Original Medicare leaves gaps. There are two routes to fill them, with different roles for Medigap and Part D, and they work very differently. I'll walk you through what each one is, what it costs in your county, and which fits the doctors and prescriptions you already have.
Original Medicare is Part A and Part B. For most Part B services you pay 20% of the Medicare-approved amount after the deductible, Part A has its own cost-sharing, there is no yearly out-of-pocket limit, and most outpatient prescriptions aren't covered. There are two routes to fill those gaps: a Medicare Advantage plan, or Original Medicare plus a Medigap policy plus a Part D plan. Which is right depends on your doctors, your prescriptions and total yearly cost; in New York you can apply for a Medigap plan year-round. I compare all of it at no fee.
The 2027 Medicare plans are out
Every Medicare Advantage plan sold in your county, from the CMS file (all counties side by side): Albany, Saratoga, Schenectady, Rensselaer, Warren, Washington, Montgomery, Fulton, Columbia, Greene, Schoharie, Otsego, Herkimer, Hamilton, Essex, Ulster, Dutchess. Then what changed for 2027, and what's the best Medicare plan in 2027?
Book a 2027 plan review: I check your doctors and prescriptions
Original Medicare is run by the federal government and has two parts. Part A covers hospital stays, skilled nursing after a hospital stay, hospice and some home health; most people pay no premium for it. Part B covers doctors, outpatient care, tests and equipment; everyone pays a monthly premium for it, $202.90 in 2026, deducted from Social Security if you're receiving it. There is also a yearly Part B deductible, $283 in 2026. Every 2026 figure, Part A to IRMAA, is on the Medicare costs page, and Medicare Parts A, B, C and D, explained puts the four parts side by side.
Under 65? Medicare starts after 24 months of Social Security disability benefits, sooner with ALS or kidney failure; Medicare under 65 on disability covers the choices in New York.
Original Medicare pays roughly 80% of Part B costs and has no cap on what you can pay out of pocket in a year. It also does not cover most prescription drugs, routine dental, vision or hearing. That's why almost everyone adds something to it — and the choice you make there is the real decision.
I start by showing how the pieces fit together. Then we can look at what each choice means for you — the seven questions I ask to decide between the two routes are written up as a guide, and what's the best Medicare plan this year? answers the question everyone asks first, with this year's plan counts by county.
Keep Parts A and B as your foundation.
Part D can also go with Original Medicare without a Medigap policy.
Receive your benefits through a private plan.
Most Advantage plans include drug coverage; check the plan.
Medigap does not supplement Medicare Advantage.
With Original Medicare, it can be a separate drug plan. With Medicare Advantage, it is usually included. In most types of Advantage plans, you cannot add a separate Part D plan.
This diagram shows the relationship between these three options. It does not show every type of additional coverage. Availability and enrollment rules still depend on your situation.
Advantage is one route on its own. The other route is built from two pieces, Medigap and Part D, that do different jobs.
A private plan approved by Medicare that replaces how you receive Part A and B. Networks, prior authorization, usually drug coverage and extras built in, a yearly out-of-pocket maximum. Often low or $0 premium on top of Part B.
Read more →A policy that pays what Original Medicare leaves to you. Any doctor who accepts Medicare, no networks, no referrals. Monthly premium. New York has unusually strong consumer rules here: you can apply for or switch a Medigap plan in any month, with no health questions. A waiting period of up to six months for pre-existing conditions can apply only if you had a gap in prior coverage. Medigap plans in New York compares every letter, A to N.
Read more →Standalone drug coverage to go with Original Medicare and a Supplement, or built into most Advantage plans. Every plan has its own drug list and pharmacy network, so the right plan is the one that covers your prescriptions cheapest.
Read more →Advertising sells Medicare plans on premium and perks. The comparison I run starts somewhere else. If you want the two-minute version first, the plan finder asks eight questions and tells you which plan types are worth pricing and which carriers your hospital lists.
There is only the plan that fits your doctors, your medications and your budget this year. That's why I re-check every client's plan each fall — plans change their networks and drug lists every January.
Plan availability and networks are set county by county, Medigap premiums by region, and the hospital systems people use differ town by town, so there is a page for each county and for the towns in it. I meet people in person in Albany, Saratoga, Schenectady, Rensselaer, Warren and Washington counties, and work with the other eleven counties by phone, WhatsApp and video.
Albany County: Albany · Berne and Knox · Cohoes · Delmar and Bethlehem · Guilderland · Latham and Colonie · Menands · Ravena and Coeymans · Voorheesville and New Scotland · Watervliet and Green Island
Saratoga County: Ballston Spa · Burnt Hills and Ballston Lake · Clifton Park · Corinth · Galway · Greenfield · Halfmoon · Malta · Mechanicville and Stillwater · Saratoga Springs · Schuylerville · South Glens Falls · Waterford · Wilton and Gansevoort
Schenectady County: Duanesburg and Delanson · Glenville and Scotia · Niskayuna · Rotterdam · Schenectady
Rensselaer County: Averill Park and Sand Lake · Brunswick · City of Rensselaer · East Greenbush · Hoosick Falls · Nassau and East Nassau · Schaghticoke · Schodack and Castleton · Troy
Warren County: Bolton Landing · Chestertown and Chester · Glens Falls · Lake George and Warrensburg · Lake Luzerne · Queensbury
Washington County: Fort Ann · Granville · Greenwich and Cambridge · Hudson Falls and Fort Edward · Whitehall
Montgomery County: Amsterdam · Canajoharie · Fort Plain
Fulton County: Broadalbin · Gloversville · Johnstown · Northville
Columbia County: Chatham · Claverack · Copake · Hudson · Kinderhook
Greene County: Athens · Cairo · Catskill · Coxsackie · Hunter and Tannersville · Windham
Schoharie County: Cobleskill · Middleburgh · Sharon Springs
Otsego County: Cooperstown · Oneonta · Richfield Springs
Herkimer County: Herkimer and Ilion · Little Falls · Old Forge
Hamilton County: Indian Lake · Speculator
Essex County: Elizabethtown · Keene · Lake Placid · Schroon Lake · Ticonderoga
Ulster County: Ellenville · Esopus · Highland · Kingston · Marlboro and Milton · New Paltz · Rosendale · Saugerties · Wallkill · Woodstock
Dutchess County: Beacon · Fishkill · Hyde Park · LaGrange · Millbrook · Pawling · Poughkeepsie · Red Hook · Rhinebeck · Wappingers Falls
Further away? I work with people anywhere in New York by phone, WhatsApp and video: how that works. Turning 65 on the Essential Plan or a NY State of Health plan has its own steps: what ends and when.
Plans for 2027: every county side by side, and every Medicare Advantage plan sold in each county on its plan page (Albany, Saratoga, Schenectady, Rensselaer, Warren, Washington, Montgomery, Fulton, Columbia, Greene, Schoharie, Otsego, Herkimer, Hamilton, Essex, Ulster, Dutchess), and what changed since 2026 shows which plans are new, which ended and which moved to a new plan ID.
I'm appointed with the national carriers and the regional plans that matter in upstate New York, including UnitedHealthcare, Aetna, Humana, CDPHP, MVP Health Care, Anthem, EmblemHealth, VNS Health, Trinity Health Plan New York, Devoted Health, Wellcare. Not every carrier offers every product in every county; I check what's actually available at your ZIP code. Each carrier has its own page with what it sells in New York, what the local hospitals say about it, and its Medigap rates where it files them. Every plan those carriers and the others sell, county by county, is on the plan pages for Albany, Saratoga, Schenectady, Rensselaer, Warren and Washington County; and if you're weighing agents, how to check any Medicare agent in New York applies to me too.
An example of the page you get after the review, with made-up plans and no prices. Yours carries the real plan names and plan IDs for your county, your own doctors and prescriptions, and the dollar amounts from each plan's own documents.
| Plan | Your doctors (4) | Your hospital | Your prescriptions (5) | Referrals and prior authorization | Yearly cost, normal year | Yearly cost, bad year | Verdict |
|---|---|---|---|---|---|---|---|
| Your plan now (Advantage HMO) | 3 of 4 in network; your cardiologist left the network for 2027 | In network | All covered; one moved to a higher tier | Referrals to see specialists | Premium + expected copays + drugs | Up to the plan's out-of-pocket maximum, plus drugs | Dropped: the cardiologist |
| Plan B (Advantage PPO) | 4 of 4 in network | In network | All covered | No referrals; prior authorization for some services | Premium + expected copays + drugs | Up to the plan's out-of-pocket maximum, plus drugs | Shortlist |
| Plan C (Original Medicare + Medigap + Part D) | Any doctor who takes Medicare | Any hospital that takes Medicare | All covered by the Part D plan picked for them | None from Medigap | Part B, Medigap and Part D premiums + drugs | A little more than the normal year, depending on the Medigap plan | Shortlist, if the premium fits the budget |
The real one also shows the date I checked each doctor in the plan's directory, which pharmacy the drug prices assume, and what changes from your current plan. The decision is yours, and if the plan you already have is the right one, that's what it says.
None of this costs you anything. How I'm paid.
Federal rules require a Scope of Appointment before we discuss specific Medicare Advantage or Part D plans — it's a short form that records what you asked to talk about. I'll send it before our call.
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.
Short answers to what people ask before they call.
Still have a question? Call (518) 902-8822 or book a call.
Three main windows. Your Initial Enrollment Period is the seven months around your 65th birthday. The Annual Enrollment Period runs October 15 – December 7 every year, when anyone can switch Medicare Advantage or Part D plans for January 1. The Medicare Advantage Open Enrollment Period, January 1 – March 31, lets people already on a Medicare Advantage plan make one change. Outside those, you need a Special Enrollment Period — moving, losing employer coverage, or qualifying for Extra Help are common ones.
No. Medicare plan comparison, help choosing and enrollment cost you nothing — the carrier pays a commission when you enroll, and your premium is identical whether you enroll through me, through the carrier, or on medicare.gov.
It depends on the plan type. With Original Medicare plus a Medigap policy, you can see any provider in the country who accepts Medicare. With Medicare Advantage, you're usually limited to a network — so we check your specific doctors, including specialists, before we look at anything else.
Original Medicare (Parts A and B) doesn't cover most dental care or dentures, eye exams for prescription glasses, hearing aids and the exams to fit them, routine physical exams, cosmetic surgery, massage therapy, or non-medical long-term care, the help with daily living that most people in a nursing home need. Most outpatient prescriptions need a Part D plan, and Medicare usually doesn't cover care while you're traveling outside the U.S. Some Medicare Advantage plans add dental, vision and hearing benefits, each with its own limits. I've answered the common ones one by one: nursing home care, eye exams and glasses, dental, hearing aids, cataract surgery, home health care, physical therapy, chiropractic, the shingles vaccine and Ozempic and Wegovy.
Most are. Part B covers a list of preventive services, including screening mammograms and colorectal cancer screenings, and you pay nothing for most of them when you get them from a provider who accepts assignment, meaning they take Medicare's approved amount as full payment. Your doctor may also recommend services Medicare doesn't cover, and those can cost you something, so it's fair to ask before the appointment. Medicare.gov keeps the full list of preventive services and how often each one is covered.
Medicare Advantage replaces how you receive your benefits — a private plan with a network, usually bundling drug coverage and extras, often with a low or $0 premium but more cost-sharing when you use care. A Supplement sits alongside Original Medicare, keeps provider freedom, and has a monthly premium but far fewer bills. Read about Medicare Advantage or Medigap in New York.
Usually yes, or you should have other creditable drug coverage. Going 63 consecutive days or more without it after your Initial Enrollment Period triggers a permanent late-enrollment penalty added to your premium for as long as you have Part D. A low-premium plan is typically the sensible hedge. More on Part D.
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.
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Your doctors, your prescriptions and your ZIP code are all I need to start. No fee for plan comparison or enrollment.
I'm based in Clifton Park and work in person across six counties, the four on the map plus Warren and Washington, or by phone.
Close to the Clifton Park office: Clifton Knolls, Country Knolls, Rexford, Vischer Ferry, Jonesville, Groom's Corners and Halfmoon across Route 9 — I'll come to you at home.
Medicare has its own county and town pages.
