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Medicare in New York

As you get closer to the retirement age of 65, you may start thinking about your health insurance needs after you stop working. Like many Americans, you may realize that health insurance for senior citizens is a primary concern and a major expense. This is where Medicare health insurance comes in. Across America and in New York, US citizens are eligible to enroll in Medicare once they turn 65 to receive government-sponsored health coverage.

Original Medicare for New York beneficiaries

Original Medicare consists of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Original Medicare is available to US citizens 65 and older; it’s also available to those under 65 with certain qualifying disabilities. New York Medicare beneficiaries are eligible to sign up for Original Medicare during the seven-month Initial Enrollment Period, which begins three months before a person turns 65 and ends four months after that date. New York Medicare beneficiaries can also join Medicare during the General Enrollment Period, which takes place every year from January 1 to March 31. But be aware that if you miss your Initial Enrollment Period and sign up for Medicare at a later date, you will probably have to pay a late-enrollment penalty.

New York Medicare beneficiaries, like those in other states, are generally eligible to enroll in Medicare Part A without paying a premium. However, there are some exceptions to this rule, most notably if you haven’t worked long enough to collect Social Security benefits. Medicare Part A in New York offers the following health benefits:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care
  • Hospice care
  • Home health services

Medicare Part B offers medical insurance, with a monthly premium. New York Medicare beneficiaries whose annual income is above a certain limit set by the government usually have to pay an additional monthly adjustment fee. As a New York Medicare Part B beneficiary, you’re eligible to receive the services and supplies listed below:

  • Clinical research
  • Ambulance services
  • Durable medical equipment
  • Mental health (inpatient, outpatient, and partial hospitalization)
  • Getting a second opinion before surgery
  • Limited outpatient prescription drugs

Medicare private insurance in New York

Medicare Advantage (Medicare Part C) is private health insurance. Throughout the U.S. and in New York, Medicare Advantage is required to offer at least the same coverage as Original Medicare, Part A and Part B. As a New York Medicare beneficiary, you can also get extra coverage as part of your Medicare Advantage plan, like dental, vision, and hearing benefits.

If you’re a New York Medicare beneficiary seeking private health and prescription drug coverage through a single health plan, you can enroll in a Medicare Advantage Prescription Drug plan. But note that even if you join a Medicare Advantage plan or a Medicare Advantage Prescription Drug plan, you have to stay enrolled in Original Medicare and continue paying the Medicare Part B premium to keep your health insurance coverage.

As a New York Medicare beneficiary, you may incur various out-of-pocket expenses associated with Original Medicare, like coinsurance, copayments, and deductibles. To get help paying for such expenses, you can enroll in a Medicare Supplement plan (also known as Medigap), available through private insurance companies.

In New York, you can also sign up for separate prescription drug coverage through Medicare Part D, which is offered by private insurance companies. New York Medicare Part D Prescription Drug Plans have different costs, depending on the extent of the coverage you select, but most plans require payment of a monthly premium, annual deductible, and copayment or coinsurance.

As a New York resident, you can choose from various Medicare Advantage plans, depending on the county in which you live. If you live in Brooklyn in New York County, you may have different Medicare plan offerings than a resident of Syracuse in Onondaga County. Considering the many New York Medicare Advantage plans available, it’s important to customize your search for plans based on your own individual health and prescription needs.

For more information about private Medicare insurance for New York beneficiaries, please see:

New York resources for Medicare beneficiaries

There are a number of resources designed to help New York Medicare beneficiaries with Medicare-related issues and concerns. Here are some of the resources that may be helpful to you: