In 2015, more than 3.3 million residents of New York received Medicare coverage in one form or another, according to the Centers for Medicare & Medicaid Services (CMS). As a Medicare beneficiary, you have a number of Medicare coverage options available to you in New York. You will want to consider the types of coverage described below.
Original Medicare is the government-run health insurance program for eligible American citizens and legal permanent residents of at least five continuous years. You're generally eligible when you are age 65 and older, although some beneficiaries under 65 may also qualify by disability or through having certain health conditions, such as Lou Gehrig's disease or end-stage renal disease.
In New York, as in the rest of the country, Original Medicare includes Part A and Part B.
Medicare Part A (hospital insurance): Covers inpatient hospital, skilled nursing facility, some home health visits, and hospice care.
Medicare Part B (medical insurance): Covers outpatient services, including doctor visits, some home health care, preventive services, and durable medical equipment.
If you're a New York beneficiary enrolled in Original Medicare, you may have noticed that you're not covered for all costs. For example, prescription drug coverage in Original Medicare is limited to medications you get during covered inpatient hospital or skilled nursing facility stays or medications you get in certain outpatient settings. However, for most other coverage, you'll need to sign up for a stand-alone Medicare Prescription Drug Plan.
Original Medicare doesn't cover costs like routine vision or dental care, hearing, long-term care, or health coverage outside of the country.
As mentioned, Medicare Part D Prescription Drug Plans (PDP) can provide stand-alone prescription drug coverage that works alongside your Original Medicare coverage. You'll typically have a separate premium for this coverage, which you'll pay directly to your Medicare Prescription Drug Plan; this is in addition to the Medicare Part B premium, which you'll need to keep paying. These plans are offered through private insurance companies approved by Medicare and doing business in New York.
Medigap (Medicare Supplement) plans are also offered by private insurance companies and can help you pay your out-of-pocket costs for services covered under Original Medicare.
What is Medigap in New York?
Senior Supplement Plans help fill in the financial gaps where Medicare leaves off.In most cases Medicare pays about eighty percent of your medical expenses leaving you a gap, a MEDIGAP. A Medigap Plan focuses on out of pocket exspenses such as copayments, coinsurance, and deductibles of Medicare Part A and B! Medicare has several parts for coverage. Part A, Part B, Part C, And Part D. and the Medigap Plans. Once an individual turns 65 they may qualify for certain Medicare benefits and services. Medigap Insurance can start as soon as Part B coverage is in place. Medicare Part A helps cover against catastrophic events, in patient care in hospital, skilled nursing facility, hospice, and home health care.
An average knee replacement, hip replacement or heart attack can cost you forty thousand dollars or more, in most cases leaving you with eight thousand dollars or more to pay. Medigap can help cover that risk for you. Medicare Part B helps cover doctors, and other health care provider services, hospital out patient care, durable medical equipment, and home health care. Also many preventive services to help maintain your health, and keep certain illnesses from getting worse. Part D medicare helps lower and cover your drug prescription costs. Lets not forget about Part C. Part C OR Medicare advantage health plan options run by medicare approved, private insurance companies, offer benefits and services covered in Part A, Part B, and usually Part D. Some of these ADVANTAGE plans may offer extra benefits for extra costs. And may offer maximum coverage with no need for additional supplement. But for those that do, get Maximum coverage with Medigap. Feel free to pause the video to view some basic Medigap plans in New York.
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