Plans in New York

There are 165 medicare plans in New York. The following are the 10 highest rated medicare plans in New York based on their CMS rating for the plan's overall quality.

Monthly CostPlan NameCMS Rating
from $38Anthem BCBS - Blue MedicareRx Value Plus (PDP)
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from $122Anthem BCBS - Blue MedicareRx Premier (PDP)
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from $0Humana - HumanaChoice H5970-016 (PPO) - Albany County
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from $0Independent Health - Independent Health Encompass 65 (HMO) - Allegany County
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from $0MVP - BasiCare with Part D (PPO) - Albany County
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from $0Excellus - Medicare Blue Choice Select (HMO-POS) - Livingston County
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from $0Excellus - Univera SeniorChoice Basic (HMO) - Allegany County
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from $0CDPHP - CDPHP $0 Medicare Rx (HMO) - Albany County
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from $0Humana - HumanaChoice H5970-015 (PPO) - Albany County
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from $0Humana - HumanaChoice H5970-017 (PPO) - Allegany County
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See all Medicare plans in New York

Best New York Medicare Plans for Managing High Blood Pressure

The following are the 5 highest rated medicare plans in New York based on their CMS rating for the plan's ability for controlling high blood pressure.

Monthly CostPlan NameCMS Rating
from $38Fidelis Care - Fidelis Medicare Advantage Flex (HMO-POS) - Albany County
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from $0Fidelis Care - Fidelis Medicare $0 Premium (HMO) - Albany County
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from $0Fidelis Care - Fidelis Medicare Advantage without Rx (HMO-POS) - Albany County
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from $297EmblemHealth - EmblemHealth VIP Gold Plus (HMO) - Bronx County
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from $254MetroPlus - MetroPlus Platinum (HMO) - Bronx County
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Best New York Medicare Plans for Managing Diabetes

The following are the 5 highest rated medicare plans in New York based on their CMS rating for the plan's ability for diabetes care including: eye exam, kidney disease monitoring, blood sugar controlled and cholesterol controlled.

Monthly CostPlan NameCMS Rating
from $297EmblemHealth - EmblemHealth VIP Gold Plus (HMO) - Bronx County
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from $254MetroPlus - MetroPlus Platinum (HMO) - Bronx County
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from $78EmblemHealth - EmblemHealth VIP Gold (HMO) - Bronx County
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from $37Healthfirst - Healthfirst Mount Sinai Select (HMO) - New York County
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from $29Healthfirst - Healthfirst Increased Benefits Plan (HMO) - Bronx County
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Best New York Medicare Plans for Managing Rheumatoid Arthritis

The following are the 5 highest rated medicare plans in New York based on their CMS rating for the plan's ability for rheumatoid arthritis management.

Monthly CostPlan NameCMS Rating
from $78Quality Health Plans - Advantage Premium - LI (HMO) - Nassau County
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from $0Quality Health Plans - Advantage Silver - NY City (HMO) - Queens County
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from $0Quality Health Plans - Advantage Silver - NY (HMO) - Nassau County
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from $106Universal American - Today's Options Advantage Plus 450A (PPO) - Dutchess County
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from $105Universal American - Today's Options Advantage Plus 150A (PPO) - Albany County
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Best New York Medicare Plans for Managing Osteoporosis

The following are the 5 highest rated medicare plans in New York based on their CMS rating for the plan's ability for osteoporosis management.

Monthly CostPlan NameCMS Rating
from $297EmblemHealth - EmblemHealth VIP Gold Plus (HMO) - Bronx County
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from $106Aetna - Aetna Medicare Value Plan (HMO) - Rockland County
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from $83UnitedHealthcare - AARP MedicareComplete Plan 3 (HMO) - Bronx County
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from $78EmblemHealth - EmblemHealth VIP Gold (HMO) - Bronx County
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from $77UnitedHealthcare - UnitedHealthcare MedicareComplete Choice Plan 4 (Regional PPO)
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Most Popular Medicare Doctors in New York

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
Internal MedicineNEW YORK, NY
Internal MedicineBROOKLYN, NY
SurgeryGREAT NECK, NY
SpecialistNEW HYDE PARK, NY
RadiologyNEW ROCHELLE, NY
Internal MedicineBROOKLYN, NY
RadiologySMITHTOWN, NY
RadiologyBAY SHORE, NY
Internal MedicineFLUSHING, NY
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Browse Medicare Plans by Cities

  1. New York, NY
  2. Buffalo, NY
  3. Rochester, NY
  4. Yonkers, NY
  5. Syracuse, NY
  6. Albany, NY
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