Medicare Supplement Plan Eligibility – NY

Medicare Supplement plans in New York provide the same coverage nationwide. Eligibility rules for New Yorkers, however, are more favorable than in many other states.

Year round open enrollment in new york

Unlike in many other states where the Open Enrollment Period is restricted to the time when you become eligible for Part B, in New York you can apply for a Medicare Supplement plan at any time.

GUARANTEED APPROVAL

Unlike other states where approval for a Medicare Supplement plan is based on answers to health questions, there is no underwriting of health conditions for New Yorkers. The insurance companies cannot deny an application or charge a higher premium due to health status or claims experience.

COVERAGE FOR PRE-EXISTING CONDITIONS

Nationwide, Medicare Supplement plans may contain up to a six (6) month waiting period before pre-existing conditions are covered. Under New York regulation, that waiting period may be reduced or waived. That is because in New York the waiting period is reduced by the number of days that you were covered under some form of “creditable” coverage so long as there were no breaks in coverage of more than 63 calendar days.

EXCESS CHARGES

Nationwide, providers are permitted to “balance bill” Medicare beneficiaries up to 15% of the Medicare approved amount, known as an excess charge. New York State law limits the amount that Medicare non-participating physicians may charge. Non- participating physicians cannot charge beneficiaries more than 5% over the Medicare approved amount for most services.

Our New York clients have most frequently enrolled in one of the following plans:

Plan F Highest premium. You pay $0 deductible / 0% co-share. (Available only to individuals eligible for Medicare before January 1, 2020) 
Plan G Lower premium. You pay the Part B deductible.
Plan N An even lower premium. You pay the Part B deductible and an office visit copay.
High Deductible Lowest premium. You pay the Parts A and B deductible and 20% co-share up to a defined amount $2700 (2023). Afterwards, 100% coverage with 0% co-share.

♦ This New York State website is updated monthly with Medicare Supplement plan information. Just click here and enter your zip code for an updated schedule of premiums by Plan Code and insurance company in your county.

Please complete and submit the form below to contact one of our local New York State agent advisors. You will see a confirmation page while your agent advisor is being notified to contact you by telephone or email.

Thank you,

Daniel G. Alcorn  Founder / General Agent

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