Medicare in New York serves about 3.6 million beneficiaries, with 49% enrolled in Medicare Advantage and the remainder on Original Medicare + Medigap. Average Medigap Plan G premium for a new 65-year-old enrollee: $205/mo. Stand-alone Part D plans average $47/mo.
Medicare Beneficiaries
3.6 million
Age 65+ and disabled
MA Enrollment
49%
% on Medicare Advantage
Avg Medigap Plan G
$205/mo
New enrollee, age 65
| Topic | Detail | Notes |
|---|---|---|
| Medicare Advantage plans available | 100+ | Varies by county; check medicare.gov plan finder |
| Top MA carriers | UnitedHealthcare, Aetna/CVS, EmblemHealth | Networks differ by county |
| Stand-alone Part D | $47/mo | Required if you have Original Medicare + Medigap |
| Annual guaranteed-issue Medigap switching | Yes — state protection applies | New York has community-rated Medigap with continuous open enrollment — no medical underwriting ever. Additionally, disabled beneficiaries under 65 have the same Medigap access rights as those 65+, a unique New York protection. |
Medigap premiums vary by carrier, age, and ZIP code. The 2026 Part B premium is $202.90/month and Part B deductible is $283. Part D out-of-pocket cap is $2,100 in 2026.
New York is one of just three states with full community rating and continuous open enrollment for Medigap — meaning New Yorkers can switch Medigap plans at any time with no health questions, and everyone in the same geographic rating area pays the same premium regardless of age or health history. This produces the highest Medigap premiums in the nation (averaging over $200/month for Plan G) but provides unparalleled consumer protection. New York City's Medicare market is one of the largest and most complex in the world — NYC alone has over 1.5 million beneficiaries. EmblemHealth (HIP/GHI), UnitedHealthcare, and Aetna are major NYC MA carriers. NewYork-Presbyterian, NYU Langone Health, Mount Sinai Health System, and Montefiore Health System are the major hospital networks.
New York's community rating also applies to disabled Medicare beneficiaries under 65, meaning a 55-year-old on Medicare disability has the same guaranteed-issue Medigap rights as a 65-year-old — a protection not available in most states. Upstate New York (Buffalo, Rochester, Syracuse, Albany) has its own well-developed MA markets, anchored by regional carriers like Independent Health and CDPHP (Capital District Physicians Health Plan). IRMAA is a significant cost factor for New York City's many high-income retirees and executive professionals in Manhattan, Westchester, and Long Island's Nassau and Suffolk counties. New York's Medicaid program (Medicaid Managed Care) interacts with Medicare in complex ways for dual-eligible beneficiaries.
In New York, traditional Medicare combined with a Medigap supplement (typically Plan G or N) plus a stand-alone Part D plan provides nationwide access with predictable costs. Plan G covers everything except the $283 Part B deductible.
Medicare Advantage (Part C) plans bundle Medicare Parts A, B, and usually D into one private plan, often with $0 premium beyond Part B. Trade-offs include network restrictions and prior authorization. 49% of New York beneficiaries currently choose MA.
New York has community-rated Medigap with continuous open enrollment — no medical underwriting ever. Additionally, disabled beneficiaries under 65 have the same Medigap access rights as those 65+, a unique New York protection.
💡 New York Pro Tip
New York City beneficiaries typically have access to 100 or more Medicare Advantage plans — one of the largest selections in the country. The Buffalo, Rochester, and Albany metro areas offer 40 to 60 options. Even smaller upstate cities like Binghamton and Utica generally have 20 to 30 plans available.
Medigap Plan G premiums in New York average approximately $205 per month for a 65-year-old, making it one of the highest-cost states. However, New York's community rating means everyone pays the same premium regardless of health status, which is enormously valuable for beneficiaries with pre-existing conditions who would face denial or much higher rates elsewhere.
Yes — New York's community rating law and continuous open enrollment mean you can switch Medigap plans at any time of year with absolutely no medical underwriting required. This applies permanently, not just at age 65, and even covers disabled Medicare beneficiaries under 65. New York's Medigap switching protections are among the strongest in the nation.
Beneficiary counts and MA enrollment percentages from CMS state-level Medicare data; premium averages from 2026 carrier rate filings for New York. Verify current plan costs at medicare.gov before enrolling.
Jennifer Walsh
Editorial Lead, Health & Medicare
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed May 2026
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