Medicare Advantage in New York

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New York

Information about Medicare Advantage Plans in New York

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39 percent of Medicare beneficiaries in New York were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.1

There are 168 different New York Medicare Advantage plans in 2019.1 Not every plan is available in each county, so you will want to be sure to find out which plans are offered where you live.

A licensed insurance agent can help you compare Medicare Advantage plans in your area of New York. Read below to learn more about Medicare in your state.

You can also learn more about other types of Medicare plans:

Average costs of Medicare Advantage in New York

New York had some of the highest average Medicare Advantage plan premiums in the United States in 2019, at $42 per month.

In 2019, there were 58 New York Medicare Advantage plans that offered $0 monthly premiums.

  • Average monthly premium cost in 2019 (weighted): $42
  • Average in-network out-of-pocket spending limit: $6,381
  • Average deductible in 2019 (weighted): $210.141

The premiums, deductibles and out-of-pocket costs of Medicare Advantage plans can vary greatly based on where you live.

Further below in this guide, we detail the average costs and enrollment figures for New York counties in 2019.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Compare New York Medicare Advantage plan costs

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

NY Medicare Eligibility & Enrollment

You cannot enroll in a Medicare Advantage plan in New York without first enrolling in Original Medicare (Part A and Part B).

You may be eligible to sign up for Medicare at age 65 if you meet the following requirements:

  • You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.

  • You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.

  • You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

You might also be eligible to enroll in Medicare under 65 if:

  • You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.

  • You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).

  • You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

If you have ESRD, you may not qualify for most Medicare Advantage plans, but you may be able to enroll in a New York Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in New York

The first time you can typically enroll in a New York Medicare Part C plan is during your Medicare Initial Enrollment Period (IEP).

Medicare Initial Enrollment Period graphic

Your Medicare IEP starts three months before your 65th birthday, continues during the month of your 65th birthday and then continues for another three months after your birthday.

You may also be able to sign up for Medicare Advantage during another Medicare enrollment period, which can include:

Medicare Advantage Open Enrollment Period graphic

Medicare Advantage Open Enrollment Period: January 1 – March 31

This enrollment period starts on January 1 and lasts to March 31 every year. During this period, you may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare.

If you return to Original Medicare during the Medicare Advantage Open Enrollment Period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare AEP graphic

Medicare Annual Enrollment Period (AEP): October 15 – December 7

From October 15 to December 7 every year, you may enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another. This is called Medicare AEP, also sometimes known as the Annual Election Period.

You may also drop your existing Medicare Advantage plan and return to Original Medicare during AEP.

During AEP, you may also join, switch or drop a Medicare Part D plan. 

Medicare Special Enrollment Periods (SEP)

You may potentially be granted a Medicare Special Enrollment Period (SEP), depending on your personal circumstances.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Find a New York Medicare Advantage plan

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in New York 2019

Each year, the Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage plans from across the U.S. using a system of one to five stars.2

If a Medicare Advantage plan earns a rating of four or more stars out of five stars, it is considered a top-rated plan.

There are 74 top-rated 2019 Medicare Advantage plans in New York that are rated four stars or higher. This equals 44 percent of all 2019 New York Medicare Advantage plans.

Medicare Star Ratings
Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

Medicare Advantage plans are rated in the following five categories:

  • Preventive care and health maintenance (screenings, tests, vaccines, etc.)
  • Management of chronic conditions
  • Member experiences and ratings of the plan
  • Member complaints, problems receiving services and member retention
  • Customer service

The information for the star ratings is gathered from information that is submitted to Medicare, Medicare’s regular monitoring activities and member surveys.

List of Medicare Advantage Plans Available in New York in 2019

To view a list of plans offered in your area within New York, use our plan comparison tool.

Find a New York Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in New York

A number of different insurance companies may offer Medicare Advantage plans in New York. Depending on where you live, you may have access to plans from one or more carriers.

Private insurance companies offer Medicare Advantage plans that may be unique to the plan area they serve.

When you’re shopping for Medicare Advantage plans in New York, you can compare plans from several different carriers by using some of the following information:

  • The Medicare Star Ratings can give you an idea of a plan’s overall quality.

  • Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.

  • Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.

  • You can read through Medicare Advantage plan reviews and testimonials from customers.

You can also call to speak with a licensed insurance agent who can help you compare Medicare Advantage plans that are available from insurance companies in your area.

New York Medicare Advantage plans by county

The chart below provides some more information about 2019 New York Medicare Advantage plans by county.1

  • Erie County had the highest number of top-rated (four stars or higher) plans in New York state, with 14 plans.

  • Erie County, Albany County and Bronx County each offered 8 $0 premium plans in 2019, which was the most out of any county in the state.
2019 NY Medicare Advantage by County
County Total of County MA Enrollees % of Medicare Beneficiaries Enrolled in MA Average Monthly Premium Number of Plans Available Number of $0 Premium Plans Available % Enrolled in a $0 Premium Plan
Albany 28085 44% $78 19 8 11%
Allegany 4231 38% $48 7 2 33%
Bronx 123198 56% $18 15 8 61%
Broome 19548 42% $39 6 3 39%
Cattaraugus 8784 46% $60 0 0 27%
Cayuga 6134 36% $37 0 0 40%
Chautauqua 14769 46% $53 0 0 35%
Chemung 8711 42% $46 2 0 33%
Chenango 4987 40% $36 1 0 35%
Clinton 4617 24% $57 3 0 16%
Columbia 5081 31% $74 0 0 10%
Cortland 3129 32% $31 0 0 36%
Delaware 3762 31% $42 1 0 23%
Dutchess 13886 22% $53 9 2 28%
Erie 121891 60% $63 22 8 30%
Essex 2558 26% $56 0 0 15%
Franklin 3038 26% $48 0 0 14%
Fulton 6674 48% $45 0 0 12%
Genesee 7484 55% $61 0 0 38%
Greene 4460 35% $74 0 0 10%
Hamilton 580 33% $60 0 0 15%
Herkimer 6213 40% $48 1 0 25%
Jefferson 6820 32% $32 0 0 20%
Kings 166967 43% $20 11 3 56%
Lewis 1875 33% $26 0 0 30%
Livingston 8270 58% $73 3 1 43%
Madison 6160 41% $34 0 0 43%
Monroe 106435 66% $54 6 2 54%
Montgomery 5855 45% $52 1 0 13%
Nassau 65176 23% $58 7 2 28%
New York 110259 37% $21 4 4 53%
Niagara 30241 59% $63 1 0 30%
Oneida 21852 40% $48 6 1 28%
Onondaga 45788 47% $35 9 5 41%
Ontario 15673 58% $61 0 0 46%
Orange 14483 21% $17 1 0 76%
Orleans 5047 54% $66 0 0 38%
Oswego 10668 41% $32 0 0 34%
Otsego 3841 25% $50 2 0 22%
Putnam 4204 21% $40 1 0 30%
Queens 173900 46% $18 6 3 60%
Rensselaer 14831 43% $75 0 0 12%
Richmond 35359 38% $32 1 0 32%
Rockland 12756 21% $16 1 0 74%
Saratoga 22792 45% $72 4 1 12%
Schenectady 16027 47% $73 0 0 12%
Schoharie 2262 31% $57 0 0 14%
Schuyler 2089 41% $40 0 0 30%
Seneca 3507 43% $57 0 0 36%
St. Lawrence 6884 28% $26 1 0 22%
Steuben 9925 42% $39 0 0 35%
Suffolk 57551 19% $44 9 3 49%
Sullivan 3101 17% $4 0 0 79%
Tioga 4787 40% $37 0 0 41%
Tompkins 4914 28% $39 0 0 31%
Ulster 10905 26% $49 2 1 38%
Warren 7979 42% $58 1 0 17%
Washington 6276 43% $56 1 0 17%
Wayne 12936 56% $50 0 0 51%
Westchester 49644 27% $25 4 1 65%
Wyoming 4921 53% $57 0 0 37%
Yates 3284 52% $54 0 0 39%

NY Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 New York Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.1

Plan type Percentage of New York enrollees (2019)
HMO 83.2%
Local PPO 13.5%
PFFS 2%
Regional <1%
Other Plans <1%

The major types of Medicare Advantage plans include:

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 New York Medicare Advantage plans that are available where you live.

Local health insurance resources in New York

  • The state of New York has a program called the Health Insurance Information, Counseling and Assistance Program that provides education surrounding Medicare, Medicare Advantage and other types of public health health insurance.

    The goal is to help the state’s insurance beneficiaries better understand their coverage and obtain the proper care. This free program may be reached at 1-800-701-0501.

  • You can also explore more information about the insurance industry in New York by visiting the state’s Department of Financial Services website.

  • New York Prescription Drug Assistance Programs
    The state of New York has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 MedicareAdvantage.com's internal analysis of CMS Medicare Advantage landscape source files, accessed May 2019. Data retrieved from www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.

Includes 2019 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown.

2 Every year, Medicare evaluates plans based on a 5-star rating system.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC is a licensed and certified representative of A Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any plan depends on contract renewal.

TZ Insurance Solutions LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult www.medicare.gov.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year.

Medicare has neither reviewed nor endorsed this information.

Last Updated: 6/26/2019