“Medigap” is a type of Medicare supplement insurance plan made to fill in the coverage gaps associated with Original Medicare Parts A & B. Though Medicare endeavors to be comprehensive, there are some healthcare needs that it won’t cover. And if you don’t have any Medigap insurance to cover those necessities, you could possibly find yourself paying thousands in out-of-pocket medical bills. To be able to get Medigap insurance, you will need to first be enrolled in Original Medicare.

Federal Regulations for Medicare Supplements

To help make sure than a senior citizen in New York gets the exact same benefits as a senior in New Jersey, the CMS (Centers for Medicare and Medicaid Services) are in charge of controlling the ten obtainable Medigap plans. Plans A, B, C, D, F, G, K, L, M, and N are presently available (E, H, I, and J have already been discontinued). Since each plan is regulated, the sole distinction between Plan G in New York and plan G in any other state is price, and provider. The benefits are the same across the country.

Medigap Enrollment In New York

Just like many other US states, Plan F is the most popular supplement sold to New York senior citizens. Plans B and C are also popular, likely because they are comparatively comprehensive to plan F (but at a lower monthly cost).

Plan Type A B C D E F G H I J K L M N
Enrollment 19,243 41,654 43,695 2,749 8,661 167,507 8,398 5,739 11,903 9,393 2,102 3,109 63 21,607

Plan Coverage & Cost

The price you pay for a Medicare supplemental insurance policy is dependent upon several unique components. Your state of health is a big issue, and your price may change according to such things as your tobacco habits, your actual age, and gender. Your premium can also be based on where you reside, right down to your county and postal code.

For better or worse, there aren’t very many things you can do to change how much your Medicare supplement insurance provider will likely charge you for your premiums. If you are relatively young, in good health, and you live in an area where healthcare is more affordable, you’ll likely get a better deal. If you engage in unhealthy habits like smoking, try and quit as soon as you can. Other than that, shopping around for different quotes in your area is the best way to make sure you get an affordable price:

Most Popular Medicare Supplement Plans in New York

Like many other states, New York occupants have a preference for Medigap Plan F to all of the other accessible plans. The reason for this is fairly simple: Plan F covers every single gap in Medicare coverage, and all older persons have to do to protect themselves is pay one reasonably priced monthly premium. Rarely is any other action needed on their part.

Plan C ranks a distant second among New York seniors, with less than 1/3 as many beneficiaries as Plan F. In other states, Plan F is usually the most popular, also. The only difference between them is that Plan C requires members to pay for Medicare Part B excess charges out of pocket, whereas Plan F does not.

How do Medicare Supplement Ratings work?

We want to make shopping around for the right health insurance provider as easy and convenient as possible. Medicare’s Overall Star Rating system annually analyzes and rates many different providers based on customer service reports, care management standards, and financial stability. The higher the star count, the better the insurance company will serve you.

Helpful Medigap Tips & Tricks

Doctor/Provider Network Restrictions

The advantage of Medigap insurance concerns how it encourages seniors to choose their very own physicians and facilities. Medicare supplement isn’t your only option for supplementing your Medicare coverage. Having said that, it is one of the few policies which won’t restrict your alternatives. Some supplemental insurance restricts you to a constrained network of doctors and facilities which have been pre-approved on your plan. However, any physician or hospital which accepts Medicare is going to be available to you with a Medigap policy. This is an excellent option for retirees who travel, or dwell a long way away from large cities, where a large number of restricted provider networks can be found.

Doctors List

One of the many strengths of Medicare Supplement (commonly referred to as Medigap) insurance is how widely it is accepted. Whether you’re trying to get a doctor’s appointment, an outpatient procedure, or hospital care, all you need to do is make sure your provider of choice accepts Medicare assignment. If so, then they will readily welcome your Medigap insurance. Not only that, but they can help file claims for you. You won’t have to do much more than that other than make sure you handle your end of financial responsibilities – like the deductible, coinsurance, or co-payments.

Drug, Vision and Dental Coverage

In the year 2010, the us government approved legislation which modified how Medigap insurance handled prescription drug coverage. Given that Medicare Part D is present, All Medicare supplement plans that supplied prescription drug benefits have been removed. While prescription drugs were once covered, vision and dental never have been (and likely never will be). You may need to get private insurance to help you with those medical expenses.

Enrollment Options & Best Time To Enroll

For straightforward enrollment with virtually no hassle, you’ll need to sign up for a Medicare supplemental insurance policy right around the time you enroll in Original Medicare (within your first 6 months of Medicare coverage, to be precise). The longer you delay, the more complicated the process can be.

  • Initial Enrollment Period: Inside your first 6 months of signing up for Medicare, you can also sign up for a Medicare supplement policy with automatic acceptance and zero health questions asked.
  • Guaranteed Issue: Just like the IEP stated earlier, you will be immediately approved without needing to answer unpleasant health queries or go through an exam. Guarantee Issue is usually for older persons who don’t sign up during the IEP simply because they were previously covered by an employer or group health plan.
  • Annual Enrollment Period (AEP): Medigap insurance is one of the few types of insurance that isn’t plagued by the AEP. You may register for or change Medicare supplement plans anytime throughout the year.
  • Underwritten: The process by which a company asks you questions and possibly runs medical tests in order to determine whether or not they might supply you with coverage.

Free Look Period

By federal law, you have 30 days to examine your Medigap coverage after your coverage begins. If, for whatever reason, you’re disappointed with your coverage, you may terminate your plan for a full refund inside your first 30 days.

What Medigap Plan Is Best For Me?

Many seniors struggle with choosing a Medicare supplement plan for two reasons: they’re not sure how to find the right company and they’re not sure which plan to choose. As far as the company goes, we have you covered. Medicare’s reliable five-star rating system helps identify the financially strong and high-performing companies who will help you get the high-quality care you deserve.

Choosing the right plan is a little bit more difficult. Obviously, you have to balance the amount of coverage you need with the amount of coverage you can afford. This is a tough task seeing as how most people cannot predict the future. But what we can do for you today, is help you find an affordable policy that helps protect your from Medicare’s gaps and is accepted by doctors and facilities near you.

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.