Life, health & Medicare
Medicare Supplement and Advantage
New York is one of only two states where you can buy a Medicare Supplement policy at any time of year with no health questions, at a price that does not rise because you had a birthday. Almost every urgent Medicare pitch you will hear is describing a deadline that does not exist here.
Original Medicare — Part A for hospital care and Part B for medical care — leaves you with deductibles, coinsurance and no annual out-of-pocket cap. Two different routes cover that gap. A Medicare Supplement policy, called Medigap, sits alongside Original Medicare and pays the cost-sharing. A Medicare Advantage plan replaces Original Medicare with a private plan, usually with a network and often including drug cover.
Which is better depends entirely on you, and anybody who tells you one is simply better is selling. What is not a matter of opinion is the New York rule that makes this state different, and it is the reason this page opens the way it does.
The New York rule, and the deadline that does not exist
New York requires Medigap carriers to accept any Medicare enrollee at any time of year, with no health questions, no medical underwriting and no refusal for pre-existing conditions. It also requires community rating: every applicant pays the same premium for a given plan from a given carrier, regardless of age or health. A sixty-five-year-old and an eighty-two-year-old pay the same for the same Plan G.
Almost everywhere else, you get one six-month guaranteed-issue window when you first enrol in Part B, and after it carriers can underwrite you and decline. That is where the entire urgency industry around Medigap comes from — and it does not apply in New York.
The consequence: nobody can lose eligibility here, your Medigap premium will not rise because you aged, and there is no window closing on you. If somebody is pressing you to decide today about a Medigap plan in New York, they are creating urgency rather than reporting it. New York premiums are among the highest in the country, which is the honest trade-off for those protections.
Medigap against Advantage, honestly
Medigap keeps Original Medicare, so any provider in the country accepting Medicare accepts you. There is no network, no referral, and no prior authorisation. You pay a monthly premium on top of your Part B premium, and you buy a separate Part D drug plan. Costs are predictable and higher.
Advantage plans frequently have low or zero additional premium and bundle drug cover, and often add dental, vision and hearing benefits that Original Medicare does not provide. In exchange there is a network, referrals and prior authorisation may apply, and you have an annual out-of-pocket maximum rather than predictable monthly costs.
The pattern that fits most people: if you travel, spend part of the year elsewhere, have complex care or specific specialists you intend to keep, Medigap's freedom is worth its premium. If your care is local and routine and budget matters more than flexibility, Advantage is a reasonable choice. There is no universally correct answer.
One asymmetry to know: switching from Medigap to Advantage is easy anywhere. Switching back is only easy where Medigap is guaranteed issue — which in New York it is. That protection makes trying Advantage far less risky here than in most states, and it is worth knowing before you decide.
Enrolment periods that DO exist
None of the above applies to Advantage and Part D, which have real annual periods. The Annual Enrollment Period runs from 15 October to 7 December for changes effective 1 January, and the Medicare Advantage Open Enrollment Period runs from 1 January to 31 March for people already in an Advantage plan.
There are also real, time-limited penalties: a Part B late enrolment penalty and a Part D late enrolment penalty, both of which are permanent surcharges on your premium for as long as you have the cover. Those deadlines are genuine and we will tell you about them clearly, which is precisely why we are careful not to invent ones that are not.
What we do and do not do here
We compare the Medigap plans available to you, and we will tell you plainly that a given lettered plan is standardised — Plan G from one carrier covers exactly what Plan G from another covers, so between two Plan G policies the only real differences are price and service. That fact alone saves people a great deal of money and it is not widely known.
We will not tell you which doctor to see, we will not advise on your treatment, and we will not pretend to know how a specific plan will handle a specific claim. For a plan's coverage of a particular drug or provider, we will check the formulary and directory with you rather than guessing, and for anything that is genuinely a benefits-counselling question we will point you to the state's free HIICAP programme, which costs you nothing and takes no commission.
In New York there is no Medigap deadline. Nobody loses their Medicare Supplement eligibility in New York, which makes most of the urgency you will hear about it false. New York community-rates Medigap and requires guaranteed issue all year round: no health questions, no medical underwriting, and the same premium for a sixty-five-year-old and an eighty-two-year-old on the same plan from the same carrier. Premiums here are among the highest in the country and they do not rise because you had a birthday. There is no window closing, so anybody telling you to decide today is selling rather than advising.
Included as standard
How we handle this line
The no-deadline fact, said first
Because it removes the pressure the rest of this market runs on, and it is the truest thing we can tell you.
Standardised plans explained
Plan G is Plan G whoever writes it. Between two identical plans, price and service are the only differences that exist.
Medigap and Advantage compared honestly
Including the cases where Advantage is the better answer, which are real and which we will not talk you out of.
Real deadlines flagged clearly
Part B and Part D late enrolment penalties are permanent, and the Advantage enrolment periods are genuine. Those we will chase you about.
Formulary and network checked
Your actual drugs and your actual doctors, looked up rather than assumed, before you choose anything.
HIICAP mentioned every time
New York's free Medicare counselling programme. It costs you nothing and pays us nothing, and we will still point you at it.
When to ring us
Signs this is worth a conversation
- You are approaching sixty-five and are being pressed to decide quickly.
- You have been told your New York Medigap premium will rise as you age.
- You are paying more than somebody else for the same lettered plan from a different carrier.
- You are in an Advantage plan and your specialist has left the network.
- You delayed Part B or Part D and nobody explained the penalty.
- You travel or spend part of the year outside New York.
Medicare — what it typically costs
- Typical monthly Medigap premium in New York. Community rating means this figure does not rise as you age, and it is identical for every applicant on a given plan and carrier.$220 – $420
This is a typical premium range for this area. It is not a quote, and it is not our price. We do not set premiums: a carrier files its rates with the Department of Financial Services and our commission is already inside the filed rate, so the same policy from the same carrier costs the same through any producer in New York. What genuinely moves your own number is which carrier writes it, the limits and deductibles you choose, and the facts on your record — which is what we would go through with you before anything is quoted.
Questions we are actually asked
Medicare — frequently asked
Is there a deadline to buy Medicare Supplement in New York?
No. New York requires guaranteed issue all year round with no health questions and no medical underwriting, and community-rates the premiums so they do not rise with age. Anybody creating urgency about a Medigap decision in New York is describing a rule that applies in other states and not here.
Will my Medigap premium go up as I get older?
Not because of your age. New York community-rates Medicare Supplement, so everybody pays the same for a given plan from a given carrier regardless of age or health. Premiums can still rise for a whole class as costs increase, but not because you had a birthday.
Should I choose Medigap or Medicare Advantage?
It depends on how you use care. Medigap gives freedom — any Medicare provider, no networks or prior authorisation — for a higher predictable premium. Advantage costs less monthly, bundles drug cover and often adds dental and vision, in exchange for networks and authorisation. In New York, trying Advantage is less risky than elsewhere because you can return to Medigap without underwriting.
Is Plan G from one company better than another?
No, in coverage terms. The lettered plans are standardised by law, so Plan G covers exactly the same things whoever issues it. The only real differences between two Plan G policies are the premium and the service, which makes it one of the easier comparisons anybody will ever ask us to make.
Related cover
Usually considered alongside this
Group benefits
Small-group health, dental and the New York statutory disability and paid family leave cover that is not optional.
$650 – $1,400
Final expense
A small whole life policy sold hard to people who are frightened. We sell it, and we will show you the arithmetic first.
$40 – $180
Life insurance
How much, for how long, and the arithmetic that answers both — done before anybody shows you a product.
$220 – $900
Policy review
An hour with your actual declarations pages, looking for the three gaps that open quietly between renewals.
No chargeBring the declarations page and we will read it with you
Ask us what it would cost
Send or bring the summary pages of what you already have — those two sheets are where most of the useful conversation is. We will tell you what we would place it with and what that would cost, what we are paid for doing it, and whether you should move at all. Quite often the answer is that your current policy is priced fairly and you should keep it, and that is an answer we give in writing like any other.