The Best Medicare Supplement (Medigap) Plans in New York
- New York Medicare Supplement (Medigap) plans pick up some of the costs Medicare doesn't cover. Read our review of Medigap plans in New York to find one that meets your needs.
Original Medicare is the basic Medicare option managed by the federal government. Because it's a basic plan, it doesn't cover all services, and it comes with several out-of-pocket costs that can be difficult to afford on a fixed income. Medicare Supplement Insurance, often referred to as Medigap, works with Medicare Part A (inpatient coverage) and Medicare Part B (outpatient and preventive coverage) to reduce these costs. Original Medicare pays a percentage of the Medicare-approved amount, and then, the Medigap plan pays its share.
Despite the advantages of supplemental coverage, many New Yorkers haven't enrolled in a Medigap plan. As of December 2018, just 481,178 residents had signed up for Medicare Supplement Insurance. That's just 21.2% of the Original Medicare enrollees in the state. If you're enrolled in Original Medicare and don't have a Medigap plan, use the research below to learn more about your options.
You can find Medicare Supplement plans where you live by comparing plans from several different insurance companies online.
What Are the Best New York Medicare Supplement Plans?
To make it easier for consumers to understand their coverage options, 37 states and the District of Columbia use the same standardization rules for every Medigap plan. Only Minnesota, Massachusetts and Wisconsin follow different guidelines. As a result, it's easy to compare one plan with another and see which one is likely to give you the best coverage for your needs. The chart below lists the plans and breaks down the benefits included with each one.
All New York Medigap plans provide 365 days of hospital coverage in addition to what Original Medicare already covers. They also pay Medicare Part A coinsurance, which typically ranges from $371 to $742 per day, depending on how many days of care you use in a benefit period. All New York Medigap plans pay Medicare copays, but not all of them cover copays at 100%. Depending on which plan you choose, there may be additional limitations.
Plans F, G and N are among the most popular Medigap options. Many people sign up for the F and G plans because they have low monthly premiums; however, plan F is not available to enrollees who didn't become eligible for Medicare before January 1, 2020. Because plans F and G have low premiums, they also have high deductibles.
Plan N also has reasonable premiums, but it offers more coverage. For example, it covers 100% of most Medicare copays. You may have to pay a $20 copay to see a doctor or a $50 copay for an emergency room visit, but Plan N will cover your other copays in full.
How Do I Enroll in a New York Medigap Plan?
To enroll in a Medigap plan, you must also be enrolled in Medicare Part A and Medicare Part B. The best time to enroll is during the Medigap open enrollment period that starts the month of your 65th birthday and lasts for six months. Medigap open enrollment is the best time to sign up because you'll have unlimited access to all New York Medigap plans. Insurance companies can't deny your application because of your health history or charge you more money than a healthy person for the same plan. Therefore, Medigap plans are a "guaranteed issue" form of insurance during your Medigap open enrollment period.
If you don't enroll during Medigap open enrollment, insurance companies can use underwriting to determine how much to charge you or decide whether to turn down your application for coverage. For example, if you have heart disease or another chronic medical condition, an insurer may charge you a higher premium than someone without any serious illnesses.
There are some exceptions, however.
- Your insurer may be allowed to impose a six-month waiting period for any pre-existing conditions, meaning it won't cover expenses related to a pre-existing condition until you've had the policy for at least six months.
- If you've had some other type of coverage for at least six months, you may be able to get immediate coverage for your pre-existing conditions.
- You keep your guaranteed issue rights if you lose your Medigap coverage through no fault of your own or if you originally enrolled in Medicare Advantage and then decided you'd rather have Original Medicare with Medicare Supplement Insurance. To keep your guaranteed issue rights in the second scenario, you must decide to leave Medicare Advantage within a year of your enrollment date.
- If you have group health coverage or some other type of health insurance after you turn 65, your Medigap open enrollment period won't start until you sign up for Medicare Part B, provided your Medicare Part B coverage starts the same month your previous coverage ends.