New York has over 24 million Medicare Advantage beneficiaries throughout the state, 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.

How Medicare Advantage Plans Work 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 plan. Most counties in New York provide at least 50 plans.

Medicare Advantage Plans Offered in New York

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 go over 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 in New York

Zero-dollar premium plans come with benefits and drawbacks. Keep in mind that you’ll have to pay more out of pocket for healthcare with these plans.

If you decide to go with 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 in New York

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.

If you’re interested in more expensive options, MVP Health (HMO-POS) has a four-star zero-dollar drug deductible plan. However, the plan 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 in New York

Not all areas around the country have five-star plans. If you have access to these plans, you may enroll during a Special Enrollment Period.

New Yorkers have access to 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 in New York

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 plan 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 you 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

You can learn more about New York Medicare Advantage plans by reaching out to our team at Medigap. 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 plans 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 give us a call at the number above or complete our rate form.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.