Medicare in New York: 2026 Plans, Costs, and Enrollment Guide

New York Medicare Snapshot

New York has one of the largest and most consumer-protective Medicare markets in the country — 205 MA plans from 25 carriers covering 62 of 63 counties for 2026 (CMS CY2026 Landscape), plus year-round guaranteed-issue Medigap under N.Y. Ins. Law §3231. New York's plan mix leans PPO and special-needs: 57 PPO, 44 HMO, 41 HMO D-SNP, 36 HMO-POS, and 6 HMO-POS D-SNP plans, reflecting both the density of the NYC metro and the more rural geography upstate.

The average consolidated MA premium is $51.69/month(median $51.40) — notably higher than national averages and reflective of New York's richer plan designs and dense provider networks. The standard Medicare Part B premium is $202.90/month in 2026. On the supplement side, New York is one of only two states (with Connecticut) where Medigap insurers must offer coverage year-round on a community-rated basis — meaning guaranteed issue and uniform premiums regardless of age or health.

Plan Types Available in New York

Medicare Advantage (Part C)

In New York, 205 MA plans are available for 2026 from 25 carriers (CMS CY2026 Landscape). Plan type mix: 57 PPO, 44 HMO, 41 HMO D-SNP (dual-eligible special needs), 36 HMO-POS, and 6 HMO-POS D-SNP plans. PPOs dominate the upstate and Long Island markets, while HMO and D-SNP plans are concentrated in the five boroughs.

County availability ranges from 79 MA plans in Kings County (Brooklyn) to 23 plans in Tompkins County (Ithaca). Top carriers by plan count: Aetna Medicare (41 plans), UnitedHealthcare (21 plans), and Excellus Health Plan (20 plans).

Medigap (Medicare Supplement)

New York's Medigap market is one of the most consumer-protective in the country. Under N.Y. Ins. Law §3231 and 11 NYCRR §52.22, Medigap insurers must offer coverage on a community-rated, continuous guaranteed-issue basis — meaning the same premium for all enrollees in a plan regardless of age, gender, tobacco use, or health, available year-round without medical underwriting.

Twelve carriers offer Plan G in New York (TPP rate database, CY2026). Plan F is closed to new enrollees as of January 1, 2020 under MACRA / the 21st Century Cures Act; the same closure applies to High-Deductible Plan F (HDF) — only beneficiaries who became Medicare-eligible before January 1, 2020 may still purchase Plan F or HDF. High-Deductible Plan G (HDG) is the post-2020 high-deductible Medigap option and is offered in New York by 6 carriers. See our MA vs Medigap comparison →

Standalone Part D (Prescription Drug Plans)

New York is CMS PDP Region 3 — New York alone. For 2026, there are 10 standalone PDP plans from 5 carriers. Average total premium is $107.43/month — among the higher state averages nationally (CMS CY2026 Landscape).

Costs in New York

Medicare Advantage Premiums

The average consolidated MA premium in New York is $51.69/month (median $51.40) (CMS CY2026 Landscape) — well above the national average. The standard Medicare Part B premium is $202.90/month in 2026.

The top three carriers by plan count are Aetna Medicare (41 plans), UnitedHealthcare (21 plans), and Excellus Health Plan (20 plans) (CMS CY2026 Landscape). Average star rating is 3.75.

Medigap Premiums — Plan G and HDG

Unlike most states, New York Medigap rates are community-rated by statute (N.Y. Ins. Law §3231) — every enrollee in a given Medigap plan from a given carrier pays the same premium, regardless of age, gender, tobacco use, or health status. Premium ranges across the 12 New York Plan G carriers (non-tobacco, ages 65–85) span approximately $265 to $840/month in 2026 (TPP rate database, CY2026); the spread reflects carrier-to-carrier variation, not age-band variation.

High-Deductible Plan G (HDG) is offered by 6 New York carriers; community-rated premiums range from approximately $53 to $111/month (TPP rate database, CY2026). HDG works well for beneficiaries who want catastrophic protection at a lower monthly cost and can absorb the $2,950 deductible (2026).

Part D Costs and the LIS Benchmark

For 2026, New York Part D premiums average $107.43/month across 10 standalone PDP plans — among the highest in the country. The CMS Low Income Subsidy (LIS / Extra Help) benchmark premium for PDP Region 3 (New York) is $58.82/month (CMS CY2026 Regional Rates and Benchmarks).

New York-Specific Medicare Rules

Year-Round Guaranteed-Issue Medigap

New York Insurance Law §3231 and 11 NYCRR §52.22 require Medigap insurers to offer coverage on a community-rated, continuous open-enrollment basis. There is no Birthday Rule because there does not need to be one: New York beneficiaries can apply for or switch Medigap coverage any day of the year, from any participating carrier, without medical underwriting, denial, or surcharge.

Practical implications:

• No 6-month-OEP cliff.Unlike states with a 6-month Open Enrollment Period tied to Part B enrollment, in New York the "guaranteed-issue window" is permanent.
• Switch carriers anytime. If a different New York Medigap carrier offers a lower community rate for your plan letter, you can switch at any point without underwriting.
• Community-rated premiums. Your age, gender, tobacco use, and health history do not affect the price you pay. Premium differences across plans reflect carrier-to-carrier variation only.

New York and Connecticut are the only two states that require year-round guaranteed-issue Medigap. (Massachusetts, Maine, Vermont, and Washington have variations on continuous or extended guaranteed-issue rules; New York's version is one of the strongest.)

Medicare Savings Programs (MSPs)

New York offers Medicare Savings Programs (MSPs) administered by the New York State Department of Health:

• QMB (Qualified Medicare Beneficiary): Covers Part A and Part B premiums, deductibles, and cost-sharing.
• SLMB (Specified Low-Income Medicare Beneficiary): Covers Part B premiums only.
• QI (Qualifying Individual): Also covers Part B premiums; subject to annual appropriations.

New York's MSP income limits are higher than many states, which expands eligibility. Apply through your county Department of Social Services (DSS) — or contact New York HIICAP (1-800-701-0501) for free enrollment assistance. MSP enrollment also automatically qualifies you for Extra Help / LIS on Part D. Learn more about MSPs →

EPIC (Elderly Pharmaceutical Insurance Coverage)

New York operates EPIC, a state-funded prescription drug program for Medicare beneficiaries age 65+ with annual incomes up to $75,000 (single) / $100,000 (married). EPIC supplements Part D coverage by helping pay for Part D premiums (Fee Plan) or covering co-payments and the coverage gap (Deductible Plan). EPIC is administered by the New York State Department of Health. More information: https://www.health.ny.gov/health_care/epic/.

New York HIICAP

New York HIICAP (Health Insurance Information, Counseling, and Assistance Program) provides free, unbiased Medicare counseling statewide through a network of local offices.

Phone: 1-800-701-0501
Website: https://aging.ny.gov/hiicap

Enrolling in Medicare in New York

Standard Enrollment Periods

• Initial Enrollment Period (IEP): 7-month window centered on your 65th birthday month. Enroll at ssa.gov or call 1-800-772-1213.
• Annual Election Period (AEP): October 15 – December 7 each year (for Medicare Advantage and Part D changes).
• Medicare Advantage Open Enrollment Period (OEP): January 1 – March 31 (one-time MA-to-MA or MA-to-Original-Medicare switch).
• Medigap in New York: Year-round guaranteed issue under N.Y. Ins. Law §3231 — no Open Enrollment cliff, no medical underwriting at any time.
• Special Enrollment Periods (SEPs): Learn more →

New York HIICAP Counseling

Contact HIICAP at 1-800-701-0501 for free one-on-one Medicare guidance statewide.

Frequently Asked Questions