If you’re a senior living in Rochester, you might wonder about Medicare in Rochester, New York. Rochester is home to 261,549 beneficiaries, 117,010 of which fall under MA plans, yielding a 67.68% participation rate. The average age of beneficiaries is 69, only three less than the national average, split into 53.06% female and 46.94% male participants.

Medicare plans in Rochester, NY

This article will cover the types of New York Medicare plans available to you or your loved one, including the average costs and what kind of coverage you can expect. We’ve based the below quotes on a female aged 65.

While this provides a good reference point, you can expect the quotes to change slightly based on your demographics.

Affordable Medicare Advantage plans in Rochester, NY

Compared to previous years, the average Medicare beneficiary has access to more Medicare Advantage plans in 2022, an 8% increase over 2021, amounting to 39 total. Of those, 31 include New York Medicare Advantage Prescription Drug (MAPD) coverage.

Medicare in Rochester, New York, has around 84,539 FFS beneficiaries and 117,010 MA beneficiaries. We’ll cover some of the more popular and cost-effective plans below.

Wellcare offers a $0 premium, appealing to almost anyone seeking coverage. Enjoy a $7,550 maximum out-of-pocket (MOOP) limit. This program is a local PPO plan with a four-star rating, making it one of the more sought-after plans on the market.

UnitedHealthcare offers the same $0 premium, and the MOOP comes to $6,700. This program is a regional PPO plan with a four-star rating.

Excellus Health sits a little above the others at a five-star rating, and this is an HMO-POS plan type with a $0 premium. Beneficiaries can expect a $4,500 MOOP.

Wellcare $0 $7,550 LOCAL PPO 4
Aetna $0 $7,550 LOCAL PPO 4
UnitedHealthcare $0 $6,700 REGIONAL PPO 4
Excellus Health $0 $4,500 HMO-POS 5
Wellcare $0 $6,700 LOCAL PPO 4

Average Medicare Supplement plans in Rochester, NY

While you might expect specific Medicare plans in Rochester, New York Medigap plans are standardized throughout the nation, separated into different letters.

This means benefits will remain the same regardless of your state. The only difference lies in monthly premiums. Plan G, for example, offers premiums as low as $184.70 and as high as $463.75.

PLAN A $152.57 $285.56
PLAN B $204.82 $382.69
PLAN C $272.95 $396.95
PLAN D $183.80 $376.42
PLAN F $300.67 $578.22
PLAN HDF $52.53 $62.22
PLAN G $184.70 $463.75
PLAN HDG $52.53 $61.93
PLAN K $77.62 $141.75
PLAN L $172.00 $222.73
PLAN M $308.38 $393.08
PLAN N $192.01 $303.50

Cheapest Medicare Part D prescription drug plans

Some patients opt to forgo traditional Medicare plans in Rochester, New York, in favor of Part D plans. These standalone plans cover prescription medications in New York. By contrast, Medigap plans don’t cover prescriptions, and only some Medicare Advantage plans do.

One of the more sought-after plans is Aetna, boasting a $7.20 premium. With Aetna, you will pay a $480 deductible. Overall, this plan earns a three-star rating, making it a fine choice for anyone looking for a solid plan.

With a slightly higher premium at $12.90, Wellcare is another popular choice. Expect a similar $480 deductible. This plan clocks in at three stars, making it one of the mainstays of Part D plans.

For something with a slightly higher premium, consider UnitedHealthcare. You will pay $34.20 with a $310 deductible. Overall, this plan has a four-star rating, making it more desirable than similar plans.

Aetna $7.20 $480 3
Wellcare $12.90 $480 3
Humana $25.00 $480 3
UnitedHealthcare $34.20 $310 4
Cigna $40.80 $480 3

Medicare Special Needs plans

Medicare in Rochester, New York, offers Special Needs Plans. SNPs comprise a subset of Medicare Advantage plans for people with chronic disabilities or special needs and come in three categories: dual, chronic, and institutional.

If you need a stellar dual plan, consider Wellcare HMO or local PPO plans. Each program sports a $0 premium, making it easy and cost-effective. Likewise, the MOOP for each amounts to $3,450.

Elderplan is an excellent option for those seeking an institutional plan. This HMO plan has a $42.40 deductible to account for high-quality services. The MOOP comes in at $7,550.

Another great option is Aetna, with a $0 premium. This HMO plan offers dual eligibility and has a MOOP of $7,550.

Wellcare $0 $3,450 HMO Dual
UnitedHealthcare $0 $7,550 HMO Dual
Aetna $0 $7,550 HMO Dual
Elderplan $42.40 $7,550 HMO Institutional
Wellcare $0 $3,450 LOCAL PPO Dual


How Much Does Medicare Cover for Ambulances in Rochester, NY?

Part B covers ambulances if you need them medically, meaning they’re the only safe way to transport you. Part B covers emergency and non-emergency ambulance services at 80% of the Medicare-approved amount. You will most likely pay a 20% coinsurance fee after meeting your deductible.

What Is the Best Low-cost Medicare Supplement Plan for Seniors in Rochester, NY?

Plan G is the best overall Medicare Supplement for new enrollees, as it provides the most coverage. Before the insurance begins paying for your health care, you must meet the $226 deductible.

How Much is a Medicare Supplement per Month in Rochester, NY?

Medicare enrollees in Rochester, New York, who opt for Part D prescription plans have premiums anywhere from $7 to $101 per month. Rates might vary based on your age and demographics.

What Does Plan G Pay for in Rochester, NY?

Part G covers all Medicare cost-sharing except the $226 Medicare Part B deductible. This is an excellent option for widespread coverage for little cost.

Can I Switch Medicare Supplement Plans Anytime in Rochester, NY?

You can switch if you meet the qualifications, including:

  • Switching from Medicare to Medigap
  • You’re no longer on your employer’s healthcare plan
  • Your current Medicare Advantage plan stopped covering individuals in Rochester, New York
  • Switching from Medigap to another Medigap

How to sign up for Medicare plans in Rochester

Medigap covers all your Medicare needs in Rochester, New York. We work with every carrier free of charge for you and compare all the best plans to find one that works for you. Give us a call or complete our rate form to get rates now.

Written By:
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Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications 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.
Reviewed By:
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Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.