Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – September 24, 2022
Reviewed by Dr. Brindusa Vanta, MD

Medicare is a federal government program that makes medical care more affordable for people over 65, younger individuals with disabilities and people dealing with end-stage kidney disease. As of 2022, 63.8 million Americans have enrolled Medicare, 3,703,618 of whom live in New York, which is less than 20% of the state’s residents. Following the national trend, New York’s Medicare Advantage enrollment is increasing and, as of late 2021, accounts for almost 47% of the state’s Medicare beneficiaries. 

Federally managed Original Medicare comprises Parts A, B and D, with each designed to cover different needs. Part A covers expenses for nursing home and hospital stays, hospice care and some aspects of home health care. Premiums are often zero as most beneficiaries paid into the Medicare system for at least 10 of their working years or they currently receive Social Security. As of 2022, Part B premiums are $170.10 per month, providing coverage for an array of medical services, such as preventative care and medical supplies. Part D covers prescription drug costs and enrollees can include it in either Original Medicare or Medicare Advantage plans.

The Centers for Medicare & Medicaid Services (CMS)-approved private insurance companies administer Medicare Advantage, also known as Part C. It offers all of the coverage Parts A and B provide (minus hospice care, which Part A always covers), in addition to covering areas that Original Medicare doesn’t, such as prescription drugs, dental and vision care. There’s also Medigap, a private Medicare supplemental insurance program for costs Medicare doesn’t cover, such as copays, coinsurance and deductibles.

This guide extensively covers Medicare in New York and includes options for personalizing Medicare plans. It also lists several organizations that can help New Yorkers navigate the sometimes confusing amount of information and choice available.

Options for Medicare Coverage in New York

Each person has their own health care needs, so despite offering extensive coverage, Original Medicare is unlikely to satisfy everyone. Happily, private insurance companies provide New Yorkers with other options that enable them to build Medicare plans that cover the costs they anticipate and add to their peace of mind. 

Original Medicare (Parts A & B)

Original Medicare is administered by the Centers for Medicare & Medicaid Services (CMS) and is open to seniors aged 65 and over, along with those under 65 years old, but with certain disabilities or end-stage kidney disease. It includes two parts. Part A covers inpatient hospital care, nursing home and skilled nursing care, hospice and home health care. Part B, or medical coverage, pays for medically necessary goods and services such as durable medical equipment, mental health services and emergency medical transportation. 

Unlike most private Medicare plans, Original Medicare’s provider network isn’t limited to the beneficiary’s geographic region, making it easier to obtain services while traveling within the country. In most cases, Medicare doesn’t pay for health services the individual receives outside the United States. 

Under this program, seniors pay for services as they receive them. They must pay an annual deductible, which is $1,556 for Part A and $233 for Part B in 2022. After they’ve paid this amount, Medicare covers all eligible services at 80%. Beneficiaries pay the remaining 20% out of pocket.

Who Should Consider Original Medicare

Original Medicare may be a good option for those who:

  • Travel frequently within the United States
  • Don’t need extra benefits such as home-delivered meals and coverage for over-the-counter medication
  • Want to choose their own prescription drug coverage

Medicare Advantage (Part C)

Medicare Advantage, also known as Part C, delivers all the coverage provided by Parts A and B (minus hospice care, which Part A covers). Unlike the federally-administered Original Medicare, CMS-approved private health insurance companies manage it, and they can determine their own fees and deductibles, as well as offer additional benefits, such as vision, hearing and dental care. Some plans also include gym memberships and many cover prescription drug costs.

All insurers must offer $0 premiums, but New York’s 2022 average is $30.20 per month due to enrollees getting extra coverage. At the beginning of 2022, there were 280 Medicare Advantage plans, an increase of five from the previous year and adding to the increasing amount of choice Part C offers. 

Who Should Consider Medicare Advantage

Medicare Advantage may satisfy the needs of those who:

  • Are generally healthy, so may benefit from lower premiums
  • Are comfortable with the provider choosing their health care professionals
  • Want more coverage, such as dental care and prescription drugs
  • Are looking to control their out-of-pocket expenses

The Top 10 Medicare Advantage Plans

With so many Medicare Advantage plans to choose from, New Yorkers may struggle to identify the ones most suited to their needs. Using enrollee figures as the benchmark, the following list comprises the state’s top 10 plans as of April 2022. It also lists the types of care plans and their costs. An additional resource for Medicare Part C plans can be found on the Medicare Advantage Plans in New York page.


Total Enrollment

Star Rating

Min Cost

Max Cost

Plan Types







Healthfirst Medicare Plan






Aetna Medicare






Excellus Health Plan, Inc


















EmblemHealth Medicare HMO






Empire BlueCross BlueShield






Highmark Blue Cross Blue Shield of Western New Yo






Independent Health






Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t pay for most prescription drugs through Part A or B coverage. Instead, seniors purchase separate prescription drug policies, also called Part D coverage. Medicare contracts with private health insurance companies to provide this coverage. There are multiple plans to choose from with varying monthly premiums, which beneficiaries pay in addition to their Original Medicare premiums. While seniors don’t have to purchase prescription drug coverage when they’re first eligible for Medicare, not obtaining this coverage at this time may result in late enrollment penalties they pay for as long as they have Medicare if they enroll later.

Each prescription drug plan has its own formulary, or list of covered drugs. Formularies are typically split up into tiers. The tier a medication is in determines how much the insurance company pays and how much the beneficiary pays for it. Lower-level tiers are usually made up of generic and low-cost brand name drugs, while higher tiers are composed of more expensive brand name and specialty drugs. In most cases, the lower the tier, the lower the policyholder’s cost-sharing responsibility.

Who Should Consider Medicare Prescription Drug Coverage

Seniors who may benefit from prescription drug coverage include those who:

  • Currently take prescription medication or expect to in the future
  • Want to avoid late enrollment penalties
  • Want to reduce out-of-pocket prescription drug expenses

Medicare Supplement Insurance (Medigap)

While Original Medicare provides coverage for many medical costs, seniors may still have significant out-of-pocket expenses. These may include copays, coinsurance and deductibles. Seniors may be able to reduce their cost-sharing obligations by purchasing a Medigap plan. These plans can only be used with Original Medicare. It’s illegal for private insurance companies to sell Medigap plans to those with Medicare Advantage plans.

For more information on Medigap plans, seniors can refer to the Best Medicare Supplement Companies of 2022 page.

Who Should Consider Medicare Supplement Insurance

Good candidates for Medigap may be those who:

  • Have ongoing health issues and expenses
  • Travel overseas often
  • Want to access an expanded network of health care providers
  • Expect to need health services not covered by Original Medicare

Medicare Resources in New York

Some New York residents may find it difficult to steer their way through the wealth of information about the different Medicare plans. It can be challenging to find the right plan, but fortunately, many organizations can help residents compare plans and find the one that suits their needs and budgets. The following resources can help potential enrollees understand the advantages, disadvantages and costs of various plans and how to apply. Some can also provide legal assistance if Medicare denies their claim.

Health Insurance Information, Counseling and Assistance Program (HIICAP)

HIICAP counselors operate from multiple local offices for the aging across New York. Working free of charge, the counselors provide information, advice and support to residents looking for the right Medicare plans for their circumstances. They can discuss every program aspect, including Original Medicare, Medigap and prescription drug coverage. They also cover Medicare Advantage, but residents needn’t be concerned about being sold insurance as the counselors are impartial and solely focused on helping their clients. 

Contact Info

To find the nearest HIICAP counselor, residents should call the Office for the Aging helpline at (800) 701-0501 and enter their zip code at the prompt. The system will then route them to their location’s HIICAP representative.

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Legal Services NYC

Legal Services NYC is a nonprofit law firm dedicated to providing New York City’s low-income residents with free legal advice and representation. It’s the largest firm of its kind in the country and has extensive experience supporting Medicare beneficiaries and those denied health care. The firm has five main offices, one in each borough, staffed by lawyers and paralegals who can assist with a wide range of Medicare-related issues that seniors may need to resolve legally.

Contact Info

To apply for free legal assistance, residents should call the hotline for Legal Services NYC at (917) 661-4500. To discover more about the branch serving their borough, residents should visit the program’s page on the law firm’s website.

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Medicare Rights Center

The Medicare Rights Center is a national nonprofit that provides similar services to HIICAP, and since it’s independent of the federal government, it may be able to offer additional support. Its counselors offer local information and aid to residents who want to understand the various Medicare plans and aligned benefits. They can also guide residents step-by-step through the enrollment process, while the agency’s website can also educate visitors about the program through its interactive Medicare tool, which can be a useful source of information if a counselor is unavailable as it operates 24/7.

Contact Info

To get in touch with their nearest Medicare Rights Center, residents should call (800) 333-4114 or visit the agency’s New York page to find the closest office.

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Senior Medicare Patrol

The Senior Medicare Patrol aims to give seniors and other Medicare beneficiaries the skills to detect fraudulent activity linked to their accounts and teach them how to respond. Its counselors can keep beneficiaries up to date with the latest scams as well as educate them on the need for vigilance, particularly regarding billing errors and falsified Medicare claims made in their names.

Contact Info

New Yorkers can email the Senior Medicare Patrol at [email protected] to learn more about its services or register their concerns. Alternatively, they can call (800) 333-4374.

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Social Security Administration

The Social Security Administration is an agency independent of the federal government that administers Social Security Retirement benefits to eligible New Yorkers, and its recipients qualify automatically for Medicare. Its webpage is a useful source of information for residents who like to conduct their own research. It provides a significant amount of information to help residents decide which Medicare plans best suit their circumstances. There’s also content regarding Medicare card applications, as well as an explanation of what happens immediately after enrollment.

Contact Info

Seniors can use the Social Security Administration’s office locator to find their nearest branch or call (800) 772-1213 to speak to a representative.

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