People living in New York have various options for Medicare coverage, including Original Medicare, Medicare Advantage (Part C), and Medicare Part D.
Medicare in New York follows all federal guidelines for healthcare coverage for those who are over 65 years old or who have qualifying disabilities or medical conditions.
However, coverage specifications, plans, and additional benefits may vary. It is important to review all the options that are available in New York.
Medicare snapshot in New York
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in New York for the 2026 plan year:
- 37.82% of people with a stand-alone Part D plan get Extra Help.
- A total of 3,970,385 residents of New York were enrolled in Medicare.
- The average monthly Medicare Advantage plan premium changed from $39.59 in 2025
- to $40.49 in 2026
- There are 218 Medicare Advantage plans available in New York for 2026, compared with 241 plans in 2025.
- All New York residents with Medicare have access to buy a Medicare Advantage plan with a $0 premium.
- For 2026, 10 stand-alone Medicare Part D plans are available in New York.
- As in most states, 10 different Medigap plans are offered in New York for 2026.
In New York,as in other states, Medicare includes several types of coverage:
- Original Medicare: This plan is managed by the federal government and includes Part A (hospital insurance) and Part B (medical insurance). It doesn’t include prescription drug coverage.
- Medicare Advantage (Part C): These plans are offered by private insurers and include all Original Medicare benefits along with other perks such as vision, dental, and drug coverage. Some plans have limited provider networks, so beneficiaries should confirm their doctors are in-network before enrolling.
- Medicare Part D: This is a private, stand-alone plan for prescription drug coverage. People can pair Part D with Original Medicare or with a Part C plan that doesn’t include drug benefits.
- Medigap (Medicare supplement insurance): These are private plans that help pay for out-of-pocket costs of Original Medicare, such as copays and coinsurance. Medigap cannot be used with Medicare Advantage. A person can choose among 10 standardized plans.
Availability for private plans varies by county, and beneficiaries can check Medicare.gov for local options.
New York residents can qualify for Medicare at age 65 if they’re U.S. citizens or legal residents for at least 5 years. People under 65 years may also qualify through disability or by living with end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).
When choosing a plan, a person may consider provider networks, costs, and quality ratings. A person has the option to join a plan or modify their coverage during one of the following enrollment periods:
- Initial enrollment: Enroll 3 months before to 3 months after the month of their 65th birthday.
- Open enrollment: Join or change plans from October 15 to December 7.
- Medicare Advantage open enrollment: Switch Medicare Advantage plans or return to Original Medicare from January 1 to March 31.
- Special enrollment period: Enroll after a qualifying life change, such as losing job-based coverage.
A person eligible for Medicare due to a disability will be automatically enrolled. If they are eligible based on age, they will need to enroll.
Keep in mind that if you delay enrolling in Medicare Part B or Part D without having other qualifying coverage, you may have to pay a late enrollment penalty, which will increase your monthly premium for as long as you have Medicare.
There are various factors people may want to consider when choosing a Medicare plan.
- Out-of-pocket costs: Monthly premiums are not the only costs to consider when choosing Medicare plans. Individuals are also responsible for copayments, coinsurance, and deductibles.
- Doctor choice: Many Medicare plans have a network of doctors and other providers. It may be a good idea to check if an individual’s current doctors are in the plan’s network.
- Services covered: All Medicare plans must cover Part A and Part B. However, people may want to consider additional benefits that may be important to them.
- Healthcare needs: If an individual has specific conditions, such as diabetes or HIV, they may wish to look into special needs plans, which are specially tailored to individual needs.
To learn more about Medicare and Medicare Advantage plans, coverage, and eligibility, individuals can contact the following:
- Social Security Administration: Individuals can contact 800-772-1213 between 8:00 a.m. and 7:00 p.m. local time, Monday through Friday. People who are deaf or hard of hearing can contact the TTY number, 800-325-0778.
- New York State Health Insurance Information Counseling and Assistance Program: Individuals can contact 800-701-0501 between 8:30 a.m. and 5:00 p.m. local time, Monday through Friday.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Various options are available for Medicare in New York. These include Original Medicare and Medicare Advantage plans.
Individuals can also choose to purchase Part D and Medigap plans.
It is important to consider individual healthcare needs, what doctors are in the plan network, and out-of-pocket costs when choosing a Medicare plan.