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Best Medicare Advantage Plans in New York for 2019

The best Medicare Advantage plan in New York for 2019 can give a local beneficiary a way to avoid expensive deductibles, coinsurance, or copayments for hospital visits or temporary skilled nursing home care that they might have with only Original Medicare. Besides that, a Medicare Part C plan may also offer valuable benefits that Medicare Part A and Part B won’t provide.  Medicare Advantage plans in New York offer almost 40 percent of the state’s Medicare beneficiaries a cost-effective way to best manage benefits.

Best Time to Enroll in Medicare Advantage Plans in New York

Most New Yorkers who qualify for Original Medicare Part A and Part B will also qualify for a Medicare Advantage plan in the state. The only health question that Medicare Part C plans in New York ask is about End Stage Renal Disease ESRD, and there are customized Medicare policies in 2019 that best assist people who have this condition and have enrolled in Medicare Part A and Part B.

At the same time, you should know about specific times that you can enroll in a Medicare Advantage plan in New York. These enrollment periods include:

  • Initial Coverage Election Period: Most New Yorkers will compare and choose their first Medicare Advantage plan in New York during the Initial Coverage Election Period, or ICEP. This period covers three months before the beginning of the month of the 65th birthday and three months after for most folks. A New York beneficiary who is enrolled in Medicare Part A and Part B earlier or later than their 65th birthday would replace their actual eligibility date for their 65th birthday.
  • Annual Election Period: This is often called Open Enrollment. The Annual Election Period covers the weeks from October 1 to December 7 every year. This is the time to compare and choose a new Medicare Advantage plan.
  • Special Election Period: Some circumstances could help trigger a Special Enrollment Period or SEP. Some of the most typical examples of these circumstances could include moving away from a local provider network or losing group medical coverage at work. Health insurance providers also have to sign a Medicare contract to sell Medicare Advantage plans from year to year; if they don’t perform a contract renewal, then you’ll have a Special Election Period to look for a new Medicare Part C plan for the remainder of 2019.

Note that you can also take advantage of the Medicare Advantage Disenrollment Period for a few weeks at the beginning of each new year. This will give you a chance to drop your Medicare Advantage plan in New York and get coverage from Medicare Part A and Part B. If needed, beneficiaries may also choose Medicare Advantage Prescription Drug plans to help with drug costs and avoid penalties for not having prescription benefits.

Best Types of Medicare Advantage Plans in New York for Each Individual

You should know that all Medicare Advantage plans in 2019 are not exactly the same. Certain kinds of Medicare Part C plans in New York are best for various situations.

These include:

  1. Health Maintenance Organization HMO plans:

    HMO plans are chosen by about 70 percent of New York enrollees. These have the strictest network rules when it comes to service area — so your options for health care providers are more limited — but they may also have low premiums and out-of-pocket costs. Some of these plans don’t even require you to pay a monthly premium.

  2. Preferred Provider Organization PPO plans:

    About 28 percent of state enrollees choose a PPO as their best Medicare Advantage plan option in New York. PPO Medicare Advantage plans are more flexible than HMOs, but they may have somewhat higher premium rates for 2019.

  3. Private Fee-for-Service PFFS plans:

    A PFFS Medicare Part C plan in New York doesn’t use a network; however, they haven’t proven as popular as network options. Only about two percent of New Yorkers choose PFFS Medicare Advantage plans.

  4. Special Needs Plans SNPs:

    Special Needs Plans may be the best choice for a Medicare beneficiary who needs to handle certain chronic health conditions or even institutional conditions. These are usually HMOs that are customized for people with certain health issues.

  5. Dual-Eligible:

    People who qualify for both New York Medicaid and Original Medicare is considered dual-eligible and may have special Medicare Part C options in New York often with a $0 premium and few out-of-pocket expenses for those who need a little extra help on top of the standard Medicare coverage.

When checking out all of these plans for 2019, you may want to look for a plan that includes Medicare Part D prescription drug coverage. Many — but not all — Medicare Advantage plans include a Medicare prescription drug plan, which can help you a lot. In addition to finding the best coverage, you should look for a company that has top star ratings so you’ll know you can count on your insurer.

Enrollment Figures for Medicare Advantage Plans in New York

It might help to know which Medicare plan that other New Yorkers have chosen. Consider these enrollment statistics for Medicare Advantage plans in New York:

  • People who qualify for Original Medicare and choose Medicare Part C: About 1.4 million
  • Percentage of New Yorkers who choose Medicare Part C over Original Medicare: About 38 percent
  • Most Popular type of Medicare Part C for New Yorkers: HMO

The following list shows the largest New York counties by their population:

  • Kings County, NY: 2,648,771
  • Queens County, NY: 2,358,582
  • New York County, NY: 1,664,727
  • Suffolk County, NY: 1,492,953
  • Bronx County, NY: 1,471,160

Do Medicare Advantage Plans in New York Cover Prescription Medicine in 2019?

You have to enroll in a Medicare Advantage Prescription Drug plan for 2019 if you just have Original Medicare. This is because Medicare Part A and Part B only cover medicine in very specific instances. The good news is that most Medicare Advantage plans in New York already come bundled with the kind of drug coverage you will need to help pay for your medicine.

If you get a stand-alone Part D plan or get drug coverage with your Medicare Part C plan in New York, you should understand that every one of these will have a formulary. This is simply the list of covered prescription medication. In addition, the insurance company may have a variety of different Prescription Drug tiers. That means generics, brand-name prescriptions, and certain specialized drugs may be covered at different rates.

As you compare various 2019 plans to find the best Medicare Part C options, you can make sure they will help you pay for the kinds of medicine that you need to take to stay healthy. Again, you are allowed to switch plans every year during Open Enrollment in case your needs change.

Network Restrictions for Medicare Advantage Plans in New York

If you join the majority of residents with a Medicare Advantage plan in New York, you should know that out-of-network medical services may only be covered in case of emergencies. You should always check the network to make sure that you can find your favorite doctor and a convenient hospital. Also, your primary care doctor, sometimes called a PCP, may need to give you referrals to visit specialists. You are most likely to find a low-cost or $0 premium HMO Part C plan.

You may decide that a PPO works best for you in 2019 because you can save more money with in-network providers. You also don’t need the doctor to give you a referral for specialists. However, if you decide to step outside the list of in-network medical providers for your doctor, hospital, or other medical providers, you can still get services covered. You just have to pay more.

Best “Extra Benefits” Provided by Medicare Advantage Plans in New York in 2019

You may best benefit from having Part D bundled in with your Medicare Part C health plan. In addition, your Medicare Advantage plan may also offer some perks that you won’t get at all with Medicare Part A and Part B. Some examples could include wellness programs, hearing care, and even routine vision and dental services.

Top-Rated Companies for Medicare Advantage Plans in New York for 2019

You might have heard of a lot of Medicare Advantage plan providers. These are some of our favorites:

  • Humana
  • Empire Blue Cross Blue Shield
  • Cigna
  • Aetna
  • BlueCross BlueShield of Western New York
  • Excellus

Best New York Medicare  Resources

You might be curious about what you need to do to sign up for Medicare Part A and Medicare Part B, and you could be wondering about the Part B premium for 2019. You may be looking for other information about Medicare, Medicare Advantage or Medigap plans. These resources can help a lot:

If you give us a call after you have signed up, we can give you a complete description of the benefits for each cost-sharing plan. We help locate the best Medicare Advantage plan in New York that is right for their 2019 needs.  We can also help them compare the difference between a Part C plan and a Medicare Supplement plan. Once you talk to one of our insurance agents, you’ll see that it’s possible to save a lot of money on your health care.