Best Medicare Companies in South Salem, New York (2024)
Discover top Medicare companies in South Salem, New York for comprehensive insurance coverage. Explore a range of plans, compare options, and make informed decisions for your healthcare needs. Find peace of mind with reliable Medicare coverage tailored to your unique requirements. Trust in our expertise for a secure future.
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Laura D. Adams
Insurance & Finance Analyst
Laura Adams is one of the nation’s leading finance, insurance, and small business authorities. As an award-winning author, spokesperson, and host of the top-rated Money Girl podcast since 2008, millions of readers and listeners benefit from her practical advice. Her mission is to empower consumers to live healthy and rich lives by planning for the future and making smart money decisions. She rec...
Insurance & Finance Analyst
UPDATED: Sep 16, 2024
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UPDATED: Sep 16, 2024
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance company and cannot guarantee quotes from any single insurance company.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code above to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- South Salem Medicare supplement can only be added to original Medicare
- South Salem, New York, Medicare supplement plans follow the New York standards for coverage
- Health insurance companies like EmblemHealth Medicare HMO and Empire BlueCross BlueShield offer Medicare Advantage plans in South Salem
Welcome to our comprehensive guide on Medicare companies in South Salem, New York. If you’re looking for reliable insurance coverage, you’ve come to the right place.
In this article, we will discuss the key topics related to Medicare in South Salem, including the different Medicare companies available, coverage options, and important considerations when choosing the right plan for your healthcare needs. We understand the importance of finding the best insurance provider that suits your requirements and budget.
To get started, simply enter your ZIP code below and compare rates from the top insurance providers in your area. Take control of your healthcare coverage today!
Medicare Advantage by Company in South Salem, New York
There are Medicare Advantage companies in South Salem, NY, offering a range of options including HMO and PPO plans. There are even some plans available at no additional cost beyond your South Salem Medicare Part B premium. Take a look at the Medicare Advantage companies in South Salem, New York, to compare plans and coverage.
Medicare Advantage Companies in South Salem, New York
Plan Name | Monthly Prem. (Parts C & D) | Deductible | Additional Gap Coverage | Preferred Pharmacy Copay/ Coinsurance 30-Day Supply | MOOP for Part A & B Benefits |
---|---|---|---|---|---|
AARP Medicare Advantage Patriot (HMO) – H3307-018-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
AARP Medicare Advantage Plan 1 (HMO) – H3307-012-0 | $0.00 | $395 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% | $6,700 |
AARP Medicare Advantage Plan 2 (HMO) – H3307-023-0 | $75.00 | $295 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% | $6,700 |
Aetna Medicare Assure Plan (HMO D-SNP) – H3312-069-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% | n/a |
Aetna Medicare Eagle Plan (PPO) – H5521-320-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
Aetna Medicare Elite Plan (PPO) – H5521-120-0 | $0.00 | $250 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% | $7,550 |
Aetna Medicare Elite Plan 2 (PPO) – H5521-309-0 | $39.00 | $300 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% | $7,550 |
Aetna Medicare Premier Plan (PPO) – H5521-121-0 | $76.00 | $250 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% | $7,550 |
Aetna Medicare Value Plan (HMO) – H3312-018-0 | $59.00 | $250 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% | $7,550 |
AgeWell New York Advantage Plus (HMO D-SNP) – H4922-010-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 | n/a |
AgeWell New York CareWell (HMO I-SNP) – H4922-004-0 | $42.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%, Tier 2: 25%, Tier 3: 25%, Tier 4: 25%, Tier 5: 25% | n/a |
AgeWell New York FeelWell (HMO D-SNP) – H4922-003-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 | n/a |
AgeWell New York LiveWell (HMO) – H4922-011-0 | $42.30 | $350 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $3.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 26% | $7,550 |
ArchCare Advantage (HMO I-SNP) – H1777-007-0 | $42.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% | n/a |
Centers Plan for Nursing Home Care (HMO I-SNP) – H6988-003-0 | $42.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% | n/a |
Elderplan Advantage For Nursing Home Residents (HMO I-SNP) – H3347-003-0 | $35.50 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% | n/a |
Elderplan Assist (HMO I-SNP) – H3347-015-0 | $42.30 | $445 . Tier 1, 2 and 3 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00, Generic: $14.00, Preferred Brand: $47.00, Non-Preferred Drug: 25%, Specialty Tier: 25% | n/a |
Elderplan Extra Help (HMO) – H3347-009-0 | $25.30 | $445 . Tier 1, 2 and 3 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00, Generic: $10.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% | $7,550 |
Elderplan For Medicaid Beneficiaries (HMO D-SNP) – H3347-002-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% | n/a |
Elderplan Plus Long Term Care (HMO D-SNP) – H3347-007-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% | n/a |
EmblemHealth VIP Assist (HMO D-SNP) – H5991-008-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 | n/a |
EmblemHealth VIP Connect (HMO D-SNP) – H5991-007-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 | n/a |
EmblemHealth VIP Dual (HMO D-SNP) – H3330-042-3 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 | n/a |
EmblemHealth VIP Dual Select (HMO D-SNP) – H5991-001-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 | n/a |
EmblemHealth VIP Essential (HMO) – H3330-032-4 | $68.00 | $295 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 27% | $7,550 |
EmblemHealth VIP Go (HMO-POS) – H3330-041-1 | $72.00 | $250 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 28% | $7,550 |
EmblemHealth VIP Gold (HMO) – H3330-021-4 | $243.00 | $200 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $10.00, Preferred Brand: $40.00, Non-Preferred Drug: $95.00, Specialty Tier: 29% | $7,550 |
EmblemHealth VIP Gold Plus (HMO) – H3330-038-0 | $302.00 | $200 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $10.00, Preferred Brand: $40.00, Non-Preferred Drug: $95.00, Specialty Tier: 29% | $7,550 |
EmblemHealth VIP Part B Saver (HMO) – H3330-040-0 | $0.00 | $445 . Tier 1 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 25% | $7,550 |
EmblemHealth VIP Passport (HMO) – H5991-003-0 | $42.30 | $295 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 27% | $7,550 |
EmblemHealth VIP Rx Saver (HMO) – H3330-039-1 | $49.00 | $395 . Tier 1, 2 and 3 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 25% | $7,550 |
EmblemHealth VIP Solutions (HMO D-SNP) – H5991-002-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15%, Tier 2: 15%, Tier 3: 15%, Tier 4: 15%, Tier 5: 15% | n/a |
EmblemHealth VIP Value (HMO) – H3330-036-0 | $0.00 | $295 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 27% | $7,550 |
Empire MediBlue Core (HMO) – H8432-037-1 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
Empire MediBlue Dual Advantage (HMO D-SNP) – H8432-007-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $6.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 | n/a |
Empire MediBlue Dual Advantage Select (HMO D-SNP) – H8432-028-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 | n/a |
Empire MediBlue HealthPlus (HMO) – H1732-005-0 | $25.00 | $200 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $4.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 29%, Select Care Drugs: $0.00 | $5,900 |
Empire MediBlue HealthPlus Dual Advantage (HMO D-SNP) – H1732-002-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $6.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 | n/a |
Empire MediBlue HealthPlus Dual Connect (HMO D-SNP) – H1732-003-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 | n/a |
Empire MediBlue HealthPlus Dual Plus (HMO D-SNP) – H1732-001-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $6.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 | n/a |
Empire MediBlue Plus (HMO) – H8432-009-0 | $62.00 | $325 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 27% | $6,200 |
Empire MediBlue Select (HMO) – H8432-016-0 | $26.00 | $200 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $4.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 29%, Select Care Drugs: $0.00 | $6,400 |
Fidelis Dual Advantage (HMO D-SNP) – H5599-006-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 47%, Specialty Tier: 25% | n/a |
Fidelis Dual Advantage Flex (HMO D-SNP) – H5599-001-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: 24%, Non-Preferred Drug: 39%, Specialty Tier: 25% | n/a |
Fidelis Medicaid Advantage Plus (HMO D-SNP) – H5599-003-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $40.00, Non-Preferred Drug: 50%, Specialty Tier: 25% | n/a |
Fidelis Medicare $0 Premium (HMO) – H5599-009-0 | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 50%, Specialty Tier: 33% | $7,550 |
Fidelis Medicare Advantage Flex (HMO-POS) – H5599-007-0 | $10.90 | $445 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 50%, Specialty Tier: 25% | $7,550 |
Hamaspik Medicare Choice (HMO D-SNP) – H0034-002-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% | n/a |
Hamaspik Medicare Select (HMO D-SNP) – H0034-001-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% | n/a |
Healthfirst CompleteCare (HMO D-SNP) – H3359-034-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00 | n/a |
Healthfirst Increased Benefits Plan (HMO) – H3359-019-0 | $42.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% | $7,550 |
Healthfirst Life Improvement Plan (HMO D-SNP) – H3359-021-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00 | n/a |
Healthfirst Signature (HMO) – H1722-002-0 | $0.00 | $350 . Tier 1 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 26% | $7,550 |
Longevity Health Plan (HMO I-SNP) – H8457-001-0 | $42.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% | n/a |
MVP Medicare Preferred Gold with Part D (HMO-POS) – H3305-021-0 | $140.00 | $0 | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $35.00, Non-Preferred Drug: 27%, Specialty Tier: 33% | $5,800 |
MVP Medicare Preferred Gold without Part D (HMO-POS) – H3305-020-0 | $62.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
MVP Medicare Secure Plus with Part D (HMO-POS) – H3305-022-0 | $90.00 | $0 | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: $45.00, Non-Preferred Drug: 27%, Specialty Tier: 33% | $7,550 |
MVP Medicare Secure with Part D (HMO-POS) – H3305-032-0 | $40.00 | $150 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $47.00, Non-Preferred Drug: 26%, Specialty Tier: 30% | $7,550 |
MVP Medicare WellSelect Plus with Part D (PPO) – H9615-009-0 | $125.00 | $0 | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $35.00, Non-Preferred Drug: 27%, Specialty Tier: 33% | $6,500 |
MVP Medicare WellSelect with Part D (PPO) – H9615-010-0 | $0.00 | $325 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: 25%, Specialty Tier: 27% | $7,550 |
MVP SmartFund (MSA) – H5613-002-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
Oscar Easy Care (HMO) – H7322-002-0 | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $45.00, Non-Preferred Drug: $95.00, Specialty Tier: 33% | $6,700 |
PHP Care Complete FIDA-IDD Plan (Medicare-Medicaid Plan) – H9869-001-0 | $0.00 | $0 | All Generics, All Brands | Tier 1: 0%, Tier 2: 0%, Tier 3: 0% | n/a |
RiverSpring MAP (HMO D-SNP) – H6776-002-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% | n/a |
RiverSpring Star (HMO I-SNP) – H6776-001-0 | $42.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% | n/a |
Senior Whole Health of New York NHC (HMO D-SNP) – H5992-007-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% | n/a |
UnitedHealthcare Assisted Living Plan (PPO I-SNP) – H2292-003-0 | $42.30 | $200 . Tier 1, 2 and 3 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% | n/a |
UnitedHealthcare Dual Complete (HMO D-SNP) – H3387-010-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 | n/a |
UnitedHealthcare Medicare Advantage Choice Plan 1 (Regional PPO) – R5342-001-0 | $16.00 | $300 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% | $6,700 |
UnitedHealthcare Medicare Advantage Choice Plan 3 (Regional PPO) – R5342-005-0 | $46.00 | $275 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% | $6,700 |
UnitedHealthcare Medicare Advantage Choice Plan 4 (Regional PPO) – R5342-006-0 | $84.00 | $150 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 30% | $6,700 |
UnitedHealthcare Medicare Advantage Patriot (Regional PPO) – R5342-002-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) – H2292-002-0 | $32.60 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%, Tier 2: 25%, Tier 3: 25%, Tier 4: 25%, Tier 5: 25% | n/a |
UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) – H3379-002-0 | $35.90 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%, Tier 2: 25%, Tier 3: 25%, Tier 4: 25%, Tier 5: 25% | n/a |
VNSNY CHOICE Total (HMO D-SNP) – H5549-003-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00, Generic: $19.00, Preferred Brand: $47.00, Non-Preferred Brand: 39%, Specialty Tier: 25% | n/a |
WellCare Absolute (PPO) – H2775-111-0 | $0.00 | $150 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 30% | $7,550 |
WellCare Access (HMO D-SNP) – H4868-004-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $3.00, Preferred Brand: $42.00, Non-Preferred Drug: 48%, Specialty Tier: 25% | n/a |
WellCare Imperial (PPO D-SNP) – H2775-112-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $9.00, Preferred Brand: $45.00, Non-Preferred Drug: 49%, Specialty Tier: 25% | n/a |
WellCare Patriot (HMO) – H4868-003-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
WellCare Preferred (HMO) – H4868-010-0 | $81.00 | $0 | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: 48%, Specialty Tier: 33% | $6,700 |
WellCare Today’s Options Advantage Plus 750B (PPO) – H2775-100-0 | $83.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $7.00, Preferred Brand: $37.00, Non-Preferred Drug: $90.00, Specialty Tier: 33% | $6,700 |
Medicare Part D by Company in South Salem, New York
South Salem Medicare Part D companies offer plans that cover prescription medications, with deductible and copay options that vary along with the monthly cost. Whether you have original Medicare or a South Salem, New York, Medicare Advantage plan, you can buy standalone Part D coverage from a local company.
Standalone Medicare Part D Plans in South Salem, New York
Plan | Details | Tiers |
---|---|---|
SilverScript SmartRx (PDP) S5601 – 178 – 0 by Aetna Medicare |
Monthly Premium: $7.30 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $19.00 Tier 3: $46.00 Tier 4: 49% Tier 5: 25% |
Elixir RxPlus (PDP) S7694 – 121 – 0 by Elixir Insurance |
Monthly Premium: $15.60 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $6.00 Tier 3: $43.00 Tier 4: 45% Tier 5: 25% |
WellCare Wellness Rx (PDP) S4802 – 172 – 0 by WellCare |
Monthly Premium: $15.60 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $5.00 Tier 3: $40.00 Tier 4: 46% Tier 5: 25% |
Humana Walmart Value Rx Plan (PDP) S5552 – 006 – 0 by Humana |
Monthly Premium: $17.20 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $4.00 Tier 3: 16% Tier 4: 35% Tier 5: 25% |
WellCare Value Script (PDP) S4802 – 138 – 0 by WellCare |
Monthly Premium: $17.70 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $6.00 Tier 3: $43.00 Tier 4: 47% Tier 5: 25% |
Express Scripts Medicare – Saver (PDP) S5983 – 007 – 0 by Express Scripts Medicare |
Monthly Premium: $23.60 Annual Deductible: $285 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $2.00 Tier 2: $7.00 Tier 3: $35.00 Tier 4: 50% Tier 5: 28% |
Cigna Secure-Essential Rx (PDP) S5617 – 282 – 0 by Cigna |
Monthly Premium: $24.00 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $2.00 Tier 3: 18% Tier 4: 40% Tier 5: 25% |
Blue Rx Enhanced (PDP) S3375 – 003 – 0 by BlueCross BlueShield: Empire, Excellus, WNY & NEN |
Monthly Premium: $30.70 Annual Deductible: $325 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: Yes |
Tier 1: $0.00 Tier 2: $3.00 Tier 3: 20% Tier 4: 39% Tier 5: 27% |
Express Scripts Medicare – Value (PDP) S5983 – 004 – 0 by Express Scripts Medicare |
Monthly Premium: $33.20 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $3.00 Tier 3: $20.00 Tier 4: 46% Tier 5: 25% |
WellCare Classic (PDP) S4802 – 077 – 0 by WellCare |
Monthly Premium: $34.80 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $4.00 Tier 3: $30.00 Tier 4: 33% Tier 5: 25% |
SilverScript Choice (PDP) S5601 – 006 – 0 by Aetna Medicare |
Monthly Premium: $35.00 Annual Deductible: $290 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $5.00 Tier 3: $35.00 Tier 4: 40% Tier 5: 27% |
Elixir RxSecure (PDP) S7694 – 003 – 0 by Elixir Insurance |
Monthly Premium: $35.80 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $7.00 Tier 3: 15% Tier 4: 34% Tier 5: 25% |
WellCare Medicare Rx Saver (PDP) S5810 – 037 – 0 by WellCare |
Monthly Premium: $36.80 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $2.00 Tier 3: $42.00 Tier 4: 35% Tier 5: 25% |
Humana Basic Rx Plan (PDP) S5552 – 004 – 0 by Humana |
Monthly Premium: $37.10 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $1.00 Tier 3: 20% Tier 4: 35% Tier 5: 25% |
Cigna Secure Rx (PDP) S5617 – 013 – 0 by Cigna |
Monthly Premium: $38.30 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $2.00 Tier 3: $25.00 Tier 4: 50% Tier 5: 25% |
WellCare Medicare Rx Select (PDP) S5810 – 277 – 0 by WellCare |
Monthly Premium: $40.20 Annual Deductible: $300 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $3.00 Tier 3: $47.00 Tier 4: 42% Tier 5: 27% |
AARP MedicareRx Walgreens (PDP) S5921 – 382 – 0 by UnitedHealthcare |
Monthly Premium: $40.90 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $6.00 Tier 3: $40.00 Tier 4: 40% Tier 5: 25% |
Blue Rx Standard (PDP) S3375 – 001 – 0 by BlueCross BlueShield: Empire, Excellus, WNY & NEN |
Monthly Premium: $49.10 Annual Deductible: $440 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $2.00 Tier 3: $34.00 Tier 4: 32% Tier 5: 25% |
EmblemHealth VIP Rx (PDP) S5966 – 003 – 0 by EmblemHealth Medicare PDP |
Monthly Premium: $49.30 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $2.00 Tier 2: $12.00 Tier 3: $40.00 Tier 4: 33% Tier 5: 25% |
Cigna Secure-Extra Rx (PDP) S5617 – 248 – 0 by Cigna |
Monthly Premium: $50.00 Annual Deductible: $100 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: Yes |
Tier 1: $4.00 Tier 2: $10.00 Tier 3: $42.00 Tier 4: 50% Tier 5: 31% |
AARP MedicareRx Saver Plus (PDP) S5921 – 379 – 0 by UnitedHealthcare |
Monthly Premium: $70.10 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $8.00 Tier 3: $31.00 Tier 4: 40% Tier 5: 25% |
Humana Premier Rx Plan (PDP) S5552 – 005 – 0 by Humana |
Monthly Premium: $72.30 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $4.00 Tier 3: $45.00 Tier 4: 39% Tier 5: 25% |
EmblemHealth VIP Rx Plus (PDP) S5966 – 004 – 0 by EmblemHealth Medicare PDP |
Monthly Premium: $72.50 Annual Deductible: $285 Zero Premium If Full LIS Benefits: No ICL: $3,970 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $0.00 Tier 3: $35.00 Tier 4: $95.00 Tier 5: 28% |
Blue Rx Plus (PDP) S3375 – 002 – 0 by BlueCross BlueShield: Empire, Excellus, WNY & NEN |
Monthly Premium: $72.70 Annual Deductible: $0 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $3.00 Tier 3: $43.00 Tier 4: 45% Tier 5: 33% |
SilverScript Plus (PDP) S5601 – 007 – 0 by Aetna Medicare |
Monthly Premium: $76.60 Annual Deductible: $0 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: Yes |
Tier 1: $0.00 Tier 2: $2.00 Tier 3: $47.00 Tier 4: 48% Tier 5: 33% |
WellCare Medicare Rx Value Plus (PDP) S5768 – 200 – 0 by WellCare |
Monthly Premium: $82.00 Annual Deductible: $0 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $4.00 Tier 3: $47.00 Tier 4: 43% Tier 5: 33% |
Express Scripts Medicare – Choice (PDP) S5983 – 006 – 0 by Express Scripts Medicare |
Monthly Premium: $87.60 Annual Deductible: $100 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: Yes |
Tier 1: $2.00 Tier 2: $7.00 Tier 3: $42.00 Tier 4: 50% Tier 5: 31% |
AARP MedicareRx Preferred (PDP) S5805 – 001 – 0 by UnitedHealthcare |
Monthly Premium: $94.80 Annual Deductible: $0 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $5.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: 40% Tier 5: 33% |
Medicare Supplement By Company in South Salem, New York
South Salem, New York, Medicare supplement plans are designed to fill in the gaps left by original Medicare. That’s why they’re also known as Medigap plans. Compare South Salem, NY, Medigap companies, and the plans they offer here.
Medicare Supplement Companies in South Salem, New York
Company | Plans |
---|---|
AARP – UnitedHealthcare Insurance Company of New York (Standard) | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan F, Medigap Plan G, Medigap Plan L, Medigap Plan N |
BlueShield of Northeastern New York | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan F, Medigap Plan F-high deductible, Medigap Plan G, Medigap Plan N |
EmblemHealth Services Company | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan F |
Empire BlueCross New York | Medigap Plan A, Medigap Plan B, Medigap Plan F, Medigap Plan G, Medigap Plan N |
Globe Life Insurance Company of New York | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan D, Medigap Plan F, Medigap Plan F-high deductible, Medigap Plan G, Medigap Plan G-high deductible, Medigap Plan L, Medigap Plan N |
Humana (Humana Insurance Company of New York) | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan F, Medigap Plan F-high deductible, Medigap Plan G, Medigap Plan G-high deductible, Medigap Plan L, Medigap Plan N |
Mutual of Omaha Insurance Company | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan D, Medigap Plan F, Medigap Plan G |
State Farm Mutual Automobile Insurance Company | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan F |
Medicare Supplement Coverage by Plan in South Salem, New York
Medicare supplement plans in South Salem, NY, are standardized, so you’ll get the same coverage regardless of which company you choose. Find out what the standard Medigap plans in New York cover here.
South Salem, New York Standard Medicare Plan Coverage
Plan Name | Monthly Cost | Copays Coinsurance | Deductibles | Plan Benefits |
---|---|---|---|---|
Medigap Plan A | Premiums range from $169-$350 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $1,484 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: No
Part A deductible: No Part B deductible: No Part B excess charges: No Foreign travel emergency: No |
Medigap Plan B | Premiums range from $226-$510 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $0 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: No
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: No |
Medigap Plan C | Premiums range from $301-$511 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $0 Hospital (Part A) deductible, $0 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: Yes Part B excess charges: No Foreign travel emergency: Yes |
Medigap Plan D | Premiums range from $391-$502 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $0 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: Yes |
Medigap Plan F | Premiums range from $305-$514 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $0 Hospital (Part A) deductible, $0 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: Yes Part B excess charges: Yes Foreign travel emergency: Yes |
Medigap Plan F-high deductible | Premiums range from $69-$91 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services after you pay $2,370 deductible | $2,370 total plan deductible. After, you pay: $0 Hospital (Part A) deductible, $0 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: Yes Part B excess charges: Yes Foreign travel emergency: Yes |
Medigap Plan G | Premiums range from $268-$476 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $0 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: Yes Foreign travel emergency: Yes |
Medigap Plan G-high deductible | Premiums range from $69-$91 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services after you pay $2,370 deductible | $2,370 total plan deductible. After, you pay: $0 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: Yes Foreign travel emergency: Yes |
Medigap Plan K | Premiums range from $86-$207 depending on your age, sex, health status, and when you buy. | 10% Generally your cost for approved Part B services up to $6,220. Then, you’ll pay $0 for the rest of the year. | $742 (50% of Part A deductible) Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: No |
Medigap Plan L | Premiums range from $181-$297 depending on your age, sex, health status, and when you buy. | 5% Generally your cost for approved Part B services up to $3,110. Then, you’ll pay $0 for the rest of the year. | $371 (25% of Part A deductible) Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: No |
Medigap Plan M | Premiums range from $524-$524 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $742 (50% of Part A deductible) Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: Yes |
Medigap Plan N | Premiums range from $190-$282 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services with some $20 and $50 copays | $0 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: Yes |
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Shop for Medicare Coverage in South Salem, New York
Finding the right coverage for Medicare in South Salem, New York, is a matter of looking at your choices and narrowing down the best fits for your needs and budget. Whether you want a PPO Medicare Advantage plan in South Salem, NY, or you prefer to bolster original Medicare with a South Salem Medicare supplement plan, shopping around is your best bet.
To compare South Salem, New York, Medicare rates, enter your ZIP code here for fast, free quotes.
Frequently Asked Questions
How do Medicare companies in South Salem, New York compare in terms of cost and coverage?
The cost and coverage of Medicare plans offered by companies in South Salem, New York can vary depending on several factors, such as the specific plan, the type of coverage, the level of benefits, and the out-of-pocket costs. Here are the five general factors to consider when comparing Medicare companies in South Salem, New York:
- Premiums: The monthly cost of a Medicare plan can vary depending on the company, the specific plan, and the level of coverage. Some Medicare plans have higher premiums but lower out-of-pocket costs, while others have lower premiums but higher out-of-pocket costs.
- Deductibles and copays: Medicare plans can have deductibles and copays that beneficiaries are required to pay before coverage begins. The amount of these costs can vary depending on the company and the plan.
- Coverage options: Medicare companies in South Salem, New York offer a range of coverage options, including Medicare Advantage plans, Medicare Supplement plans, and prescription drug plans. Each type of plan has different levels of coverage and costs.
- Network coverage: Some Medicare plans may have restrictions on which doctors, hospitals, and other healthcare providers beneficiaries can use. It is important to review the network coverage of each plan offered by a Medicare company to ensure that it includes the doctors and hospitals you prefer.
- Additional benefits: Some Medicare companies in South Salem, New York offer additional benefits beyond traditional Medicare coverage, such as dental, vision, or hearing coverage. These benefits can vary by company and plan.
When comparing Medicare companies in South Salem, New York, it is important to consider your specific healthcare needs and budget to find a plan that provides the coverage and costs that are right for you.
Can I choose any Medicare company in South Salem, New York or am I restricted to a specific network?
When it comes to choosing a Medicare company in South Salem, New York, beneficiaries have some flexibility in their options, but there may be some restrictions based on these three types of plan they may choose.
- Original Medicare If you are enrolled in (Part A and Part B), you can see any healthcare provider that accepts Medicare, regardless of the company that provides your coverage.
- Medicare Advantage if you choose this plan, you will be restricted to using the providers in the plan’s network, with the exception of emergencies or urgent care situations.
- Medicare Supplement (Medigap) if you choose this plan, you can see any provider that accepts Medicare, but the plan may have restrictions on which services are covered.
It’s important to review the network of providers for any Medicare Advantage plan you are considering to make sure that your preferred doctors, hospitals, and other healthcare providers are included. If you are considering a Medicare Supplement plan, it’s important to review the plan’s coverage and restrictions to ensure that it meets your healthcare needs.
In summary, while beneficiaries are not restricted to a specific Medicare company in South Salem, New York, the network restrictions associated with certain types of plans may impact the choice of providers they can see.
What is the maximum out-of-pocket expense for Medicare beneficiaries with companies in South Salem, New York?
The maximum out-of-pocket expense for Medicare beneficiaries with companies in South Salem, New York can vary depending on the type of Medicare plan they have. Here’s a breakdown of the maximum out-of-pocket expenses for each of these three types of the plan:
- Original Medicare (Part A and Part B): There is no cap on out-of-pocket expenses for Original Medicare. Beneficiaries are responsible for paying a portion of the cost for each healthcare service they receive, including deductibles, copays, and coinsurance.
- Medicare Advantage: The maximum out-of-pocket expense for Medicare Advantage plans in South Salem, New York cannot exceed the limit set by Medicare each year. In 2023, the maximum out-of-pocket limit for Medicare Advantage plans is $7,550 for in-network services. This means that once a beneficiary reaches this limit for covered services, their plan will cover the remaining costs for the year.
- Medicare Supplement (Medigap): Some Medigap plans offer out-of-pocket limits, but they are not required to do so. If a Medigap plan does have an out-of-pocket limit, it can vary depending on the specific plan.
It’s important to note that the out-of-pocket expenses for Medicare beneficiaries in South Salem, New York can also vary depending on the healthcare services they receive and the providers they use. It’s important to review the details of each Medicare plan to understand the potential out-of-pocket costs and how they may affect your budget.
What is the quality rating of Medicare companies in South Salem, New York and how is it determined?
Medicare companies in South Salem, New York are rated on their quality of care using a star rating system developed by the Centers for Medicare and Medicaid Services (CMS). The star rating system evaluates Medicare Advantage and Medicare Part D prescription drug plans based on a range of factors related to the quality of care and services provided to beneficiaries.
The star rating system assigns a rating of one to five stars to each Medicare plan based on its performance across several categories, here are the five key points:
- Preventive care: This category measures the extent to which the plan provides preventive services, such as vaccinations and cancer screenings, to its members.
- Management of chronic conditions: This category assesses how well the plan manages chronic conditions, such as diabetes, heart disease, and respiratory illnesses, to prevent complications and improve health outcomes.
- Member experience: This category evaluates how satisfied plan members are with the care and services they receive, including access to healthcare providers, customer service, and coordination of care.
- Customer service: This category assesses the quality of customer service provided by the plan, including the timeliness and accuracy of responses to member inquiries.
- Drug safety and accuracy: This category evaluates how well the plan manages prescription drugs to ensure they are safe and effective for its members.
The star ratings are calculated each year and are based on data from multiple sources, including member surveys, claims data, and clinical measures. Plans that receive higher star ratings are generally considered to provide better quality care and services to their members.
In summary, the quality rating of Medicare companies in South Salem, New York is determined by the CMS star rating system, which evaluates plans based on their performance across several categories related to the quality of care and services provided to beneficiaries.
What happens if my chosen Medicare company in South Salem, New York goes out of business or is no longer available in my area?
If your chosen Medicare company in South Salem, New York goes out of business or is no longer available in your area, here are your three options to choose from to ensure that you continue to have Medicare coverage:
- Special Enrollment Period (SEP): If your Medicare Advantage plan or Medicare Part D prescription drug plan is no longer available in your area or has gone out of business, you will be eligible for a Special Enrollment Period (SEP). This will allow you to enroll in a new plan during a specific time period outside of the annual enrollment period.
- Guaranteed Issue Rights: If you have a Medicare Supplement (Medigap) plan and your plan is no longer available, you may be eligible for Guaranteed Issue Rights, which means that you have a right to purchase a new Medigap plan without medical underwriting. However, you must enroll in a new plan within 63 days of losing your previous plan.
- Return to Original Medicare: If you are enrolled in a Medicare Advantage plan and it goes out of business, you can return to Original Medicare (Part A and Part B). You may also have the option to enroll in a different Medicare Advantage plan if one is available in your area.
It’s important to note that if you lose your Medicare coverage due to the company going out of business or leaving your area, you may be eligible for a Special Enrollment Period to enroll in a new Medicare plan. It’s important to act quickly and review your options to ensure that you continue to have Medicare coverage.
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Laura D. Adams
Insurance & Finance Analyst
Laura Adams is one of the nation’s leading finance, insurance, and small business authorities. As an award-winning author, spokesperson, and host of the top-rated Money Girl podcast since 2008, millions of readers and listeners benefit from her practical advice. Her mission is to empower consumers to live healthy and rich lives by planning for the future and making smart money decisions. She rec...
Insurance & Finance Analyst
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