As a Medicare beneficiary in New York, you may be able to get help paying for your Medicare out-of-pocket costs by joining a Medicare Supplement (Medigap) plan. This article gives you a brief overview Medigap plans to help you decide whether this type of plan would work for you.
How Medigap plans work in New York
In New York, as in the rest of the United States, Medicare Supplement plans can help Medicare beneficiaries pay for out-of-pocket expenses associated with Original Medicare, Part A and Part B, such as copayments, coinsurance, and deductibles. In 47 states, including New York, there are 10 standardized Medicare Supplement plans. Each Medigap plan is identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), and plans of the same letter offer the same benefits. Three states–Massachusetts, Minnesota, and Wisconsin–have different types of standardized Medigap plans.
Remember that you must already be enrolled in Original Medicare, Part A and Part B, to sign up for a Medigap plan in New York. Also, note that Medigap Plan A and Medigap Plan B are not the same as Medicare Part A and Part B, despite the similar-sounding names.
The Medigap Open Enrollment Period, which begins the first day you are both age 65 or older and enrolled in Medicare Part B is a good time to sign up for a Medigap plan. It lasts for six months, during which you can join any Medigap plan available in your area, with the insurance company of your choosing, without being denied coverage for medical underwriting or pre-existing conditions (waiting periods may apply in certain cases). You can still apply for a Medicare Supplement plan in New York after your Medigap Open Enrollment Period ends, but you may be charged more for your insurance plan or even be denied coverage.
Since Medigap plans are designed to supplement rather than replace Original Medicare, you must remain enrolled in Original Medicare, and continue paying your Medicare Part B premium, to retain your health insurance coverage. In addition, Medigap plans currently do not offer prescription drug coverage, so you may want to consider enrolling in a Medicare Part D Prescription Drug Plan to get help paying for your prescription drugs.
Please note that plan availability and costs may vary.
Types of Medigap plans in New York
There are 10 types of standardized Medicare Supplement plans available in New York. Here’s a look at the benefits available under each type of plan. The Xs indicate coverage, while blank cells signify no coverage.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional
365 days after Medicare benefits are exhausted
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility (SNF) care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B ‘excess charges’||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Medicare Part B preventive care coinsurance||X||X||X||X||X||X||X||X||X||X|
|Out-of-pocket limits apply**|
Medigap plans in New York also have the following characteristics:
- Medicare Supplement Plan K and Plan L have out-of-pocket limits that are subject to change each year.
- Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, but you may still need to pay up to $20 copayment on some office visits and up to $50 copayment on emergency room visits.
- Medicare Supplement Plan F is the most comprehensive plan, covering almost 100% of Medicare-associated costs listed above.
Choosing a suitable Medigap plan in New York
Medicare Supplement plans in New York with the same letter designation don’t vary in coverage or benefits, as explained above. However, each independent insurance company offering Medicare Supplement plans can determine its own monthly premium structure. This means that if you live in Buffalo in Erie County, you may pay a different premium than a resident of Brooklyn in Kings County for an identical Medicare Supplement plan. Keeping in mind the possible differences in costs, it may be smart to compare all Medicare Supplement plans available in your area so you can choose a Medigap plan in New York that may fit your individual budget and health needs.
For more information about Medicare coverage options in New York, see Medicare Advantage in New York.
With a variety of Medigap plans available in New York, you might want to compare the plans sold in your specific area. Just enter your zip code in the form on this page to get started.
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.