Medicare
Medicare in New York refers to the federal health insurance program provided to eligible individuals aged 65 and older, as well as certain younger individuals with disabilities or specific medical conditions. It helps cover various healthcare costs such as hospital stays, doctor visits, prescription drugs, and preventive services. In New York, as in the rest of the United States, Medicare is administered by the federal government through the Centers for Medicare & Medicaid Services (CMS).
Coverage
Medicare consists of different parts, including Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage). Beneficiaries can choose how they receive their Medicare coverage, either through Original Medicare (Parts A and B) or through Medicare Advantage plans (Part C) offered by private insurance companies.
Eligibility
Eligibility for Medicare in New York follows the same criteria as the rest of the country. Generally, individuals aged 65 and older qualify for Medicare based on their work history or their spouse’s work history. Younger individuals may also qualify if they have certain disabilities or end-stage renal disease (ESRD).
Enrollment
Most individuals are automatically enrolled in Medicare when they turn 65 and are receiving Social Security benefits. Those who aren’t automatically enrolled can sign up during their Initial Enrollment Period (IEP) or during specific enrollment periods throughout the year.
Costs
While many services under Medicare are free or have low-cost premiums, beneficiaries may still incur out-of-pocket costs such as deductibles, copayments, and coinsurance. Medicare Advantage and Medicare Part D plans often have premiums and cost-sharing requirements as well.
Additional Assistance
Some individuals with limited income and resources may qualify for assistance programs like the Medicare Savings Program, which helps cover Medicare premiums and cost-sharing, and Extra Help, which helps with prescription drug costs.
Coverage Options
In addition to Original Medicare, beneficiaries in New York have the option to enroll in Medicare Advantage plans offered by private insurance companies. These plans often provide additional benefits beyond what Original Medicare covers, such as dental, vision, and hearing services.