Medicare Advantage in New York

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New York

Information about Medicare Advantage Plans in New York

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There are 142 different New York Medicare Advantage Prescription Drug (MAPD) plans in 2021.1 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.

Average costs of Medicare Advantage in New York

The average premium for a New York Medicare Advantage plan with prescription drug coverage is $40 per month in 2021.

  • Average monthly premium cost in 2021 (weighted): $40
  • Average in-network out-of-pocket spending limit: $6,672
  • Average drug deductible in 2021 (weighted): $2341

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 2021.

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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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 be able to enroll in a Medicare Advantage plan or 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 to speak with a licensed insurance agent. We accept calls 24/7!

Top-rated Medicare Advantage Plans in New York 2021

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 70 top-rated 2021 Medicare Advantage Prescription Drug plans in New York that are rated four stars or higher. This equals over half (52 percent) of all 2021 New York MAPD 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 2021

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

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

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

Learn more about Medicare Advantage plans in some of New York's most populous counties.

The chart below provides some more information about 2021 New York Medicare Advantage plans by county.1

2021 NY Medicare Advantage by County
County Total Enrollees in County Average Premium % of Plans Rated 4 Stars or Higher Avg. Annual Drug Deductible # Plans Available
Albany 30227 $40.86 60% $178.30 55
Allegany 4639 $50.11 76% $147.18 49
Bronx 129220 $28.56 32% $287.98 49
Broome 21617 $35.16 62% $149.61 50
Cattaraugus 9571 $47.34 78% $152.37 49
Cayuga 7173 $36.30 64% $140.67 39
Chautauqua 15850 $50.26 84% $148.47 46
Chemung 9659 $38.50 63% $138.89 36
Chenango 5739 $37.52 70% $129.41 45
Clinton 5240 $40.79 66% $170.00 36
Columbia 5643 $40.85 71% $188.16 49
Cortland 3446 $37.43 63% $133.93 37
Delaware 4471 $37.72 64% $193.43 47
Dutchess 16428 $51.04 44% $207.68 34
Erie 127650 $52.03 67% $159.21 48
Essex 2926 $42.46 67% $176.67 37
Franklin 3294 $41.47 75% $151.82 32
Fulton 7437 $48.63 73% $170.83 46
Genesee 7999 $59.86 83% $150.30 41
Greene 4916 $40.85 71% $188.16 49
Hamilton 649 $34.21 74% $178.83 41
Herkimer 6735 $39.84 73% $133.57 46
Jefferson 7525 $35.21 71% $147.31 35
Kings 177145 $30.44 29% $308.09 54
Lewis 2338 $33.39 67% $154.81 36
Livingston 8871 $69.37 100% $222.00 19
Madison 6845 $41.27 78% $122.58 41
Monroe 112272 $53.30 71% $207.73 30
Montgomery 6181 $45.79 73% $173.75 51
Nassau 70304 $39.44 39% $272.07 33
New York 116887 $30.51 28% $299.46 52
Niagara 31850 $48.65 69% $168.06 47
Oneida 23450 $35.81 64% $138.38 49
Onondaga 49552 $35.70 57% $139.69 41
Ontario 16889 $62.93 73% $189.77 28
Orange 17099 $50.85 41% $208.97 36
Orleans 5426 $58.48 91% $181.38 36
Oswego 12132 $38.26 61% $147.41 38
Otsego 4253 $40.09 70% $151.40 36
Putnam 5149 $48.16 48% $215.69 35
Queens 187042 $30.89 28% $301.56 55
Rensselaer 15779 $41.63 64% $178.30 54
Richmond 37077 $32.52 36% $285.59 41
Rockland 14146 $44.03 41% $223.19 44
Saratoga 25123 $40.12 59% $178.30 56
Schenectady 17152 $40.86 59% $178.30 55
Schoharie 2654 $44.24 63% $154.46 36
Schuyler 2301 $38.50 67% $138.89 35
Seneca 3875 $52.50 67% $208.10 29
St. Lawrence 7681 $38.55 62% $140.45 31
Steuben 10864 $33.50 67% $153.85 35
Suffolk 65756 $60.25 40% $263.04 26
Sullivan 4114 $46.36 52% $223.23 39
Tioga 5456 $38.40 70% $133.33 44
Tompkins 5506 $42.81 70% $126.05 27
Ulster 12412 $51.13 46% $207.68 33
Warren 8597 $42.56 63% $180.83 52
Washington 7258 $42.56 63% $180.83 52
Wayne 13790 $53.30 71% $207.73 30
Westchester 54302 $49.42 35% $235.00 42
Wyoming 5222 $52.34 78% $163.79 43
Yates 3450 $45.25 71% $211.20 34

NY Medicare Advantage plans by plan type

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 2021 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.

 

1 MedicareAdvantage.com's The Best States for Medicare in 2021 report. (Oct. 27, 2020).

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