Medigap in New York works differently — in your favor
In most states a Medicare Supplement can turn you down or charge you more once your first six months are over. Not in New York. Here's what that means, how the plans compare, and when a Supplement is the better answer.
A Medigap policy pays what Original Medicare leaves to you, works with any doctor who accepts Medicare, and has no network. New York is unusual: any Medicare beneficiary can buy any Medigap plan at any time with no health questions, and premiums are community rated, the same for everyone regardless of age. Most New Yorkers choose Plan G or Plan N.
What a Medicare Supplement does
Original Medicare pays most of the bill and leaves the rest to you: the Part A hospital deductible, the Part B deductible and 20% coinsurance. Because Original Medicare has no out-of-pocket cap, a bad year can cost a great deal more. A Medicare Supplement, or Medigap policy, is private insurance that pays those leftover amounts.
The plans are standardised by letter. A Plan G from one carrier covers exactly what a Plan G from another carrier covers; the only differences are premium and service. You keep Original Medicare and see any provider in the country who accepts Medicare. The Supplement adds no network, referral or prior-authorization rules of its own — Original Medicare's own coverage rules still apply.
Why New York is different
Three rules set New York apart from most of the country:
- Guaranteed issue, all year. Insurers must accept any Medicare beneficiary who applies, whenever they apply. There is no medical underwriting and no "open enrollment window" that closes on you.
- Community rating. Everyone on a plan pays the same premium regardless of age or health. An 82-year-old and a 65-year-old on the same Plan G with the same carrier pay the same amount.
- Continuous coverage on switching. You can move between carriers or plan letters any month without a health questionnaire, and a Medigap insurer will accept you when you return from Medicare Advantage to Original Medicare — though leaving the Advantage plan itself still has to happen in an enrollment period (AEP, the January–March Advantage open enrollment, or a Special Enrollment Period). One caveat: a waiting period of up to six months for pre-existing conditions can apply; prior creditable coverage reduces or removes it depending on how long and how continuous it was.
The practical consequence: in New York, a Medigap decision is never final. That changes the advice. Elsewhere, people are told to "buy Medigap at 65 or risk never qualifying." Here, you can start with Medicare Advantage while you're healthy and move to a Supplement later, during an enrollment period, if you want to. The reverse works too.
Community rating cuts both ways
Because premiums can't be lower for younger, healthier people, New York Medigap premiums at 65 are higher than in states that rate by age. The trade is predictability: no age-based increases waiting for you at 75 or 80. What that costs here, carrier by carrier, is on the Albany-region rate table; what each lettered plan covers, side by side, is on Medigap plans A to N compared.
The plans people actually buy
| Plan | What you still pay | Who it suits |
|---|---|---|
| Plan G | The Part B deductible once a year; after that, the Medicare-approved share is covered for Medicare-covered care (dental, vision, hearing and long-term care are outside Medicare and outside Medigap). | The default choice for most people new to Medicare who want near-zero bills. |
| Plan N | The Part B deductible, up to a small copay at office visits and at the ER, and any "excess charges" from doctors who don't accept Medicare's rate (New York caps these at 5% above the Medicare rate for most services). | People who want a meaningfully lower premium and don't mind small copays. |
| High-deductible G | Medicare still pays its share; you pay the Medicare cost-sharing until you've met the plan's yearly deductible, then the plan pays. | People comfortable self-insuring the first couple of thousand dollars for a much lower premium. |
| Plan F | Nothing. | Only available if you were eligible for Medicare before 2020. Usually not worth switching into now. |
| Plans A, B, K, L | Varies — less coverage than G or N. | Niche situations; I'll tell you if one applies. |
Medigap or Medicare Advantage?
This is the real question, and the answer is different for different households. Roughly:
- Choose Medigap if you want to see any doctor without checking a network, you have (or expect) an ongoing condition with regular specialist care, you travel or split the year between states, or you'd rather pay a known monthly amount than deal with bills and approvals.
- Choose Medicare Advantage if your doctors are in one local system, you're healthy and budget-focused, and you value bundled drug, dental and vision coverage more than provider freedom.
I'll show you the total yearly cost of each path for your actual situation — premium plus expected out-of-pocket — rather than the premium alone. More on Medicare Advantage.
Spending winters in Florida or the Carolinas
Plenty of Capital Region retirees spend a few months a year in Florida, the Carolinas or near family in another state. How your Medicare follows you depends on the path you pick:
- Original Medicare with a Medigap policy works the same in every state: any doctor or hospital in the U.S. that takes Medicare, with no network and no referrals. Your New York Medigap policy pays its share wherever Medicare pays. For most people who winter elsewhere, this is the simplest setup.
- A Medicare Advantage HMO covers emergency care and urgent care anywhere in the country, but routine care away from home, such as a checkup, a specialist visit or a scheduled scan, generally isn't covered outside its network.
- A Medicare Advantage PPO generally pays for out-of-network care for covered services, usually at a higher cost. Some plans also offer a visitor or travel benefit for routine care in certain other areas; that's plan by plan and worth checking every fall.
- The six-month rule. A Medicare Advantage plan must disenroll you if you're away from its service area for more than six months in a row, unless it offers a visitor/traveler benefit, which can let you stay enrolled for less than 12 months away. Original Medicare and Medigap have no such limit.
- Drug plans. Whichever path you take, check that your Part D plan has network pharmacies where you spend the winter, or that mail order works for you.
- Moving for good is different. You must live in a Medicare Advantage plan's service area to belong to it. If the other state becomes your permanent home, you get a Special Enrollment Period, starting the month you move (or the month before, if you tell your plan first) and lasting two full months after, to choose a plan there or return to Original Medicare. You can keep your Medigap policy wherever you live, as long as you stay on Original Medicare. New York programs such as EPIC require your permanent home to be in New York.
If you split the year between two states, tell me where and for how long; it changes which plans are worth looking at. The Advantage side is covered on Medicare Advantage in the Capital Region.
Getting quotes
Because plans are standardised, shopping Medigap is mostly about premium and the carrier's rate-increase history. I compare the carriers I'm appointed with in your ZIP code and show you the same plan letter side by side. If you already have a Supplement, a quick re-quote every year or two is worth doing — you can switch any month. Guides: what to do when your premium goes up, how to switch, Plan G vs Plan N, and moving to New York with an existing policy.
You'll also need a Part D plan for prescriptions; I compare those at the same time. And if money is tight, check whether you qualify for help before deciding anything.
- Protections for Medicare beneficiaries residing in New York (NY DFS) — community rating, year-round acceptance
- Compare Medigap plan benefits (medicare.gov) — foreign travel emergency at 80% on Plans C, D, F, G, M and N
- Illegal Medigap practices (medicare.gov) — no Medigap sale to someone in Medicare Advantage unless switching back; read October 14, 2026
- Travel outside the U.S. (medicare.gov) — read October 14, 2026
- Compare Original Medicare & Medicare Advantage (medicare.gov) — Original Medicare: any doctor or hospital that takes Medicare, anywhere in the U.S.; read October 15, 2026
- Health Maintenance Organizations (medicare.gov) — network only, except emergency, out-of-area urgent care and temporary out-of-area dialysis
- Preferred Provider Organizations (medicare.gov) — out-of-network covered, usually at higher cost
- Joining a plan (medicare.gov) — live in the plan's service area; if you live in another state part of the year, check if the plan covers you there; read October 15, 2026
- Special Enrollment Periods (medicare.gov) — moving out of the service area: from the move (or the month before, if you tell the plan) through 2 full months after; read October 15, 2026
- 42 CFR §422.74(d)(4), absence from the service area (eCFR) — disenrollment after more than 6 months away; visitor/traveler exception up to less than 12 months; read October 15, 2026
- Can I switch or drop my Medigap policy? (medicare.gov) — keep your Medigap policy wherever you live while you have Original Medicare; read October 15, 2026
- EPIC eligibility requirements (NY DOH) — permanent home, not a summer or winter home, in New York; read October 15, 2026
- NY Public Health Law §19 — reasonable charges for Medicare beneficiaries — 5% excess-charge cap
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. Insurers' legal names and home offices: carriers page.
Common questions
Short answers to what people ask before they call.
Still have a question? Call (518) 902-8822 or book a call.
Can I be turned down for a Medigap plan in New York?
No. New York requires Medigap insurers to accept any Medicare beneficiary who applies, at any time of year, regardless of health history. There's no six-month window to worry about and no medical underwriting.
Does my premium go up as I get older?
New York uses community rating, so insurers charge the same premium to everyone on a given plan regardless of age. Premiums can still rise over time for everyone on the plan, but you won't be singled out for turning 75 or for a diagnosis.
Which Medigap plan is most popular?
Plan G is one of the most common choices for people new to Medicare — of the gaps in Original Medicare, it covers all but the Part B deductible, for services Medicare itself covers. Plan N is a lower-premium alternative that adds small copays for office and ER visits. Plan F is only available to people who were eligible for Medicare before January 1, 2020.
Does a Medigap plan cover prescriptions?
No. You pair it with a standalone Part D plan. The two together are the classic alternative to Medicare Advantage.
Can I have both Medigap and Medicare Advantage?
No. Medigap only works with Original Medicare, and it's illegal for anyone to sell you a Medigap policy if they know you're in a Medicare Advantage plan, unless you're switching back to Original Medicare or your Advantage coverage will end before the Medigap policy starts. If you're making that switch, we line up the dates so there's no gap between the two. In New York the switch is easier than in most states, because Medigap insurers here must accept you in any month.
Does Medigap cover me when I travel or live part of the year in another state?
Inside the U.S., yes. Medigap pays alongside Original Medicare, which works with any doctor or hospital in the country that accepts Medicare, so there's no network to leave when you spend the winter somewhere else. Outside the U.S., Medicare usually pays nothing, but Plans C, D, F, G, M and N include a foreign travel emergency benefit that pays 80% of emergency care, up to the plan's limits. If you travel abroad often, that's worth weighing when you pick a plan letter.
Can I switch from one Medigap plan to another?
Yes — in New York you can switch companies or plan letters any month, again with no health questions. It's worth a quote comparison every year or two, because premiums for the same plan letter vary between carriers.
Want a note before the next enrollment window?
One email a few days before each Medicare enrollment window opens — Annual Enrollment in October, Advantage Open Enrollment in January — with the dates and what to have ready. Nothing else, ever; reply "stop" to come off the list.
Get Medigap quotes for your ZIP
Plan G, Plan N and high-deductible G from the carriers I represent, with each one's rate history.