Guides for New Yorkers
Plain answers to Medicare, Social Security and insurance questions, with the New York specifics that national articles leave out. Written and kept current by one licensed agent, with the primary source cited under each guide. Unfamiliar word? The glossary defines it.
Pages and glossary terms; results appear as you type.
Medicare and Social Security
How to choose a Medicare plan in New York
A seven-question framework — doctors, drugs, budget, travel, health outlook, county, help you qualify for — and which route each answer points to.
Read the guide →9 min readMedicare Annual Enrollment Period 2026
October 15 – December 7. What you can change, what to read when the ANOC letter arrives, and a five-step review that takes an hour.
Read the guide →5 min readReading your 2027 Annual Notice of Change
The ANOC is due by September 30 and is easy to file unread. The six numbers to find, the two lists it won't show you, what's already known about 2027, and the calendar from here to December 7.
Read the guide →6 min readYour Medicare Advantage plan is being discontinued. Now what?
Non-renewal letters are due by October 2. What the letter means, your extended window to choose, the Medigap door it opens, and what happens if you do nothing.
Read the guide →6 min readMedicare Advantage vs Medigap in New York
The two ways to fill Original Medicare's gaps, compared line by line: what each costs in a normal year and a bad one, networks and prior authorization, travel, drugs, extras, and the New York rule that makes the choice reversible.
Read the guide →9 min readMedigap Plan G vs Plan N in New York
The two plans most New Yorkers choose between, what the premium gap buys, and why the answer is different here than in age-rated states.
Read the guide →5 min readMedicare while working past 65
The 20-employee rule, the HSA trap, why COBRA doesn't count, and the exact enrollment windows when you finally stop.
Read the guide →6 min readSwitching Medigap plans in New York
New York lets you change Medicare Supplement plans any month with no health questions. How it works, what the waiting-period rule really says, and when a switch is worth it.
Read the guide →8 min readEPIC explained: New York's prescription help for people 65+
Income up to $75,000 single or $100,000 married, copays of $3 to $20, and help with your Part D premium. Who qualifies, the Fee Plan vs the Deductible Plan, and how to apply.
Read the guide →8 min readIRMAA — the Medicare income surcharge
Why higher-income retirees pay more for Part B and Part D, the two-year lag that catches new retirees, and how to appeal it with form SSA-44.
Read the guide →5 min readMedicare and Medicaid together in NY: how dual-eligible plans work
If you have both Medicare and Medicaid, you have choices most people never explain: Original Medicare with Medicaid behind it, a D-SNP, or an integrated MAP plan. What each does and how to switch.
Read the guide →8 min readMedicare for Empire Plan (NYSHIP) retirees
The Empire Plan already coordinates with Medicare, reimburses your Part B premium and includes its own Part D. Why the plans advertised every October can break that, and what to do at 65.
Read the guide →7 min readMedicare and VA health care: do you need both?
VA care doesn't count for Part B but does for Part D. What that means for a Capital Region veteran at 65, when an Advantage plan adds something, and how TRICARE for Life is different.
Read the guide →6 min readMoving to New York on Medicare? What changes and what doesn't
Original Medicare travels with you; Advantage and Part D plans usually don't. The moving Special Enrollment Period, New York's Medigap rules, and the state programs nobody tells newcomers about.
Read the guide →7 min readYour Medigap premium went up. Here's what to do in New York.
Why New York Medigap rates rise for everyone at once, how far apart carriers are for the exact same plan, and the four moves that cut the bill without giving up coverage.
Read the guide →7 min readSpousal, survivor and ex-spouse benefits
Up to 50% of a spouse's benefit while both are alive, up to 100% after a death, and the same rights after a 10-year marriage ends. The rules, the reductions for claiming early, why the higher earner's claiming age matters most, and the 2025 repeal that changed things for public pensions.
Read the guide →9 min readNYS pension and Social Security: how the two fit together
For NYSLRS and other New York public retirees: why the pension doesn't reduce Social Security, what the 2025 WEP/GPO repeal changed, retiring at 55–63 with Social Security at 62–70, the earnings test, New York's tax exemptions, and the Medicare step at 65.
Read the guide →8 min readMedicare for snowbirds who winter out of state
Original Medicare and Medigap work across the U.S.; Medicare Advantage networks are local. The six-month rule, Part D pharmacies, changing your permanent address, and trips abroad.
Read the guide →10 min readFEHB and Medicare at 65
Whether to take Part B with FEHB, who pays first, the late-enrollment penalty, the drug coverage in your FEHB plan, and the Part B rule for postal retirees in PSHB.
Read the guide →8 min readMedicare Advantage denied a service or claim
The denial letter, the 65-day deadline for the first appeal, 72-hour fast appeals, the automatic second review, and the separate fast route when a plan ends a hospital or rehab stay.
Read the guide →11 min readObservation status versus inpatient
Overnight in a hospital bed can still be outpatient care. How that changes who pays, why observation days don't count toward the three days for rehab coverage, the MOON notice, and when you can appeal.
Read the guide →9 min readMedicaid at 65 and older in New York
What Medicaid adds on top of Medicare, how it differs from the Medicare Savings Program, where to apply in the Capital Region, the resource test and the spend-down program.
Read the guide →9 min readHelping a parent with Medicare
What you can do with your parent's permission, the Medicare form that lets you call for them, Social Security's payee rules, sitting in on an agent call, and spotting scams.
Read the guide →9 min readWhy stand-alone Part D premiums are changing for 2027
The federal demonstration that held stand-alone drug-plan premiums down in 2025 and 2026 ends this year. What it did, what else changes for 2027, how to check your own plan, and where to get help with the premium.
Read the guide →8 min readThe one-time $90 Part B premium payment
In October 2026 Medicare is sending a one-time $90 payment to offset the October Part B premium. Who gets it, how it arrives, how to check it, who doesn't qualify, and how to spot a scam built around it.
Read the guide →5 min readTurning 65 on the Essential Plan or a NY State of Health plan
The Essential Plan stops at 65 and a Marketplace plan loses its tax credit. How the switch to Medicare works in New York, what NY State of Health does, and what you have to do yourself.
Read the guide →7 min readFull retirement age: 62, 67 or 70?
What your full retirement age is by birth year, what claiming at 62 or waiting to 70 does to your check for life, how working before full age changes it, and why Medicare still starts at 65.
Read the guide →4 min readMedicare vs Medicaid: the difference
Medicare is health insurance you earn by age or disability; Medicaid is help based on income and assets. What each covers, who qualifies in New York, and what happens when you have both.
Read the guide →4 min readMedicare Parts A, B, C and D, explained
What each part of Medicare covers, what it costs, how the parts fit together, the two routes (Original Medicare or Medicare Advantage), and where Medigap fits.
Read the guide →4 min readMedicare with a green card
Who can get Medicare as a permanent resident, why it's five years of living here, why Part A may not be free, and why years worked abroad don't count.
Read the guide →4 min readMedicare and a younger spouse
Medicare covers one person, not a household. What the spouse under 65 can do when the job coverage ends: COBRA, a NY State of Health plan, the Essential Plan, and the timing.
Read the guide →4 min readMedicare numbers change every January
Premiums, deductibles, income thresholds and plan line-ups reset each year. Where a figure matters, these guides say which year it applies to and link to the official source. If something looks out of date, tell me and I'll fix it.
What Medicare covers, and what it doesn't
Short, sourced answers to the questions that start "Does Medicare cover…", with the New York and Capital Region specifics.
Does Medicare cover hearing aids?
Original Medicare pays for the hearing test your doctor orders, not for the hearing aids. What Part B does cover, what Advantage plans add, and the over-the-counter option that changed the math.
Read the answer →6 min read Does Medicare cover…Does Medicare cover dental?
Original Medicare pays for almost no dental care. The narrow exceptions, what Advantage plans add and how to read a 'dental allowance', and when a stand-alone dental plan is the honest answer.
Read the answer →6 min read Does Medicare cover…Does Medicare cover the shingles vaccine?
Shingrix costs nothing under any Medicare drug plan since 2023. Why it's Part D and not Part B, where to get it so it's actually free, and the trap for people without a drug plan.
Read the answer →3 min read Does Medicare cover…Does Medicare cover Ozempic or Wegovy?
Ozempic for diabetes, yes through Part D. For weight loss alone, Medicare drug plans can't pay by law, but since July 1, 2026 the Medicare GLP-1 Bridge offers Wegovy, Zepbound and Foundayo for $50 a month to people who qualify. What's covered, for whom, and how it works.
Read the answer →7 min read Does Medicare cover…Does Medicare cover cataract surgery?
Yes: Part B pays 80% of cataract surgery with a standard lens, plus one pair of glasses afterward. What you pay, what premium lenses cost extra, and how Medigap and Advantage change the bill.
Read the answer →5 min read Does Medicare cover…Does Medicare cover eye exams and glasses?
Routine eye exams and glasses, no. Eye disease, yes: a yearly diabetic eye exam, glaucoma tests for people at high risk, macular degeneration care, and one pair of glasses after cataract surgery.
Read the answer →5 min read Does Medicare cover…Does Medicare cover chiropractic?
Part B pays for one thing at the chiropractor: manual spinal manipulation to correct a subluxation. Not X-rays, not massage, not maintenance. What that means for your bill, and where Advantage plans add more.
Read the answer →3 min read Does Medicare cover…Does Medicare cover home health care?
Yes for skilled care at home if you're homebound; no for a home aide, meals or 24-hour help. The four conditions, what it costs ($0 for the services), and the line between home health and long-term care.
Read the answer →4 min read Does Medicare cover…Does Medicare cover nursing home care?
Short-term skilled care after a hospital stay, yes, up to 100 days. Long-term custodial care, no. The three-day rule, the observation-status trap, the 2026 daily costs, and who pays after that.
Read the answer →8 min read Does Medicare cover…Does Medicare cover physical therapy?
Yes: Part B pays 80% of medically necessary physical therapy with no yearly cap since 2018. What the $2,480 threshold really means, what Advantage plans change, and the Medigap difference on a long course of therapy.
Read the answer →4 min readPrograms that pay Medicare's costs have their own pages: Medicare Savings Program, Extra Help, EPIC.
Business insurance
Certificate of insurance: what your landlord or client is asking for
The one-page form behind every lease, client contract and vendor onboarding: what it proves, what it doesn't, the New York-specific forms for workers' comp and disability, and how to get one issued today.
Read the guide →9 min readHiring your first employee in New York: workers' comp, DBL and PFL
Workers' comp from the first day of payroll, DBL and Paid Family Leave a few weeks later: what each costs, the contractor trap, and the penalties for getting it wrong.
Read the guide →6 min readRestaurant insurance checklist before you open in New York
What the lease requires, what the law requires, and what a kitchen fire or a drunk-driving lawsuit actually costs. The policies to have in place before the first service, in order.
Read the guide →6 min readYour first job for a general contractor: the insurance they'll ask for
The certificate, the additional insured endorsements, the workers' comp forms and the Scaffold Law exclusion that will get your policy rejected. What the GC's insurance requirements mean, line by line.
Read the guide →7 min readJust formed an LLC: do you actually need insurance?
What the LLC protects and what it doesn't, the two coverages New York requires the moment you hire, the ones your lease or clients will demand, and a sensible first-year program for a one-person business.
Read the guide →6 min readCoverage-by-coverage detail is on the business insurance pages.
Auto, home and the bad day
Your home insurance was non-renewed. Why, and what to do now
What the notice has to say under New York law, the reasons carriers actually give in 2026 (roof age, aerial imagery, claims, carrier retreat), the 45-day clock, and the order to work in: fix, shop standard, shop specialty, NYPIUA.
Read the guide →6 min readRoof age and aerial imagery: why your homeowners renewal changed
Carriers now check your roof from the air and against a maximum age. What they see, what they do with it (surcharge, ACV roof settlement, conditional renewal, non-renewal), and what to do 90 days before renewal.
Read the guide →4 min readWhy did my insurance go up when I haven't had a claim?
The four things that move a New York premium that have nothing to do with you, the two that do, what an insurer can and can't surcharge you for, and the 20-minute check that tells you whether to stay or re-shop.
Read the guide →5 min readThe first hour after a car accident or a house fire
A printable, phone-saveable checklist: what to do at the scene, what to photograph, what to say and not say, and the three New York deadlines (police, DMV form, no-fault) that start the moment it happens.
Read the guide →5 min readDriving for Uber, Lyft or DoorDash? Your policy has a gap
A personal auto policy can stop covering you the moment you log into the app. What New York's rideshare law makes the platform carry in each period, why delivery driving is worse, and the endorsement that closes the gap for a few dollars a month.
Read the guide →6 min readWhen do I have to add my teenager to my policy?
The permit stage is usually free; the license is when the bill arrives. New York's junior-license rules, the household-member rule that decides when a teen must be listed, what actually moves the premium, and the six discounts and choices that bring it down.
Read the guide →6 min readWhat car and home insurance cost around Albany
Published 2026 averages for Albany car and home insurance, with the driver and house each figure assumes, why two reputable surveys are 20% apart, what moves your quote away from the average, and the honest use of a number like this.
Read the guide →7 min readRenters insurance in Schenectady: what it covers and what it doesn't
What a renters (HO-4) policy pays for, why replacement cost beats actual cash value, the gaps in an older Schenectady building (flood, sewer backup, a roommate's things), what a landlord means by 'interested party', and bundling with auto.
Read the guide →9 min readInsuring a two- to four-family house in Albany or Troy
Owner-occupied homeowners form or a landlord (dwelling) policy, DP-1 against DP-3, loss of rents, liability for tenants and their guests, lead paint and New York's Lead Rental Registry, code upgrades on older houses, and an umbrella on top.
Read the guide →10 min readTwo tools go with these: the coverage gap check and should I file this claim?
We do not offer every plan available in your area. Currently we represent 10 organizations which offer 81 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (TTY 1-877-486-2048) is available 24 hours a day, 7 days a week.
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