New York has over 24 million Medicare Advantage beneficiaries nationwide, with an overall 42.12% participation rate. Counties like Rochester have the highest participation rates, while other areas like White Plains only have around 32% participation.
Find out more about New York Medicare Advantage plans with this article.
Medicare Advantage plans in New York
Insurance companies offer Medicare Advantage plans throughout New York. These plans allow you to get insurance coverage without relying on programs provided by the government, meaning they give you coverage in place of Medicare Part A or Part B.
The costs and coverage of different Medicare Advantage plans vary based on the company offering the program. Most counties in New York provide at least 50 plans.
Medicare Advantage plans available
The government does not standardize Medicare Advantage plans, setting them apart from Medigap coverage. We’ll discuss these plans in more detail by focusing on those offered in a single ZIP code in New York.
This article will review the Medicare Advantage plans available to New York residents. You can find plans with high ratings, low premiums, and other advantages.
Medicare Advantage plans with a zero-dollar premium
Zero-dollar premium plans come with benefits and drawbacks. Remember that you’ll have to pay more out of pocket for healthcare with these plans.
If you choose a zero-dollar premium plan, you may want to consider the EmblemHealth (HMO) option. This three-star plan has a $7,500 MOOP.
You can also select a four-star plan by looking into the Wellcare (Local PPO) option. This plan also comes with a $7,550 MOOP.
Getting four-star service doesn’t always mean spending more. Humana (Local PPO) offers a four-star plan with a $4,550 MOOP.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATING |
| Wellcare | $0 | $7,550 | LOCAL PPO | 4 |
| Aetna | $0 | $7,550 | LOCAL PPO | 4 |
| Humana | $0 | $4,500 | LOCAL PPO | 4 |
| EmblemHealth | $0 | $7,550 | HMO | 3 |
| Healthfirst | $0 | $7,550 | HMO | 4 |
Medicare Advantage plans with a zero-dollar drug deductible
You may also select a plan with a zero-dollar drug deductible while living in New York. Aetna (HMO) offers a three-star plan with a $0 premium and a $7,550 MOOP.
MVP Health (HMO-POS) has a four-star zero-dollar drug deductible plan if you’re interested in more expensive options. However, the program does come with a $211 premium.
Finally, Excellus Health (HMO-POS) offers a five-star plan. The company charges a $129.00 premium and has a $6,700 MOOP for this zero-dollar drug deductible plan.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATING |
| Wellcare | $0 | $7,550 | HMO | 4 |
| Excellus Health | $129.00 | $6,700 | HMO-POS | 5 |
| MVP Health | $211.00 | $7,550 | HMO-POS | 4 |
| Aetna | $0 | $7,550 | HMO | 3 |
| MediGold | $0 | $6,200 | HMO | N/A |
Medicare Advantage plans with a five-star rating
Not all areas around the country have five-star plans. If you can access these plans, you may enroll during a Special Enrollment Period.
New Yorkers can access a five-star plan offered by Excellus Health (HMO-POS). This plan has a $0 premium and a $4,500 MOOP.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATING |
| Excellus Health | $0 | $4,500 | HMO-POS | 5 |
Medicare Advantage plans with a Part B reduction
Availability for Part B Reduction plans varies by area in New York. People in some ZIP codes have access to these plans, while others may not.
Depending on your location, you may be able to sign up for a three-star plan offered by UnitedHealthcare. The program has a $0 premium and offers you a $20 Part B Reduction.
Humana offers a significantly higher Part B Reduction of $40 with a $0 premium. The company has a four-star rating.
Wellcare offers the largest Part B Reduction in New York at $74. However, the company does not currently have a star rating.
| PLAN | PREMIUM | MOOP | PART B REDUCTION | STAR RATING |
| Humana | $0 | $4,500 | $40.00 | 4 |
| UnitedHealthcare | $0 | $6,700 | $20.00 | 3 |
| Wellcare | $0 | $7,550 | $74.00 | N/A |
| Aetna | $0 | $7,550 | $35.00 | 4 |
| Excellus Health | $0 | $7,550 | $40.00 | 4 |
Ancillary/DVH
Some Medicare Advantage plans offer extra benefits that you can’t get from Medigap or Medicare coverage provided by the government. For example, you may get prescription drug coverage or dental coverage.
Cities in New York with estimated premiums for Medigap coverage
Medicare Supplement plans come with a monthly cost. For the following cities in New York, we’ve complied charts to show you the estimated premiums for this coverage:
FAQs
What is the best Medicare Advantage plan in New York?
Some Medicare Advantage companies have better ratings than others in New York. The top-rated companies include CDPHP Medicare Advantage, Excellus Health Plan, Highmark Blue Cross Blue Shield, and Independent Health.
Which Medicare Advantage plan has the most New York enrollees?
UnitedHealthcare has maintained the largest membership numbers in New York for over a decade. The company had 19% enrollment in 2010, which grew to 27% in 2021.
How many Medicare Advantage plans are available in New York?
More than fifty Medicare Advantage plans are available throughout much of New York. New Yorkers also have access to Medigap plans and Special Needs Plans.
Are Medicare Advantage premiums deducted from Social Security in New York?
Yes, the Social Security Administration (SSA) can deduct the premium for your Medicare from your Social Security payment. The deduction occurs every month in New York.
Is Medicare Advantage more expensive than Medicare in New York?
Generally, Medicare Advantage plans cost around $44 a month for individuals in New York. However, these costs may vary based on the plans you choose. Individuals pay around $171 a month for Medicare Part B, making Medicare Advantage plans cheaper in most cases.
How to get help enrolling in a New York Medicare Advantage plan
Contact our Medigap team can learn more about New York Medicare Advantage plans. We focus on your needs and offer free services to our clients throughout New York. You can count on us to compare all the available programs to help you find the one that best fits your needs.
We work with all carriers operating in New York, giving us the scope necessary to help you find the right company. You can call us at the number above or complete our rate form.
