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When people finally reach an age when they can be officially called ‘seniors,’ they deserve nothing but a life full of comforts, free from any financial strains, and be equipped with well-rounded social benefits.

But even after meticulous financial planning and diligent spending, a single excessive medical bill can quickly lead to bankruptcy, and many people stay indebted their entire lives for this very reason. With the rising healthcare costs in the US, we’ve seen this scenario repeat itself way too often, where many senior citizens and individuals with disabilities are paying exorbitant out-of-pocket expenses and being left with nothing.

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A Quick Guide on the Different Medicare Options Available in New York

Original Medicare

One of the most reliable Medicare options for the people of New York, the Original Medicare consists of two parts – Part A and Part B.

Part A provides coverage for hospital services like in-patient treatments, lab tests, skilled nursing facilities, and hospice care.

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Private Fee-For-Service (PFFS)

This healthcare plan is offered by State-licensed organizations that agree to the terms and conditions of Medicare & Medicaid Services.

For this healthcare plan:

  • You do not require a primary care provider or a specialty referral
  • Drug coverage is usually included but can also be purchased separately
  • You will have to pay higher premiums if you choose an out-of-network provider

Special Needs Plan (SNP)

SNPs are only available for people with specific chronic diseases and characteristics. This treatment plan is specifically designed for those people who have special needs and requirements.

  • A primary care provider and a specialty referral are required
  • Plans include drug coverage
  • You can join this plan at any time if you meet the eligibility criteria

There are many different options included in Medicare Advantage, with several coverage plans that aren’t a part of Original Medicare. When selecting a Medicare Advantage plan, make sure to consider the plan’s premiums, copayments, and coinsurance to subscribe to a plan that is best suited to your financial situation.

Browse through the Medicare Hope website to find out more about Medicare Advantage plans in New York. You can also use our Medicare plan finder tool to check out all the Medicare Advantage plans available in your region.

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Supplemental Health Insurance – Medigap in New York

Since the Original Medicare Part A and Part B only cover 80% of the total medical expenses, people in New York also have the option to sign up for the supplemental healthcare plan called Medigap, which pays for the leftover 20% of the coinsurance.

Medigap, also known as Medicare Supplement, is a comprehensive healthcare plan that provides adequate coverage for everything that isn’t covered in Original Medicare. This set of health insurance policies is labeled from A to N.

Private insurance agencies that provide Medigap coverage must adhere to federal regulations because each state’s insurance commissioner governs these policies.

You can only sign up for this secondary healthcare plan if you’re already enrolled in the Original Medicare plan. You become eligible for Medigap if:

  • You’ve been diagnosed with amyotrophic lateral sclerosis (ALS)
  • You’re 65 years old or older
  • You’re receiving disability benefits from Social Security or the Railroad Retirement Board
  • You’ve been diagnosed with end-stage renal disease(ESRD)

How do Medigap Insurers Set Their Premiums in New York?


Issue Age Rating

This approach depends on the enrollee’s age at the time they apply. Enrolment premiums are less costly for people who are under 65 than for people over the age of 80. The overall rates may be affected due to inflation and other reasons but never because of the enrollee’s age.

Attained-age Rating

Most insurance companies prefer using this approach to calculate premiums. The person’s premiums become higher as they get older. These premiums are less costly for younger buyers.

Community Rating

The premiums are not affected by age in this method. Eight states in the US mandate this approach, but insurers tend to avoid it.

Most insurance companies like to use the issue-age rating, while others use the attained-age rating. The attained-age rating is the most prevalent method of calculating premiums unless the state demands it differently.

When signing up for Medicare for the first time, the enrolment process can seem overwhelming due to the number of choices you have. But our Medicare Hope insurance agents aim to simplify things as much as they can and can help you select comprehensive healthcare policies that provide ample coverage for all of your specific needs and requirements.

To learn more about the different Medicare options available in New York, make sure to go through our blog and learn the step-by-step process of applying to Medicare.

Comparing Medicare Advantage Plans in New York

Here are some factors you should consider before enrolling yourself in a Medicare health insurance plan.

Provider Network

Many Medicare programs provide their enrollees with a network of healthcare providers to choose from. You can save a lot of money by opting for an in-network provider since out-of-network providers have higher premiums and extra charges.

Make sure to do proper research and find physicians and hospitals that are a part of their network, so you don’t have to spend an excessive amount on medical bills.

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Medicare Enrolment in New York

Initial Enrolment

The initial registration period begins three months before and ends three months after your 65th birthday. If you’re already enrolled in a Medicare program, you can use this time period to switch or upgrade your current plan.

General Enrolment

Those who miss the initial enrolment period can sign up for Medicare health insurance during the general enrolment period, which begins January 1st and ends March 31st. During this period, you can enroll in Original Medicare (Part A and B), Medicare Advantage (Part C), Medigap, and Part D (drug coverage) plans.

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Our Medicare Insurance Agents Can Help You Get the Right Insurance Plan

At Integrity Now Insurance Brokers, our team of highly qualified Medicare insurance agents are annually accredited by the AHIP and are committed to helping you find the most comprehensive health insurance plans at competitive rates.  

Our Medicare insurance brokers have ample experience when it comes to working with senior citizens, youth with disabilities, and other individuals who require Medicare and Medigap plans to get proper coverage for their medical treatments.

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